Types of Depression

The reason many people do not seek help for depression is that they simply do not recognize the symptoms. Listed below are eleven more types of depression. Let me know if I’ve missed any and I’ll be glad to include them.

1) Major Depressive Disorder See below

2) Dysthymic Disorder See below

3) Manic Depression See below

4) Mixed States See below

5) Seasonal Affective Disorder (SAD) – A type of depressive disorder which is characterized by episodes of major depression which reoccur at a specific time of the year (e.g. fall, winter). In the past two years, depressive periods occur at least two times without any episodes that occur at a different time.

6) Post Partum Depression – Major depressive episode that occurs after having a baby. Depressive symptoms usually begin within four weeks of giving birth and can vary in intensity and duration.

7) Atypical Depression (Sub-type of Major Depression or Dysthymia) - Characterized by a temporary improvement in mood in reaction to positive events and two (or more) of the following:
• Increase or decrease in appetite
• Over sleeping
• Heavy feeling in arms or legs
• Long standing pattern of sensitivity to rejection

8) Chronic Depression – Major depressive episode that lasts for at least two years.

9) Double Depression – Someone who has Dysthymia (chronic mild depression) and also experiences a major depressive episode (more severe depressive symptoms lasting at least two weeks).

10) Endogenous Depression – Endogenous means from within the body. This type of depression is defined as feeling depressed for no apparent reason.

11) Situational Depression or Reactive Depression (also known as Adjustment Disorder with Depressed Mood) – Depressive symptoms developing in response to a specific stressful situation or event (e.g. job loss, relationship ending). These symptoms occur within 3 months of the stressor and lasts no longer than 6 months after the stressor (or its consequences) has ended. Depression symptoms cause significant distress or impairs usual functioning (e.g. relationships, work, school) and do not meet the criteria for major depressive disorder.

12) Agitated Depression – Kind of major depressive disorder which is characterized by agitation such as physical and emotional restlessness, irritability and insomnia, which is the opposite of many depressed individuals who have low energy and feel slowed down physically and mentally.

13) Psychotic Depression – Major depressive episode with psychotic symptoms such as hallucinations (e.g. hearing voices), delusions (false beliefs).

14) Melancholic Depression (Sub-type of Major Depressive Disorder) - Main features of this kind of depression include either a loss of pleasure in virtually all activities or mood does not temporarily improve in response to a positive event. Also, three (or more) of the following are present:
• Depressed mood that has a distinct quality (e.g. different from
feeling depressed when grieving)
• Depression is consistently worse in the morning
• Waking up earlier than usual (at least 2 hours)
• Noticeable excessive movement or slowing down
• Significant decrease in appetite or weight loss
• Feeling excessive or inappropriate guilt

15) Catatonic Depression -
(Sub-type of Major Depressive Disorder) – This type of depression is
characterized by at least two of the following:
• Loss of voluntary movement and inability to react to one's environment
• Excessive movement (purposeless and not in response to one's environment)
• Extreme resistance to instructions/suggestions or unable/unwilling to speak
• Odd or inappropriate voluntary movements or postures (e.g.
repetitive movements, bizarre mannerisms or facial expressions)
• Involuntarily repeating someone’s words or movements in a meaningless way

http://www.depression-help-resource.com/types-of-depression.htm
http://www.psychnet-uk.com/dsm_iv/_misc/complete_tables.htm
http://www.psychologyinfo.com/depression/depression_types.html

Symtoms of Depression

1. Agitation
2. Anxiety
3. Fatigue
4. Guilt
5. Impulsiveness
6. Irritability
7. Suicidal ideation
8. Panic
9. Paranoia
10. Pressured speech
11. Rage

Aside from
• Pressured Speech (rapid, loud and difficult-to-interrupt speech)
-- I don’t talk loud or fast (well maybe when Sherry and I are having
a ‘discussion’. During times such as these I find she understands
me better if I just ‘speak a little louder’) lol
• Paranoia
-- For some reason I’ve always just assumed everybody liked me – not
everybody, I guess, but that’s their problem
• Panic
-- Anxious? yes but panic? nah

I look at that list of eight horrible, terrible traits I know that was me. It’s hard to believe that was really me.
What I find puzzling is that most people in the ‘depression blog’ seem to be in pretty good spirits. Is it that blogging is therapeutic or are folks not really able to blog ‘unless’ their depression is under control?
I will continue to explore now that I can kind of (I hope forever) look at depression objectively.

