Symptoms of Depression

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In our previous article, we started by looking at facts and statistics on depression. Very importantly, we also mentioned how the American Psychiatric Association’s Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classified depression as:

“A disruptive mood dysregulation disorder, major depressive disorder (including major depressive episode), persistent depressive disorder (dysthymia), premenstrual dysphoric disorder, and depressive disorder due to another medical condition”

The point of view of the American Psychiatric Association stems from the different ways depression can occur and that is where its types are derived from. Premenstrual dysphoric disorder for instance means depressive feelings a woman or pubertal girl experiences just before she menstruates.
Let’s take a look at some of the types of depression people battle with!

Types of depression
Major depressive disorder: This is the same thing as depression or clinical depression and it’s described as a serious mood disorder affecting about 16.2 million adults in the United States. It is also believed that 6.7% of American adults have experienced at least a major depressive episode in a given year. It is the commonest type of depression.

Persistent depressive disorder: This is otherwise referred to as dysthymia. Persistent depressive disorder is a low-level depression with a lower severity level. It is also chronic in duration. By chronic, it means the depression can lasts for a minimum of two years. It can be just one or many bouts of major depression with periods of mild symptoms.
Women are more prone to this disorder than men, and 50% of all cases are described as serious.

Bipolar disorder: This is also called manic-depressive disorder.With this type of depression, one can have moments when they are “high” ie. bursting with energy. It would then be followed by depressive episodes. It can also be the other way round, where depressive where depressive episodes precede the high energy so exuded. So there’s an alternating of very high moods with very low moods and vice versa. That is why it is BI-polar – two extremes.
Bipolar disorder is so classified as a type of depressive disorder specifically because of the low moods that accompanies it, which satisfy the criteria for major depression.
It affects both women and men equally. It plagues approximately 2.8% of the U.S. population in a specific year. 83% of cases present as severe.

Seasonal depression (or seasonal affective disorder)
This is a a type of Depression that has a seasonal pattern. In essence, your mood changes with seasons. In a given year, close to 5% of the U.S. population are affected. For every 5 persons with depression cases, 4 are likely to be affected by seasonal depression.
Seasonal affective disorder occurs between the onset of autumn and throughout winter. Rarely does it occur in summer or spring.

Postpartum depression (or peripartum onset)

Postpartum means after birth. So this is referring to “new mothers”, women who have just given birth.
Give or take, 80% of new mothers go through what’s called “baby blues”. Symptoms typical of “baby blues” are fatigue, mood swings and sadness. These feelings are transient and usually disappear after a week or two.
Postpartum depression is due to hormonal changes following childbirth, pressures of nursing a new baby and lack of sleep.

When “baby blues” persist beyond several weeks and the severity soars, it may a red flag for major depressive disorder, with peripartum onset.
New mothers with peripartum onset would also experience appetite loss, uncontrolled negative thoughts and withdrawal from people.
The American Psychological Association submits that some 10-15% of U.S. women suffer from postpartum depression within the space of 3 months after childbirth. 1 out of every 5 new mothers goes through minor depressive episodes

New fathers aren’t left out too as approximately 10% of them go through same.
Postpartum depression is often described as “a familial disease” that negatively affects the baby when not treated on time.

Psychotic Depression

This is when major depression or bipolar disorder coexists with delusions, hallucinations, or paranoia.
Statistics show that an estimated 25% of patients on admission for depression truly have psychotic depression. 1 out of every 13 people globally is likely to experience a psychotic episode before 75 years old.

Signs of depression
Signs are nothing but pointers to something else.
Depression can come as mild, and it often does in most presentations. However, in every 10 presentations (or cases), one will be either moderate or severe.
Most major depressive disorder patients who showed up for medical help were found to appear “normal” outwardly. However, those having more severe symptoms, tend to be tardy in their dressing and show some noticeable weight loss.

Depression symptoms can come in different categories:

Psychological symptoms

Physical symptom.

Psychological Symptoms:

  • Miserable feeling: more often than not, such feeling seem to stay with you for a greater part of the day although its intensity might vary considerably. Sometimes, this miserable feeling can linger on for weeks.
  • Irritable mood
  • Disinterest or indifference towards the same activities you normally look forward to and of course, enjoy. This is medically called anhedonia.
  • Unpleasant thoughts that keeps recurring particularly those about being bad, guilty and unworthy
  • Slowed or inefficient thinking commonly accompanied with lack of concentration
  • Difficulties solving making decisions, planning or problem solving.
    Crazy thoughts like “I’d be better off dead” – suicidal thoughts you know, that may or may not be backed up with tangible plans.
    Trying to harm yourself in some way.

Psychomotor agitation or retardation.

  • Physical Symptoms:
    Poor feeding habits that result in appetite loss and subsequent excessive weight loss. In kids, they may fail to attain a weight peculiar to their age.
  • Loss of interest in sexual activities.
    Energy loss in spite of not being physically active.
  • Sleep disturbances i.e. inability to sleep (insomnia) even when exhausted from work. And even when the affected person tries to sleep, it’s usually characterized by restlessness and dissatisfaction, waking up 1-2 hours earlier than normal sleep time. Note however that it’s possible for some other persons to sleep unusually longer than necessary. this is called hypersomnia.
  • Restlessness
  • Slowed speech and activity. Now, it is important to note that anyone who displays any of these signs and symptoms may be depressed. Experts believe that exhibiting at least five of these symptoms qualifies one to be suffering from a depressive disorder.

References
“NIMH » Depression” https://www.nimh.nih.gov/health/topics/depression/index.shtml
Depression: Practice Essentials, Background, Pathophysiology” https://emedicine.medscape.com/article/286759-overview

https://www.psychiatry.org/patients-families/depression/what-is-depression
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013.
“Depression Central: Types, Causes, Symptoms, Statistics, & Treatment” https://www.psycom.net/depression.central.html

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