The Major Depressive Disorders Explained
The major depressive disorders are generally classified in one of two classes: unipolar or bipolar. The unipolar disorders are those with symptoms that include periods of depressed mood, extreme, profound sadness, or loss of interest in activities that used to interest you. Bipolar depressive disorders are those that involve periods of depressed mood that alternates with periods of mania (an elevated mood with increased energy and euphoria). Unipolar and bipolar both break down into subsets that have specific symptoms and diagnostic criteria.
The major depressive disorders actually are fairly common medical conditions. The unipolar disorders will affect 20% of people some time during their life. Bipolar disorders affect up to 4% of people. Unipolar disorders are twice as common in females than it is in men. On the other hand, bipolar disorders affect the sexes equally. There are multiple causes behind the major depressive disorders.
Many genetic factors come into play as well as a host of possible environmental stressors. Most are triggered by a combination of factors. A person who is genetically predisposed to a depressive disorder may only need a very little bit of environmental stress to trigger a depressive disorder, while a person with slight genetic factors may require something a severe as physical or sexual abuse to provoke a disorder.
There are multiple disorders within each type of depressive disorder. The major depressive disorders within the unipolar category are: major depressive disorder, dysthymia, and seasonal affective disorder. All of these disorders share the same symptoms, but differ in the degree of the illness, time of onset, and duration of the symptoms. This class includes the depressive disorders caused by substance abuse. Some of these disorders are occasionally accompanied by auditory and/or visual hallucinations and delusions.
Major depressive disorder is usually characterized by feeling sad or having a loss of interest that lasts for at least two weeks accompanied by an inability to function at work, school, or home. Relationships with friends and family are also affected. There are many symptoms of major depressive disorder. They are the same for many unipolar depressive disorders:
- A low mood that lasts most of the day
- Unreasonable feelings of guilt
- Feelings of worthlessness
- Being nervous or anxious
- Feeling slow and sluggish
- Sudden changes in appetite
- Weight loss or gain
- Being irritable and agitated
- Sleep pattern changes/not enough or too much
- Decreased sexual desire
- Loss of concentration or memory
- Loss of energy or feeling fatigued
- Unexplained physical symptoms-nausea, diarrhea, vomiting, etc.
- Breakdowns or crying
- Suicidal thoughts or wishes for death
Usually major depression is treated with a combination of drugs and therapy. Studies have shown that the combination is much more effective than one or the other alone. There is a wide variety of medications that may be used.
Dysthymia is a chronic, low grade depression that has lasted for at least two years and the individual does not go without depression symptoms for any two months in a row. It is less severe than major depressive disorder. Typically, dysthymia is shown by feelings of disinterest and an inability to feel enjoyment or pleasure. These symptoms can or can not be accompanied by feelings of depression.
Seasonal affective disorder develops on a yearly basis. Most generally patients are affected in the winter months when there is a low intensity of sunlight and the days are shorter. The farther north that a person lives the more apt they are to suffer from SAD. The disorder is more common in young females than anyone else. With the onset of spring and longer periods of sunlight the person begins to shake off the disorder and return to feeling normal.
The major depressive disorders within the bipolar category include: bipolar I, bipolar II, cyclothymia, and postpartum depression. There is a vast array of symptoms that manifest with bipolar disorders. Some of them are:
Depression phase:
- Loss of interest and pleasure
- Reduced energy
- Fatigue and lethargy
- Apathy
- Depressed mood
- Decrease in concentration and attention span
- Unreasonable guilt
- A decrease in self-esteem and self-confidence
- Feelings of unworthiness
- Pessimism
- A decrease in sleep and appetite
- Thoughts and plans for suicide and/or self-harm
Manic phase:
- A marked increase in energy and activity level
- Impaired judgment
- Lack of insight
- Easily distracted
- Hostile to others
- Disjointed thoughts
- Feelings of euphoria
- Physically and mentally efficient
Bipolar I patients may also see and hear hallucinations or have paranoia that make them unable to function properly.
With bipolar II, the symptoms are the same except in the severity of the manic phase. This is called hypomania. Along with hypomania, bipolar II patients will not have the hallucinations or feelings of paranoia. Both types of bipolar depressive disorder cause a severe impairment to daily living because of the depressed cycle. It always lasts longer than the manic phase and interferes with work, etc.
Cyclothymia is related to bipolar disorder. The major difference is that bipolar can improve over a period of years whereas cyclothymia is a condition that is chronic and lasts for a much longer time. It is more closely related to bipolar II. There may not be the severe interruption in daily living, but the effects on social interactions are notable, especially with family.
Pospartum depression is the manifests itself in the exact same way as any other unipolar or bipolar disorder except that it will appear within the first four weeks of having a child. It is believed to happen because of the combination of hormonal changes and social changes brought on by child birth especially the constant demands on a new mother’s time. Mothers who experienced poor parenting are more susceptible to this disorder. Postpatum depression is exhibited by a hardship and inability to function at home, work, etc, including having trouble bonding with the newborn.
The major depressive disorders all have the same or very similar symptoms. Doctors have to carefully listen to their patients to correctly diagnose them. Many times a patients diagnosis will change over time as new symptoms manifest themselves or medication eliminates some of them.