Personal Depression

After over 30 years of doctors, psychiatrists, and therapists I was diagnosed with Mixed States. I was put on Lithium, Equatro, and Thyroid. It took about 3 months but almost miraculously I actually began to feel better. It was as though I were tentatively finding my way out of a long dark tunnel. At first the light was so intense that I really couldn’t bear it. I retreated back into the tunnel where I was ‘comfortable’.
After seeing improvement then retreat, my wife almost threw up her hands, but I guess she figured she had so much invested that she may as well hang in there a little longer.
I’ve been on my new medications for about one and a half years. I’m not completely out of the tunnel though. My doctor still has to tweak my meds by changing dosages and adding things like folic acid and Co Enzyme Q-10.
The biggest problem I face now is how do I overcome the personal quirks that depression has forced on me over the last 30 years?
For example; my temperament is that of an easy-going, fun-loving person, but the rage in my depression has driven my wife away from me. When she would isolate, then, of course, I would too. How do I change this emotionless shell I’ve built around myself? I’m trying to be the man God meant me to be but I just don’t know how to change. Can anybody help me? I just need some advice.

Test For Depression

Here's a real short test that will confirm what you already know. It's linked to the National Institute of Mental Health which has some very good stuff

http://www.med.nyu.edu/psych/screens/depres.html

Personal Depression

I wander thru the darkened corridors of my mind. Ominous clouds roil above me. Lightening races across a leaden sky, followed by the voice of an angry God.
I place my hand against the wall. It comes away wet and cold.
I press on. Others have told me there is a place of warmth and beauty; a place that is always rich and bright.
Ahead I see a doorway. Hope gives rise to urgency. I hurry forward
and turn the corner only to see a canyon deep and dark. I drop to my knees as my soul cries bitter tears.
I raise my face to heaven and cry, “Why me Lord? Why me?”

Types of Depression

There are several different types of depression. They are distinguished by the length and severity of symptoms. Most of these are found in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), an American Psychiatric Association publication which describes psychiatric disorders.


1) Major Depressive Disorder (296.02-.36) (also known as Major Depression, Clinical Depression) – A major depressive episode occurs with symptoms that last for most of the day, nearly every day for at least two weeks. A symptom must either be
1) Depressed mood or
2) A noticeable decrease in interest or pleasure in most activities.
3) At least four additional symptoms are present:
• decrease or increase in eating
• difficulty sleeping or increase in sleeping
• fatigue or loss of energy
• feeling worthless or excessively guilty
• difficulty concentrating or making decisions
• repeatedly thinking about death or suicide, trying to attempt suicide or having a specific plan to commit suicide
• excessive movement or slowing down associated with mental tension (observed by others)

2) Dysthymic Disorder (300.40) (or also referred to as Chronic) – Nearly constant depressed mood for at least 2 years accompanied by at least two of the following:
• decrease or increase in eating
• difficulty sleeping or increase in sleeping
• fatigue or loss of energy
• feeling worthless or excessively guilty
• difficulty concentrating or making decisions
• feeling hopeless
Symptoms do not occur for more than two months at a time. Generally, this type has persistent but less severe depressive symptoms than Major Depression.

3) Manic Depression (296.20-36) (now known as Bipolar Disorder) – This kind of depression includes periods of mania and depression. Cycling between these two states can be rapid or only mania can be present. A manic episode consists of a persistent elevated or irritable mood that is extreme, which lasts for at least one week. At least three (four if only irritable mood) other features are also present:
• Inflated self-esteem or self-importance
• Decreased need for sleep
• More talkative than usual or compelled to keep talking
• Experiencing racing thoughts or ideas
• Easily distracted
• Increase in goal-oriented activity (social, work, school, sexual)
• Excessive involvement in potentially risky pleasurable behavior (e.g. over spending, careless sexual activity, unwise business investments)
Symptoms can be severe enough to warrant hospitalization to prevent harm to self or others or may include hallucinations, delusions.

4) Mixed States (296.06-.80) is a condition during which symptoms of mania or hypomania (lower than mania) and symptoms of depression occur simultaneously. During a mixed episode, the person may experience
• Impulsiveness
• Insomnia
• Irritability
• Flights of ideas
• Suicidal thoughts
• Guilt
• Feelings of hopelessness
• Changes in appetite
These are common during depressive episodes. Mixed episodes can be incredibly distressing to the individual. It can lead to panic attacks, substance abuse, and suicide.

