Many faces of depressionDepression, or in other words unipolar affective disorder is commonly known to be a mood disorder characterised by sadness, fretfulness and prolonged low mood. A person with depression lacks the energy to do even simple, daily activities like getting up from the bed or brushing teeths. The person loses interest in doing activities which previously was pleasurable to her and became apathetic. Having said that, depression is s tricky condition which can take many different forms and manifest differently depending on an individual example. With the aim of making the diagnosis process possible and enabling the personalised treatment, specialist created a classification which describes different types of depression. The knowledge about various types of disease will make us more aware of disturbing behaviours of our relatives and ourselves which should be noticed. Being aware of symptoms will make it possible to provide adequate help on the early stage of the disease. Let`s deliberate on the topic of what different forms can depression take?
Clinical Depression and Atypical DepressionThe symptoms of Clinical depression are commonly known and used in public awareness campaigns – low mood, especially in the morning, anhedonia, sleeping problems, loss of appetite, anxiety. Thanks to widespread psychoeducation, people are aware of the need for looking for help in case of mentioned symptoms occurrence. It is worth to be aware of the symptoms of the atypical type of the disease. In that case, the commonly known symptoms of the depression can manifest totally opposite way – what can be seen are excessive sleepiness and appetite, the reactivity of the mood, mood lowering in the evening and feeling sluggish. A depressed person can exhibit binge-eating, especially sweets, which can result in getting weight. If you recognise those symptoms in your or your friends/family members don’t hesitate to look for help.
I`m SAD – Seasonal Depression (Seasonal Affective Disorder)This specific type of depression is also known as “SAD”. It characterises by untypical course of the disease, the symptoms get more intense during the specific season of the year, mainly in autumn or winter when the weather changes dramatically and the temperature decrease. The exposure to light tends to be reduced what is said to explain etiology of SAD. In spring and summer symptoms are subject to remission, sometimes oscillate even to hypomania. What is more, patients with seasonal depression exhibit mixed symptoms of classical depression-like anhedonia and decreased activity and atypical depression – excessive sleepiness and appetite. The most effective treatment of SAD is, besides pharmacological treatment (the most widely used medicine is bupropion), phototherapy – a periodic exposition to very bright light.
Cryptic depression – when emotions hurtThis type of depression perfectly shows how the organism can react to a mental disorder. In the case of cryptic depression, the disease put on a mask of somatic symptoms – sleeping problems, gastric discomfort, chronic pain or itching. Mentioned dysfunctions are probably the effect of hyperactivity of the sympathetic nervous system and disturbance of hormonal and neurotransmitters balance as a result of prolonged stress. The patient might seek help from many different specialists and visit doctors frequently what should be a warning sign for medics to take depression diagnosis into consideration. The correctness of the diagnosis is confirmed when the somatic symptoms disappear after antidepressants treatment. The cryptic version of depression is the most common in the Asian population where the psychiatric disorders are seen to be shameful.
Recurrent Brief DepressionUnlike the clinical depression, which episode continues after fourteen days, the episode of recurrent brief depression lasts between couple of days to maximum two weeks. This type of depression keeps recurring every month (irregardless of menstruation time). A depressive person can experience the various intensity of the episode. Unfortunately, pharmacological treatment is rarely effective.
Is it only “the baby blues”? – Postpartum DepressionBaby blues is postpartum sadness that occurs after giving an birth. It is a common physiological response of an organism. It occurs in about 80% of cases of giving birth and lasts less than 10 days after the delivery. However, if the low mood escalates and another typical for depression symptoms appear, we should be alert. Postpartum depression affects roughly 7-20% of the mothers. The risk is higher when there were depressive episodes observed in the past, difficult labour or medical condition of the child. According to the literature, postpartum depression should be diagnosed when depressive symptoms occur in the fourth week after giving birth. The desire to be a good parent often intensifies symptoms. The untreated disease might raise the risk of neglecting not only the mother but also the child, because of the mother struggle with new responsibilities and depression manifestation like tiredness and fear of being incompetent. Recognising and reacting to the early stage of the disease is crucial. The main methods of treatment are psychotherapy and psychoeducation.
Premenstrual Dysphoric DisorderKnown as PMDD or premenstrual syndrome (PMS) is scientifically approved by DSM-5 classification. The characteristic symptoms of the condition are typical for depression: low mood, anxiety and irritability, sleeping problems, disturbed appetite. It might be related to hormonal changes and distorted functioning of the hypothalamic-pituitary-gonadal axis (HPG) around the time of menstruation. Besides psychical symptoms, some of the somatic manifestations can be observed like menstrual cramps and pain. The condition of the patient typically gets better about one week after the period.
Geriatric DepressionIn the case of elderly people, unipolar affective disorder constitutes a serious problem because of the fact that family and medics commonly underestimate the severity of the condition. The possibility of depression episode occurrence is ignored in the favour of memory and disabled activity related to the age. In fact, depression in elderly people can take the form of cognitive dysfunction called depressive pseudodementia. The responsibility for recognising the problem focuses on General Practise Physicians who keep the most frequent contact with elderly people. The accurate diagnosis of depressive pseudodementia is crucial as the anti-depressive treatment brings huge change for the patient quality of life.
Depression in the course of other diseasesThe chronic disease might be a burden not only for the patient but also for people close to him. Somatic diseases rate is higher in the group of people with depression comparing to the general population. Depression and diabetes co-occurrence in 20% of the cases whereas about 40% of people with cancer suffer for depression. Depression can threaten the effectiveness of somatic diseases treatment by deteriorating the quality of life of the patient, influencing doctor-patient relationship and not following the medical advice. On the other hand, the chronic disease treatment process might be the source of constant stress which makes it difficult to deal with depression. Dealing with depression and somatic diseases the same time is still a great challenge.
Reactive depressionThis type of depression comes from observation of people who have experienced traumatic events and manifest depressive symptoms afterwards. The typical examples of traumatic events can be accident, death of beloved person, experiencing violence, relocation or losing a job. Strong emotional response can be a simple organism reaction to trauma but if the condition of the person is not getting better for a long time, it can be considered to become a reactive depression. For example, in case of the reaction for friend or family member death, if the grief lasts longer than two months it might be because of depression.
- Psychiatria. Red. Jarema, Marek. Warszawa, PZWL Wydawnictwo Lekarskie, 2016, ISBN 978-83-200-5033-2