Chapter 6: Anxiety
Depression
Types of Depression
Three main types of depressive disorders—major depression, persistent depressive disorder, and bipolar disorder—can occur with any of the anxiety disorders.
Major depression involves at least five of these symptoms for a two-week period.
- Persistent sad, anxious or “empty” mood
- Feelings of hopelessness, pessimism
- Feelings of guilt, worthlessness, helplessness
- Loss of interest or pleasure in hobbies and activities, including sex
- Decreased energy, fatigue, feeling “slowed down”
- Difficulty concentrating, remembering, making decisions
- Insomnia, early-morning awakening, or oversleeping
- Low appetite and weight loss or overeating and weight gain
- Thoughts of death or suicide, suicide attempts
- Restlessness, irritability
- Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and pain for which no other cause can be diagnosed.
Such an episode is disabling and will interfere with the ability to work, study, eat, and sleep. Major depressive episodes may occur once or twice in a lifetime, or they may recur frequently. They may also take place spontaneously, during or after the death of a loved one, a romantic breakup, a medical illness, or other life event.
Some people with major depression may feel that life is not worth living and some will attempt to end their lives.
Persistent depressive disorder, or PDD, (formerly called dysthymia) is a form of depression that usually continues for at least two years. Although it is less severe than major depression, It involves the same symptoms as major depression, mainly low energy, poor appetite or overeating, and insomnia or oversleeping. It can manifest as stress, irritability, and mild anhedonia, which is the inability to derive pleasure from most activities.
People with PDD might be thought of as always seeing the glass as half empty.
Bipolar disorder, once called manic-depression, is characterized by a mood cycle that shifts from severe highs (mania) or mild highs (hypomania) to severe lows (depression).
During the manic phase, a person may experience abnormal or excessive elation, irritability, a decreased need for sleep, grandiose notions, increased talking, racing thoughts, increased sexual desire, markedly increased energy, poor judgment, and inappropriate social behavior.
During the depressive phase, a person experiences the same symptoms as would a sufferer of major depression. Mood swings from manic to depressive are often gradual, although occasionally they can occur abruptly.