Ipswich Counselling Blog

by michelle clements | Ipswichcounsellor.co.uk

Depression - Part 2: Types of depression

Posted on 25/1/2015 by Michelle Clements

Different forms of depression

Depression can manifest itself in a number of forms, from clinical to mild. Regardless of the level depression it can be a debilitating and distressing emotional illness. It can disrupt our every waking moment. Just getting up in the morning can be like climbing Mount Everest, and recovery can be a long and arduous journey. Depression can have a ripple effect, by not only effecting the person who is suffering with it, but also significant others, family and friends. I have heard clients describe their own experience of depression using many different metaphors and phrases. “I feel like I have a dark cloud following me around. I can’t seem to shake it” “I’m in the bottom of a deep pit of darkness. I can see no way out” “I’ll never be able to reach the top of that mountain. I can’t move I’m stuck” “I feel like I’m on auto pilot, not living just existing, emotionless, and empty” There is a distinct sense of a feeling of hopelessness, sadness and fear amongst these statements.

Major depression...

Also known as: a major depressive disorder, unipolar, and clinical depression; symptoms that present themselves but are not limited to. Tend to include consistent low mood (usually two weeks or more). Lack of concentration, disrupted sleep and appetite patterns: lethargy, feelings of worthlessness and guilt. Loss of interest in activities that usually gives the person pleasure such as hobbies or socialising: And in some cases suicidal thoughts, Relationships and work are usually also effected. Everyday functioning can become almost impossible. Medication such as Anti-depressants and talk therapies can be helpful to treat Major depression.

Persistent Depressive Disorder...

Also known as Dysthymia disorder: This is when depression lasts longer than two years. Symptoms are more or less the same as Major depression but not usually as severe. However differs in the duration of its stay. As with a Major depression, a mixture of talking therapies and anti-depressants are found to be helpful.

Bipolar Disorder...

Bipolar disorder which used to be known as “manic depression” involves episodes of mood from extreme high mood, with the person experiencing a high level of energy, feeling great with an “I can achieve anything attitude”, however a lack of concentration on specific tasks and racing thoughts, make this difficult. There are not usually short periods of high mania. In some cases psychosis may develop delusions with the person believing they have superpowers, hallucinating for example hearing voices or seeing something that is not really there, and a general loss of being in touch with reality. To extreme lows in mood: with feelings not dissimilar to Major depression. The person experiences a swing between high and low moods with level moods in between, because of this diagnoses can be difficult unless the person is closely observed. In some cases Medication such as Lithium, are usually prescribed as a means of stabilising the moods. Anti-depressants are not recommended for Bipolar disorder as there is a risk of inducing high mood. Psychotherapy may also be beneficial to help significant others, and family manage and understand the disorder.

Seasonal Affective Disorder (SAD)...

Seasonal affective disorder is a period of major depression that most often happens during the winter months, when the days grow short and you get less and less sunlight. However there can also be periods of mania. It seems that winter months have the most effect on this disorder, commonly symptoms cease with end of the winter season. Along with similar symptoms of depression the person is likely to have an increased appetite, gain weight and crave carbohydrates. Countries such as Australia have very few cases of SAD, in comparison with countries that experience colder climates and shorter days and nights. If you have SAD, antidepressants may help. Light therapy in some cases has shown to be effective. You'll need to sit in front of a special bright light box for about 15-30 minutes each day.

Psychotic depression...

A person diagnosed with Psychotic depression not only has symptoms of Major depression. Alongside this they also have “psychotic symptoms” for example hallucinations, hearing or seeing things that are not there. False beliefs, these are known as delusions believing they may be possessed, or having committed a crime. The person can also suffer from paranoia, believing that people are out to get them or harm them in some way. Treatment is usually carried out in hospital setting as the person needs to be monitored while the right medication is found. A mixture of antidepressants and antipsychotic drugs can treat this form of depression. As a last resort Electroconvulsive therapy may be used and has been found to be a very effective treatment for Psychotic depression.

Post-partum depression...

Also known as Post natal depression: This is not to be confused with the “baby blues” where the new mother can go through short periods of tearfulness and feeling emotional. This usually occurs within 3 to 10 days after giving birth. The “baby blues” although distressing it is usually manageable and only lasts a few days. Post natal depression differs in the fact that can develop suddenly or gradually within six weeks of giving birth. Symptoms range from moderately mild to severe. As well as symptoms of Major depression the mother can feel an inability to cope, high levels of guilt, anger and irritability or indifference or hostility towards the partner or baby. Practical support and talking therapies have been shown to be the most effective treatment. However in some cases anti-depressants may be prescribed.

Smiling depression...

This form of depression is little known. A person with depression is often thought of as someone who daily functioning is impaired (bedridden or incapable). People with Smiling depression usually have the same symptoms as a person with depression, however outwardly they wear a smiling mask to hide how they are really feeling inside. This mask is usually worn through fear of others knowing how they really feel inside, being judged or seen as weak. Inwardly they tend to have feelings of despair, hopelessness, anxiety, anger and irritability. To the outside world the person appears perfectly fine, holding down a job, managing home and family, and leading busy social life. People with Smiling depression have a tendency to minimized how they are really feeling, in other words brushing their feelings under the carpet. This can make diagnoses very difficult. In some cases the person doesn’t realise that they have this form of depression, or they may have a general feeling of emptiness and minimum explanation as to why they would feel this way, in the world of the person with Smiling depression everything is fine. Counselling or Psychotherapy can help the person to explore the feelings associated with smiling depression. And gain an understanding of how it is developed, triggers and defences put in place to avoid these feelings. Anti-depressants may also be prescribed. There many types of depression, with the intensity of it ranging from mild to extreme. There is no need to suffer in silence there is help in the form of counselling, psychotherapy, support groups and other organisations specifically designed for individuals with emotional health and well-being needs. I often say to my clients who feel embarrassed, ashamed or see themselves as weak for seeking support for their depression “If you had an injury that was visible, let’s say a broken arm or leg would you feel the same in seeking support” often the response is of course not, “Then why would you feel those feelings for being depressed and seeking support. It is after all similar in as much as it is like and injury to your emotional well-being”. Often this promotes a light bulb moment, and a realisation that it is okay to be supported with their depression.
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