Depression is a common and serious form of mood disorder that negatively impacts how a person feels, thinks, and acts. Depression can take many forms among different people, each with varying symptoms and treatment recommendations. Fortunately, many types of depression are highly treatable.
Different forms of depression are best treated in different ways, so a specific diagnosis is important to inform appropriate treatment. For example, transcranial magnetic stimulation (TMS) therapy may be recommended for treatment resistant depression, whereas psychotherapy may be the first treatment recommended for situational depression.
Types of depression and the most effective treatments for each:
Major depression: Also sometimes known as clinical depression, major depression effects just under 7{2997f8544d703ffd995cbf0748d9148f9150b33c2eb54c93a5197645ffc3f066} of the United States population older than 18 and is characterized by a depressed mood that persists through the majority of the day for at least two weeks straight. People with major depression tend to feel sad much of the time and lose interest in interpersonal relationships and their usual daily activities. Insomnia, fatigue, guilt, inability to concentrate, restlessness, weight loss or gain, and recurring thoughts of suicide are also common. Somewhere between 20{2997f8544d703ffd995cbf0748d9148f9150b33c2eb54c93a5197645ffc3f066} and 25{2997f8544d703ffd995cbf0748d9148f9150b33c2eb54c93a5197645ffc3f066} of the population will experience major depression at some point in life.
Psychotherapy and antidepressant medication are the most common forms of treatment for major depression, and it is not uncommon for a doctor to prescribe a few different medications before finding something that works. When medication and talk therapy are ineffective, electroconvulsive therapy (ECT) is sometimes used.
Persistent depressive disorder: Persistent depressive disorder is an illness that’s chronic in nature and characterized by depression that lasts two years or more. Symptoms may include under or oversleeping, difficulty concentrating, fatigue, change in appetite, feelings of hopelessness, and low self esteem, though these symptoms usually won’t be as severe as with major depression.
Treatment for persistent depressive disorder includes talk therapy, medication, or a combination of both.
Treatment resistant depression: This is a form of major depression where the treatment doesn’t help to alleviate symptoms. Sometimes treatment makes a bit of a difference, but usually not to a noticeable degree, leaving many feeling hopeless. Nearly one third of people with depression do not experience an improvement in their condition after trying several different treatments.
Sometimes a doctor is able to treat treatment resistant depression by prescribing a different class of antidepressants or switching to a different drug within the same class. Repetitive transcranial magnetic stimulation (rTMS) therapy is also effective in many cases of treatment resistant depression. According to the Mayo Clinic, rTMS is frequently used when standard treatments like psychotherapy and medication prove ineffective. When rTMS is effective, depression symptoms will improve for some, and for others the symptoms will disappear altogether.
Atypical depression: Individuals with atypical depression will feel sad and down, but a key aspect is that these feelings will improve in response to pleasurable or positive situations and events. This type of depression is fairly common, with symptoms including some combination of increased sleep and appetite, sensitivity to criticism, and heaviness in the arms and legs.
Antidepressant medication is a common treatment for atypical depression. Selective serotonin reuptake inhibitors (SSRIs) are often the first type of medication prescribed, though other varieties of antidepressants, such as monoamine oxidase inhibitors (MAOIs), may be prescribed. Talk therapy is also used to treat atypical depression.
Seasonal Affective Disorder: Often referred to as SAD or seasonal depression, seasonal affective disorder is more common in the fall and winter when sunlight levels are lower than the rest of the year. People with this form of depression will experience mood changes, fatigue, sadness, difficulty concentrating, weight gain associated with overeating, and other symptoms, many of which interfere with daily life. Seasonal affective disorder occurs among about 5{2997f8544d703ffd995cbf0748d9148f9150b33c2eb54c93a5197645ffc3f066} of adults in the United States and is more common among women and people who live far from the equator.
Common treatments include talk therapy, light therapy, and medication.
Peripartum depression: Known by many as ‘postpartum depression,’ this form of depression occurs when an individual experiences a major depressive episode during pregnancy or within one month of delivering their baby. Around one in seven women experience this form of depression, and it is typically characterized by symptoms including indifference, fatigue, anxiety, feelings of sadness or helplessness, and changes in sleep, energy, and appetite. For many, it will last several months or more.
Recommended treatments include talk therapy, lifestyle changes, support system strengthening, and medication.
Premenstrual dysphoric disorder: Women who have premenstrual dysphoric disorder will experience depressive symptoms during distinct phases of their menstrual cycle, usually beginning after ovulation and ending about a week later just after the start of menstruation. Sadness, fatigue, anxiety, difficulty concentrating, headaches, muscle pain, mood swings, irritability, and change in appetite all common, among a number of other symptoms.
Premenstrual dysphoric disorder is usually treated with medications such as antidepressants and oral contraceptives.
Bipolar Disorder: Bipolar disorder is a condition that impacts a person’s energy, mood, and ability to function, and is characterized by extreme emotional states and mood swings where the individual fluctuates between periods of mania, hypomania, depression, and normal mood. During a period of mania, the person is likely to feel very high energy and often irritable, whereas when they transition to depression they’ll experience low energy, hopelessness, low self-esteem, and other symptoms associated with major depression.
Bipolar disorders are usually treated with medication or a combination of medication and talk therapy. In some cases, electroconvulsive therapy (ECT) is a treatment option.
Psychotic Depression: Psychotic depression is a form of major depression involving psychosis. The psychosis can take various forms such as hallucinations, delusions, or some sort of break with reality. Usually the delusions and hallucinations will relate to ideas consistent with depression such as failure and worthlessness. Around 25{2997f8544d703ffd995cbf0748d9148f9150b33c2eb54c93a5197645ffc3f066} of people admitted to the hospital for depression suffer from psychotic depression.
Psychotic depression is typically treated with a variety of medications prescribed under the care of medical professionals in a hospital. This frequently involves a combination of antipsychotic and antidepressant medications. Electroconvulsive therapy (ECT) is sometimes used as well.
Situational Depression: Situational depression tends to come about after a significant life event such as the death of a loved one, a job loss, or relationship troubles. It’s typically short in duration and characterized by feelings of hopelessness, sadness, crying, disinterest in food and normal activities, difficulty concentrating, anxiety, and stress.
Psychotherapy is the most common form of treatment for situational depression. In certain cases, medications are prescribed—these include SSRIs and dopamine reuptake blockers.
TMS Neuro Institute is one of the earliest adopters in using transcranial magnetic stimulation to treat depression in Los Angeles. To schedule a consultation, call 888.823.4867 or book an appointment online here.