As mentioned earlier, I suffer from Mixed States. I manifest everyone of the symptoms. When I get a little more courage, I’ll share some of my experiences.

http://www.dr-bob.org/tips/dsm4a.html
http://www.depression-help-resource.com/types-of-depression.htm

Symtoms of Depression

Depression is a serious medical illness that involves the brain. It's more than just a feeling of being "down in the dumps" or "blue" for a few days. If you are one of the more than 20 million people in the United States who have depression, the feelings do not go away. They persist and interfere with your everyday life.

To meet criteria for depression, five or more of these symptoms must be present for more than 2 weeks:

• Ongoing sad, anxious or empty feelings
• Feelings of hopelessness
• Feelings of guilt, worthlessness, or helplessness
• Feeling irritable or restless
• Loss of interest in activities or hobbies that were once
enjoyable, including sex
• Feeling tired all the time
• Difficulty concentrating, remembering details, or difficulty
making decisions
• Not able to go to sleep or stay asleep (insomnia); may wake in the
middle of the night, or sleep all the time
• Overeating or loss of appetite
• Thoughts of suicide or making suicide attempts
• Ongoing aches and pains, headaches, cramps or digestive problems that
do not go away.


This website contains a great tutorial that is well worth watching

http://www.nlm.nih.gov/medlineplus/tutorials/depression/htm/_no_50_no_0.htm




http://www.nimh.nih.gov/health/publications/depression-easy-to-read.shtml
http://www.healthyplace.com/Communities/Depression/definition.asp
http://www.indepression.com/

Hope For Depression

Hospital of St Mary of Bethlehem

Hospital of St Mary of Bethlehem has been a part of London since 1247, first as a priory for the sisters and brothers of the Order of the Star of Bethlehem. In 1330 it is mentioned as a hospital, and it admitted the mentally ill from 1377 though by1403 there were only nine inmates.

Early sixteenth century maps show Bethlehem as a courtyard with a few stone buildings, a church and a garden. Conditions were consistently dreadful, and the care amounted to little more than restraint. There were 31 patients and the noise was "so hideous, so great; that they are more able to drive a man that hath his wits rather out of them"'. Violent or dangerous patients were manacled and chained to the floor or wall. Some were allowed to leave, and licensed to beg. In 1598 an inspection showed neglect; the cesspool badly needed emptying, and the kitchen drains needed replacing. There were 20 patients there, one of whom had been there in excess of 25 years.

Between 1728 and 1852, Bethlehem's physicians all came from the Monro family -- James, John, Thomas and Edward Thomas They brought in a few therapeutic innovations -- cold and hot baths for instance -- but Bethlehem’s mainstays were the familiar purgatives (induced diarrhea) and emetics (induced vomiting), with a routine spring bloodletting using leeches, and manacles for the troublesome.
When Bethlehem was visited in 1814 by Edward Wakefield, he was shocked on encountering one patient.

James Norris:
A stout iron ring was riveted round his neck, from which a short chain passed through a ring made to slide upwards and downwards on an upright massive iron bar, more than six feet high, inserted into the wall. Round his body a strong iron bar about 12 inches wide was riveted; on each side of the bar was a ring; which was fashioned to and enclosed each of his arms, pinioned them close to his sides.
James Norris had been thus immobilized for twelve years.

Bethlehem Hospital became famous and infamous for the brutal ill-treatment meted out to the insane. In the 18th century people used to go there to see the lunatics. For a penny one could peer into their cells, view the freaks of the "show of Bethlehem" and laugh at their antics, generally of a sexual nature or violent fights. Entry was free on the first Tuesday of the month. Visitors were permitted to bring long sticks with which to poke and enrage the inmates. In 1814, there were 96,000 such visits, approximately 260 per day.
Let me tell a story that very well may have taken place in the 19th century
A man has a beloved son who often throws himself to the ground writhing and foaming at the mouth. The man takes his son to the local priest hoping against hope that something could be done. Didn’t Jesus Himself cast demons from a boy in a similar situation?

The priest prayers for days and performs exorcisms to no available.
The man, sadly, turns to Bethlehem as the only place to shelter his son.
The young man, perhaps named James Norris, spends the next twelve years as described above; sitting in his own feces with nothing to look forward to but the weekly visits of the town-folk with the their sticks and their jeers.
Today we have medications that allow epileptics to lead relativity normal lives. We know so much more about brain chemicals that James Norris would never have had to suffer as he did.

