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Mental Health: Depression

Sometimes physical problems can cause depression. But other times, symptoms of depression are part of a more complex psychiatric problem. There are several different types of depression, including:

  • Major depressive disorder
  • Dysthymia and chronic depression (now called persistent depressive disorder)
  • Seasonal affective disorder
  • Psychotic depression
  • Bipolar depression

Major Depression

An individual with major depression, or major depressive disorder, feels a profound and constant sense of hopelessness and despair.

Major depression is marked by a combination of symptoms that interfere with the person's ability to work, study, sleep, eat, and enjoy once pleasurable activities. Major depression may occur only once but more commonly occurs several times in a lifetime.

What Are the Symptoms of Major Depression?

Symptoms of depression include:

  • Sadness
  • Irritability
  • Loss of interest in activities once enjoyed
  • Withdrawal from social activities
  • Inability to concentrate
  • Disrupted sleep
  • Fatigue or loss of energy
  • Appetite changes
  • Thoughts of suicide


Psychotic Depression

Roughly 25% of people who are admitted to the hospital for depression suffer from what is called psychotic depression. In addition to the symptoms of depression, people with psychotic depression may have:

  • Hallucinations -- seeing or hearing things that aren't really there.
  • Delusions -- irrational thoughts and fears.

How Is Psychotic Depression Different Than Other Mental Disorders?

While people with other mental disorders, like schizophrenia, also experience these symptoms, people with psychotic depression typically have symptoms that reflect the despair and negativism of depression, such as profound feelings of hopelessness, being punished, or having committed a sin.  People also may be ashamed or embarrassed and try to hide their psychotic symptoms, or minimize their intensity, which can make diagnosing this condition difficult.

What Are the Symptoms of Psychotic Depression?

  • Anxiety -- fear and nervousness
  • Agitation
  • Paranoia
  • Insomnia -- difficulty falling and staying asleep
  • Physical immobility
  • Intellectual impairment
  • Hallucinations (false perceptions)
  • Delusions (fixed, false beliefs)



Dysthymia, sometimes referred to as a form of chronic depression, is a less severe form of depression but the depression symptoms linger for a long period of time, typically years. Those who suffer from dysthymia are usually able to function normally, but seem consistently unhappy.

It is common for a person with dysthymia to also experience major depression at the same time, swinging into a major depressive episode and then back to a more mild state of dysthymia. This is called double depression.

What Are the Symptoms of Dysthymia?

Symptoms of dysthymia include:

  • Difficulty sleeping
  • Loss of interest in activities or the ability to enjoy oneself
  • Excessive feelings of guilt or worthlessness
  • Loss of energy or fatigue
  • Difficulty concentrating, thinking or making decisions
  • Changes in appetite
  • Thoughts of death or suicide

Dysthymia differs from major depression in that dysthymia involves fewer of the above symptoms than occurs in major depression. To be diagnosed with dysthymia, symptoms must persist for at least two years in adults or one year in children or adolescents.

WebMD Medical Reference

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