What Are the Different Types of Depression?

Depression can present itself in several ways. There are several types of depression that range from mild to severe and can be short-lived or chronic. Special circumstances, like the birth of a baby or the changing of the seasons, can trigger depression symptoms.

Depressive disorders generally cause symptoms like appetite changes, feelings of sadness or hopelessness, and loss of interest in enjoyable activities. Different types of depression include bipolar disorder, psychotic depression, and seasonal affective disorder (SAD).

Understanding the type of depression a person is experiencing helps healthcare providers determine treatment. Having information about your specific symptoms can be beneficial if you're diagnosed with depression. Read on to learn what the different types of depression are and how to treat them.

1. Major Depression

Approximately 21 million American adults have experienced at least one major depressive episode. The exact cause of depression is unclear. A mix of environmental and genetic factors may trigger changes in chemicals in the brain that control mood.

People must have at least five symptoms persisting for two weeks or longer to be diagnosed with major depression:

• Appetite changes
• Feelings of sadness, emptiness, or hopelessness
• Feelings of worthlessness or guilty
• Loss of energy or interest in enjoyable activities
• Purposeless physical activity, such as trouble sitting still
• Sleep habit changes
• Slowed movement or speech
• Thoughts of death and suicide
• Trouble concentrating, remembering, or thinking

Most cases of major depression are highly treatable and consist of medication, therapy, or both. Antidepressants are a class of medications that help alleviate symptoms. A healthcare provider may prescribe a selective serotonin reuptake inhibitor (SSRI) or serotonin and norepinephrine reuptake inhibitor (SNRI).

Some people benefit from talk therapy, with or without medication. Talk therapy helps you identify negative thoughts and feelings and replace them with positive ones.

2. Persistent Depressive Disorder

People with persistent depressive disorder (PDD) have a low mood on most days and at least two additional depression symptoms lasting two years or more. PDD may be diagnosed if symptoms of irritability or depression persist for a year or more in children or adolescents.

People must also have two of the following symptoms:

• Feelings of hopelessness
• Low energy or fatigue
• Low self-esteem
• Poor appetite or overeating
• Poor concentration or difficulty making decisions
• Sleep problems (i.e., sleeping too much or too little)

Symptoms may wax and wane in intensity, but it's generally a low level of depression. PDD usually requires treatment with a combination of medication and therapy.

3. Disruptive Mood Dysregulation Disorder (DMDD)

Screaming and temper tantrums can be features of disruptive mood dysregulation disorder (DMDD). DMDD is a type of depression diagnosed in children who have difficulty regulating their emotions. Other symptoms include an irritable or angry mood that lasts most of the day on most days. Children might have trouble getting along in school, at home, or with their peers.

DMDD is treated using medications and therapy. Parents might receive training on how to deal with a child's irritable behavior effectively.

4. Bipolar Disorder

Swings in mood and energy, from elation to hopelessness, are the signatures of depressive episodes in bipolar disorder. A person must have experienced at least one bout of mania to be diagnosed with this form of depression. Mania is a period of energetic behavior.

Bipolar disorder commonly shows up in young adulthood. Bipolar disorder usually worsens without treatment but can be managed with mood stabilizers, antipsychotic medicines, and talk therapy. The depressive symptoms can be treated with antidepressants and mood stabilizers.

5. Seasonal Affective Disorder (SAD)

Seasonal affective disorder (SAD), or seasonal depression, is a recurring type of depression that usually strikes in the fall or winter. Symptoms can also occur in summer, although it's less common. People with SAD tend to have mood changes and low energy. They may overeat, oversleep, crave carbs, gain weight, or withdraw from social interaction.

The exact cause of SAD is unclear. Some evidence suggests that it may be related to an imbalance of a chemical in the brain called serotonin. An overabundance of the sleep hormone melatonin and insufficient levels of vitamin D may also play a role. Women, younger adults, and people who live in places with shorter daylight hours have a higher risk of SAD. This type of depression can also run in families.

Treatments for SAD can include a daily dose of light therapy and medication. Light therapy helps replace the light that decreases during the colder, darker months.

6. Psychotic Depression

People with psychotic depression have severe depression accompanied by psychosis. Psychosis means losing touch with reality. Symptoms typically include hallucinations and delusions. Hallucinations mean seeing or hearing things that aren't really there. Delusions are false beliefs about what's happening.

Healthcare providers usually prescribe antidepressants and antipsychotic medicines to treat psychotic depression. Not everyone responds to these treatments. Research has shown that electroconvulsive therapy (ECT) is also somewhat effective. This therapy sends small currents of electricity to the brain while you're under anesthesia.