In a few years the average person will realize that depression is not “the blues” or just plain old “laziness” but a chemical imbalance that can be corrected
The name of the hospital was later shortened to “Bedlam”. Bedlam now means a place, scene, or state of uproar and confusion.

http://instruct.uwo.ca/english/234e/site/bckgrnds/maps/lndnmpbedlam.html

http://books.google.com/books?id=3EEOAAAAQAAJ&pg=PA29&lpg=PA29&dq=st+mary+bethlehem+hospital&source=web&ots=gTc9iMfXh1&sig=G-HZBAFCOewAOa0ewtphOWLkRj4&hl=en&sa=X&oi=book_result&resnum=7&ct=result

What to Say to a Depressed Person

REMEMBER – YOU CAN”T FIX DEPRESSION!!

1. "I love you!"
2. "I care"
3. "You're not alone in this"
4. "I'm not going to leave/abandon you"
5. "Do you want a hug?"
6. "I love you (if you mean it)."
7. "It will pass, we can ride it out together."
8. "When all this is over, I'll still be here (if you mean it) and so will you."
9. "Let me hold your hand and listen while you cry."
10. "All I want to do do is give you a hug and a shoulder to cry on.."
11. "Hey, you're not crazy!"
12. "God does not play dice with the universe." --A. Einstein
13. "We are not on earth to see through one another, but to see one
another through" –
14. "If the human brain were simple enough to understand, we'd be too simple
to understand it." --a co-developer of Prozac, quoted from "Listening
to Prozac"
15. "You have so many extraordinary gifts; how can you expect to live
an ordinary life?"
16. "I understand your pain and I empathize."
17. "I'm sorry you're in so much pain. I am not going to leave you.
I am going to take care of myself so you don't need to worry that your
pain might
hurt me."
18. "I listen to you talk about it, and I can't imagine what it's like for you.
I just can't imagine how hard it must be."
19. "I can't really fully understand what you are feeling, but I can offer
my compassion."
20. "You are important to me."
21. "If you need a friend..... (and mean it)"

What Not To Say

What NOT to say to a person suffering from depression

It is most tempting, when you find out someone is depressed, to attempt to immediately fix the problem. However, until the depressed person has given you permission to be their therapist (as a friend or professional), the following responses are more likely to hurt the depressed.

1. "Will you stop that constant whining? What makes you think that anyone cares?"
2. "Have you gotten tired yet of all this me-me-me stuff?"
3. "You just need to give yourself a kick in the rear."
4. "But it's all in your mind."
5. "I thought you were stronger than that."
6. "No one ever said life was fair."
7. "As you get stronger you won't have to wallow in it as much."
8. "Pull yourself up by your bootstraps."
9. "Do you feel better now?" (Usually said following a five minute conversation in which the speaker has asked me "what's wrong?" and "would you like to talk about it?" with the best of intentions, but absolutely no understanding of depression as anything but an irrational sadness.)
10. "Why don't you just grow up?"
11. . "Stop feeling sorry for yourself."
12. "There are a lot of people worse off than you."
13. "You have it so good, why aren't you happy?"
14. "It's a beautiful day!"
15. "You have so many things to be thankful for, why are you depressed?"
16. "What do you have to be depressed about?."
17. "Happiness is a choice." (two prominent physicians)
18. "You think you've got problems..."
19. "Well at least it's not that bad."
20. "Maybe you should take vitamins for your stress."
21. "There is always somebody worse off than you are."
22. "Lighten up!"
23. "You should get off all those pills."
24. "You are what you think."
25. "Cheer up!"
26. "You're always feeling sorry for yourself."
27. "Why can't you just be normal?"
28. "Things aren't that bad, are they?"
29. "Have you been praying/reading the Bible?"
30. "You need to get out more."
31. "We have to get together some time." [Yeah, right!]
32. "Get a grip!"
33. "Most folks are about as happy as they make up their minds to be." (Lincoln himself)
34. "Well, everyone gets depressed sometimes!"
35. "Smile and the world smiles with you, cry and you cry alone."
36. "You don't look depressed!"
37. "You're so selfish!"
38. "You never think of anyone but yourself."
39. "You're just looking for attention."
40. "You'll be a better person because of it!"
41. "Everybody has a bad day now and then."
42. "You catch more flies with honey than with vinegar."
43. "Why don't you smile more?"
44. "A person your age should be having the time of your life."
45. "The only one you're hurting is yourself."
46. "You can do anything you want if you just set your mind to it."
47. "This is a place of business, not a hospital." (after confiding to my supervisor about my depression)
48. "Depression is a symptom of your sin against God."
49. "You brought it on yourself"
50. "You can make the choice for depression and its effects, or against depression, it's all in your hands."
51. "Get off your rear and do something." -or- "Just do it!"
52. "Why should I care?"
53. "Snap out of it, will you?"
54. "You just want to feel this way."
55. "You have no reason to feel this way."
56. "Its your own fault."
57. "That which does not kill us makes us stronger."
58. "You're always worried about your problems."
59. "Your problems aren't that big."
60. "What are you worried about? You should be fine."
61. "Just don't think about it."
62. "Go Away."
63. "Just wait a few weeks, it'll be over soon."
64. "Go out and have some fun!"
65. "You're making me depressed as well..."
66. "I just want to help you."
67. "The world out there is not that bad..."
68. "Just try a little harder!"
69. "Believe me, I know how you feel. I was depressed once for several days."
70. "You need a hobby."
71. "Just pull yourself together"
72. "You'd feel better if you went to church"
73. "I think your depression is a way of punishing us." (friends or relatives)
74. "Sh** or get off the pot."
75. "So, you're depressed. Aren't you always?"
76. "What you need is some real tragedy in your life to give you perspective."
77. This one is best executed with an evangelical-style handshake, i.e., one of my hand imprisoned by two belonging to a beefy person who thinks he has a lot more charisma than I do: "Our thoughts and prayers are with you”."
78. "You will be ok, just hang in there, it will pass." "This too shall pass." --Ann Landers
79. "Oh, perk up!"
80. "Try not being so depressed."
81. "Quit whining. Go out and help someone else and you won't have time to brood..."
82. "Go out and get some fresh air... that always makes me feel better."
83. "You have to take up your bed and carry on."
84. "Well, we all have our cross to bear."
85. "Just change your mind."
86. "You're useless."
87. "Nobody is responsible for your depression but you."
88. "You don't like feeling that way? So, change it."
89. What's your problem?"
90. "Why don't you give up going to these quacks (i.e., doctors) and throw out those pills, then you'll feel better."

