Major Depressive Disorder affects approximately 7% of the U.S. population aged 18 and older, but how much do most of us really know about this mental illness? More common in women than men, depression can come on at any age over the average age for those diagnosed with Major Depressive Disorder is 32.5-year-old.
It can manifest in a number of very different ways including sadness, anxiety, guilt, irritability, recklessness or worthlessness, with these symptoms ranging anywhere from being incredibly subtle to extreme and debilitating.
For those that live with mental illness, it can be extremely difficult to explain what you are experiencing. On one hand, these topics have largely been considered taboo in the past creating a high level of stigma. For example, you could call your boss and say you need a day off due to the stomach flu and no one would even bat an eye, however, the idea of calling in due to a day of significant struggle with your mental health elicits fear of judgment and ridicule.
Those who have not experienced mental illness first-hand struggle to understand the significant impact it can have on your life, and this is further complicated by the fact that illnesses like depression can present in a number of very different ways, making every experience unique. While there are lists of common symptoms to watch out for, not everyone is going to experience every symptom and not every symptom experienced will be ‘common’ among sufferers. The American Psychiatric Association summarizes it stating: “Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.”
In a recent article for Psychology Today Gregg Henriques, PhD, director of the Combined Clinical and School Psychology Doctoral Program at James Madison University explained that this variation in symptoms can better be understood by looking at the various types of depression that exist. He explains that there are 23 different types of depressive reactions that one may experience. While these labels are not considered official, they help those of us outside of the medical field to better understand the experiences that we are having, as well as to comprehend the explanations from those around us of their own depression.
The 23 Types of Depressive Reactions Include:
#1 – Adjustment-Based
The type of depressive reaction often depicted in movies and television shows, this is the experience that is triggered by a change in an individual’s life that they find difficult to adjust to. For example, they may have recently moved to a new city or are experiencing life after a divorce. Those experiencing this type of depressive reaction may feel as though things ‘aren’t right’ and they wish they could return to the way that things used to be.
#2 – Bipolarity
The term ‘bipolarity’ can be broken down to describe the experience that these individuals are feeling – ‘Bi’ meaning two, and ‘polarity’ referring to the fact that they are experiencing two very different extremes of the spectrum of human emotions, or the polar opposites of extreme happiness and complete hopelessness. Characterized by intense mood swings, they may feel like they are on top of the world one moment however it all comes crashing down in the next breath.
#3 – Complicated Bereavement/Loss-Based
When an individual is grieving the loss of someone in their life it brings about understandable feelings of sadness and loss. If, however, the person that they have lost was a central part of their life, that feeling of loss may be intensified, causing their grieving process to appear to be impossible to worth through.
#4 – Dead-Ended/Impoverished
In order to feel happy or complete in our lives we require psychological nourishment – experiences that provide us with feelings of fulfillment and engagement. If these are missing it can leave a significant hole in one’s life, lacking any tangible reason to feel joy and happiness. One example may be someone who is living in a state of homelessness with nothing to distract them or preoccupy their mind.
#5 – Diseased-Based
At times depressive reactions may be the result of something else that has occurred within the body, a symptom of a disease or illness. This may be due to a shift in one’s hormone levels or a rewiring of some form in the brain causing a neurological change. For example, the medical community has discovered a significant link between hypothyroidism and depression, revealing that there may be a large number of people currently taking antidepressants that really should be prescribed thyroid medication.
#6 – Double-Developmental
As infants, toddlers and young children we go through a significant developmental process, programming our minds on various triggers, what to notice and how to best react. If something has occurred to hinder or change this process, child abuse for example, this can cause the brain to be programmed in a significantly different way. As such, someone may not respond to the world around it in the ways that we acknowledge as being ‘healthy’ and ‘normal.’
#7 – Dysthymic
Unlike some of the more severe depressive reactions, dysthymic depression refers to a subtle but ongoing feeling of being ‘off.’ Today the mental health community refers to this as ‘persistent depressive disorder,’ and it is an official diagnosis. Diagnosis occurs when a patient has been feeling depressed for ‘most of the day, for more days than not, for at least 2 years (or at least 1 year for children and adolescents)’.
#8 – Existential Meaninglessness
While medical health professionals won’t stipulate that one specific religion or belief is ‘correct,’ there is a consensus that the belief in a higher purpose in life can lead to better mental health. The complete absence of which is referred to as existential meaninglessness. These individuals often find themselves questioning what the point of living is, or what difference anything that they do will make, believing that their lives are hollow and without meaning.
#9 – Failure-based
Similar to the depressive reaction that is associated with grief, failure-based depression is the result of an individual dedicating their lives to one purpose, such as a specific career or project, which then fails leaving them feeling ashamed, paralysed and at a loss for what they should do next in their lives. They are essentially grieving the loss of the success they had assumed they would continue to experience in this area of their lives.