7. Postpartum (Peripartum) Depression

The birth of a baby can bring enormous joy but sometimes leads to postpartum depression (PPD). PPD, also known as "peripartum depression," is fairly common: One in nine females will experience symptoms after giving birth.

Feelings of emptiness and emotionlessness are typical in the first three to five days after giving birth, also known as the "baby blues." Symptoms can become PPD if they last for longer than two weeks.

Factors like a shift in hormones and fatigue likely trigger PPD. Symptoms can begin any time in the first year following childbirth, but they usually appear soon after. Intense feelings of sadness, anxiety, and exhaustion become overwhelming and can interfere with daily life. These feelings can provoke thoughts of harming yourself or your baby if they become extreme, known as postpartum psychosis.

The "baby blues" is a mild, short-lived, and extremely common condition causing anxiety and depressive symptoms in the immediate wake of a baby's birth. PPD, in contrast, usually requires treatment with medication, therapy, or both.

8. Premenstrual Dysphoric Disorder (PMDD)

Up to 16% of people of childbearing age experience premenstrual dysphoric disorder (PMDD). This severe form of premenstrual syndrome (PMS) can trigger depression, sadness, anxiety, or irritability in the week before a person's period. PMDD can be uncomfortable, disabling, and interfere with your day-to-day life.

People with PMDD may have an abnormal sensitivity to hormonal changes during the menstrual cycle. Taking antidepressants, specifically SSRIs, in the two weeks before a period or throughout the month can be effective. Certain types of contraception and pain relievers may also help with symptoms.

9. Depression Due to an Illness

Coping with a serious chronic disease, like heart disease, cancer, multiple sclerosis (MS), and HIV/AIDS, can cause depression. Research has found that people who have been diagnosed with chronic diseases are more susceptible to depression.

Disease-related inflammation may play a role in the onset of depression. Inflammation causes the release of certain chemicals by the immune system that cross into the brain. These changes in the brain can trigger or worsen depression in certain people.

Antidepressants may improve the ability to function. Therapy can help many people cope with mental and physical illnesses.

10. Atypical Depression

Atypical depression is a type of major depression in which positive events can boost your mood. Symptoms typically include:

• Anxiety
• Emotionally reactive
• Heavy arms or legs
• Increased appetite 
• Sleeping more than typical

A healthcare provider might prescribe an antidepressant, such as an SSRI, to treat atypical depression. Research has shown that an antidepressant called a monoamine oxidase inhibitor (MAOI) can alleviate atypical depression.

11. Subsyndromal Depression

A person who has depressive symptoms but doesn't quite check all the boxes for a diagnosis of major depression may be deemed "subsyndromal." They may have another specified depressive disorder. The person might have at least two symptoms or experienced depression for less than the two-week minimum.

A healthcare provider will usually look at functionality rather than symptoms. You may still benefit from treatment, including medication, if you're struggling with daily activities.

12. Treatment-Resistant Depression

Some people with major depression don't readily respond to treatment. Treatment-resistant depression means you have gone through at least two unsuccessful pharmacotherapy trials. You have tried two different medications, and neither has worked for your symptoms.

Helping people overcome treatment-resistant depression begins with a thorough work-up to ensure a proper diagnosis. A healthcare provider may identify other causes of symptoms. They can counsel you on proper dosage and duration of treatment.

A healthcare provider will try switching to a similar drug or one from a different class. You may benefit from adding a second antidepressant from a different class or another type of medicine, such as an antipsychotic.

Do I Have Depression?

Depression can affect anyone, from young children to adolescents and older adults. You might have depression if you have symptoms like persistent sadness and trouble sleeping for two weeks or more. These symptoms typically interfere with your daily activities.

Contact a healthcare provider right away if you:

• Are taking a medication that might be causing depression symptoms
• Cry a lot, often without an apparent cause
• Drink alcohol in the morning
• Have three or more depression symptoms 
• Hear voices that are not there
• Think you need to decrease your alcohol intake or feel guilty about how much you drink

A Quick Review

Depression comes in many different forms. Depressive disorders can be mild or severe and short-lived or chronic. Some people develop postpartum depression after childbirth, while others can have symptoms when the seasons change. Other types of depression include bipolar disorder and major or psychotic depression.

A mental health specialist can complete an evaluation to help you figure out a diagnosis. Knowing the type of depression you have can help inform the best course of treatment.