Medications For Depression

Over the course of 33 years I was seen by 28 physicians and prescribed some 20 different medications. Each one seemed to work for a few months to a year. Then back I would go. It seemed as though my body would acclimate itself as quickly as possible to the new drugs and there I would be; back in hell.
1. Anafranil(clomipramine)
2. Buspar(buspirone)
3. Celexa(citalopram)
4. Desyrel(trazodone)
5. Effexor(venlafaxine)
6. Elavil(amitriptyline)
7. Equetro(carbamazepine)
8. Ludiomil(maprotiline)
9. Luvox(fluvoxamine)
10. Norpramin(desipramine)
11. Paxil(paroxetine)
12. Prozac(fluoxetine)
13. Remeron(mirtazapine)
14. Serzone(nefazodone)
15. Surmontil(trimipramine)
16. Tofranil(imipramine)
17. Vivactil(protriptyline)
18. Wellbutrin(bupropion)
19. Zoloft(sertraline)
20. Electro-convulsive therapy
This is only a partial list because my memory fades in and out with regards to what I’ve ingested.

Hope For Depression

Personal Quote
"It is impossible to explain the pain, anger, and exhaustion a mixed episode causes. It is to be filled with rage, at yourself and others and at the world. It is to have so much angry energy inside that you are sure you will explode. The mind can focus on nothing but death and hate. There is no reason. And there is no escape.
At least during a depressive episode you can escape in sleep, but when mixed there is no way out. There is no outlet for the fire, no way to ignore the pain of being."
Unknown

Finding Depression

I was diagnosed with depression in 1975. Given Tofranyl, I began to feel better for the first time in years. I frequently asked my wife, “Is this the way normal people feel all the time?”
The euphoria lasted only a few months and then I was back to the fear and the rage. It was not until 2008 that I found an accurate description of what I was really feeling.

In the context of mental illness, a mixed state (also known as dysphoric mania, agitated depression, or a mixed episode) is a condition during which symptoms of mania and depression occur simultaneously (e.g., agitation, anxiety, fatigue, guilt, impulsiveness, irritability, morbid or suicidal ideation, panic, paranoia, pressured speech and rage). Typical examples include tearfulness during a manic episode or racing thoughts during a depressive episode. One may also feel incredibly frustrated in this state, since one may feel like a failure and at the same time have a flight of ideas. Mixed states can be the most dangerous period of mood disorders, during which substance abuse, panic disorder, suicide attempts, and other complications increase greatly.

http://en.wikipedia.org/wiki/Agitated_depression
http://www.angelfire.com/home/bphoenix1/mixed.html
http://health.discovery.com/centers/mens/articles/depression_02.html