#10 – Helplessness/Powerlessness
If someone is forced into a situation in which they no longer feel control over their lives, this may cause them to experience a depressive state. These individuals may be imprisoned, abused or cut-off from the world around them, further adding to their lack of control as it is being held by the person responsible. For example, depression is common among victims of domestic abuse.
#11 – Hopeless/Despair
When one reaches a point in their lives that they fell there is no longer any hope to change their outcome, leaving them trapped in a negative and unfulfilling journey then they may experience this depressive state. They feel as though they are still stuck participating in the game of life, however, the game can no longer be won, and they are merely going through the actions. This is the depressive state that is most often seen in elderly Americans, plaguing nursing homes and assisted care facilities.
#12 – Lonely/Isolated/Neglected
In order for one to feel psychologically fulfilled and happy they must feel as if they are of value to others around them. This requires the development of important relationships and connections, an experience that is becoming more and more neglected in today’s society. With the influx of social media and online communication we are increasingly isolated, leading to a large number of Americans feeling lonely in their day to day lives. This absence of connection leads, in many cases, to depression.
#13 – Melancholic
One of the more major forms of depressive state, those who experience a melancholic depression may experience delusions, difficulty thinking and making decisions, slowed speech and difficulty functioning with their regular lives. Once seen as a separate diagnosis altogether, melancholic depression is now associated with the umbrella title of Major Depressive Disorder.
#14 – Neurotic/Negative Affect Syndrome
Those who experience neurotic depression are highly sensitive, feeling strong emotional reactions to even the most minor or triggers. They also lack the tolerance for distress, confusion or stress causing them to jump to an extremely negative reaction much quicker than the average healthy adult. They spend much of their lives feeling worried, anxious and highly defensive.
#15 – Pain/Injury/Illness-Based
When someone is diagnosed with an ongoing illness, or are experiencing chronic-pain it affects every part of their lives. Furthermore, there is no end in sight which can cause them to feel not only physically distressed, but it can also have a significant impact on these individuals mentally and emotionally.
#16 – Personality-Based
If someone is struggling with identifying, understanding and accepting their own personal identity this can cause significant difficulties in processing their own thoughts and emotions. They don’t understand their own reactions or why their mind is working the way that it is, let alone possess the capability to reason with it and manage their reactions. This can cause them to shut down, shutting not only others but even themselves out.
#17 – Postpartum
Awareness of postpartum depression has been rising in the United States, encouraging women to talk about it more and share their experiences with others. The process of giving birth isn’t just incredibly taxing on a woman physically, but with the shift in hormones, stress of the major life change and the emotions that are flying during this time, it can lead to a depressive state. Women may experience incredible mood swings, excited about their new baby one moment, and experiencing negative feelings like self-blame and guilt the next.
#18 – Private/Split-Off
Individuals who fall into this type of depressive reaction can be at a high risk for suicide due to the fact that no one else is aware that there is a problem. Highly functional, they appear happy and successful to everyone around them, however, they are burying intense feelings of depression and misery. They feel as though they can’t share this information with anyone else so instead they suffer alone while putting up a front to hide it from the world around them.
#19 – Rage-Based/Turning Against the Other
When one is unable to trust anyone in their lives, insistent that everyone is ‘out to get them’ in some way shape or form this can lead to a depressive state. Often the victims of trauma in the past, someone has, at some point, given them reason not to trust and they have held onto this and applied it to the human population as a whole. They treat others poorly in an effort to push everyone away, isolating themselves in an effort, they believe, to protect themselves.
#20 – Seasonal
An accepted diagnosis among the mental health community, seasonal depression refers to those who feel increasingly sad, down or ‘off’ during the winter months. These feelings occur generally at the same time each year, coming on in the fall, lasting throughout the winter and retreating as you move into the spring. Many experts believe that this is a reaction to the lack of light and the colder temperatures. In rare cases people may also experience spring/summer seasonal depression.
#21 – Shame-Based/Turning Against the Self
A Shame-based depressive reaction is a vicious cycle, and once one enters it, it can be difficult to escape. They experience feelings of shame and frustration with themselves, blaming themselves for the feelings of negativity in their lives. This shame and frustration ultimately leads to more negativity, continuing the cycle. They are highly self-critical, and generally worry about how they are viewed by everyone else around them.
#22 – Substance Abuse Induced
The existence of a depressive state in conjunction with substance abuse has been the cause of the age-old question of the chicken and the egg in mental health communities. It is difficult to determine which comes first – were they depressed and used substances to numb their pain, leading to more depression, or did they first try the substance, feeling depressed that they then became addicted. While that answer is unknown, it is clear there is a distinct association between the two.
#23 – Trauma-Based
Also known as Post Traumatic Stress Disorder (PTSD), this type of depressive state is the result of a traumatic event or experience in an individual’s life. They often experience flashbacks, nightmares and intrusive thoughts taking them back to the event responsible for their struggles. PTSD gained a significant amount of public attention when it was discovered in conjunction with soldiers and the impact of going to war, however, that is not the only potential trigger.