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Beyond the Blues

Everyone feels a bit down, sometimes. But if you’re sad and empty, and have trouble concentrating, eating, and sleeping for 2 weeks or more, you could have depression.

It's not a one-size-fits-all illness. It comes in many forms, each with slightly different symptoms. But depression can be treated, usually with medicines, talk therapy, or both.

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Major Depressive Disorder

Sometimes called clinical depression, this is the most common form of the disorder. More than 16 million adults have had at least one episode. To make a diagnosis, doctors look for at least five symptoms that affect how you feel, think, and behave, including:

  • Sadness
  • Loss of interest in activities
  • Sleeplessness
  • Trouble making decisions
  • Difficulty concentrating
  • Sleepiness
  • Suicidal thoughts or actions
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Persistent Depressive Disorder

If you've been feeling down for at least 2 years, you may have persistent depressive disorder. Your doctor may call it dysthymic disorder or dysthymia. More women than men seem to have PDD. Kids and teens can have it, too. It makes them more irritable than depressed, and for them to have this diagnosis, their symptoms need to last only a year.

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Bipolar Disorder

Once called manic depression, it features emotional highs -- called mania -- and the lows of depression. These swings affect not only how you feel, but your behavior and judgment, too. That can cause problems with work, relationships, and day-to-day life. Suicidal thoughts and behaviors also are common with bipolar disorder.

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Seasonal Affective Disorder

The gloomy days of fall and winter can be hard for those with seasonal affective disorder (SAD). Its symptoms are the same as depression but generally happen only during the fall and winter, when there's less daylight. About 5% of adults in America have SAD. Treatments, such as light therapy or medication, can quickly ease symptoms. But they can also improve on their own when spring arrives.

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Psychotic Depression

This is a severe type of depression. Its symptoms include hallucinations and delusions. You may be agitated and be unable to relax. Your ability to think clearly or move normally may slow down. Psychotic depression usually requires a short hospital stay.

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Postpartum Depression

Most moms feel a little blue after their baby’s birth. But if those feelings are severe, you could have postpartum depression. Symptoms can creep in a few weeks after the baby’s birth, or even up to a year later. Mood swings, difficulty bonding with your baby, changes in thoughts and behavior, and fears about your mothering are common. If you think you have more than the baby blues, see your doctor.

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Premenstrual Dysphoric Disorder

Many women get the cramping and moodiness of premenstrual syndrome (PMS). But if you have severe PMS that affects your job and relationships, you may have PMDD. Symptoms start 7 to 10 days before your period and go away a few days after it starts.

If you think you have PMDD, see your doctor. She’ll help rule out other things. Treatment can include:

  • Lifestyle changes, such as diet and exercise
  • Oral contraceptives
  • Antidepressants
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Adjustment Disorder

Any of life’s unexpected curveballs can bring stress. However, if it's difficult to move forward, you may have an adjustment disorder that can cause depression, anxiety, or both. You may hear someone call this “situational symptoms.” They start within 3 months of a stressful event, and they're usually gone 6 months later. They can last longer, depending on the cause. Usually, talk therapy is the treatment for it.

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Atypical Depression

Most forms of depression make you feel sad and empty. But if yours lifts briefly after good news or a positive experience, you may have atypical depression.

It isn’t rare, but its symptoms are a little different. Other than the temporary mood lift, you may:

  • Have a bigger appetite
  • Sleep 10 or more hours a day
  • Be especially sensitive to criticism.
  • Get a heavy feeling in your arms and legs that's not because you're tired
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Treatment-Resistant Depression

For most people with depression, today’s treatments work well to help you get your life back on track. But up to about a third of people with the disorder need a little more help.

Doctors are looking at why some people respond well to treatment while others don’t. Some folks may have success with their treatment for a little while, then have it stop working.

Even if your depression is tougher to treat, you should keep seeing your doctor.

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Subsyndromal Depression

Subsyndromal means that you may have some symptoms of a disorder, but not enough for a diagnosis. Subsyndromal depression means you have at least two symptoms, but fewer than the five necessary for your doctor to say you have major depression.

For you to get a diagnosis of this type of depression, your symptoms must affect your quality of life for at least 2 weeks.

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Disruptive Mood Dysregulation Disorder

Although all kids have temper tantrums, children with this disorder are usually irritable and have outbursts well beyond what's expected. The previous diagnosis for some of these kids was pediatric bipolar disorder, but their symptoms didn't always fit.

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Sources | Medically Reviewed on 01/09/2018 Reviewed by Joseph Goldberg, MD on January 09, 2018

IMAGE PROVIDED BY:

1. Getty Images

SOURCES:

National Institutes of Mental Health: “Depression.”

Anxiety and Depression Association of America: “Understand The Facts -- Depression.”

FamilyDoctor.org, American Academy of Family Physicians: “Persistent Depressive Disorder (PDD).”

Mayo Clinic: “Bipolar Disorder.”

American Psychiatric Association: “Seasonal Affective Disorder (SAD).”

NHS Choices: “Psychotic Depression.”

Mayo Clinic: “Postpartum Depression.”

Cleveland Clinic: “Premenstrual Dysphoric Disorder (PMDD).”

Mayo Clinic: “Adjustment Disorders.”

National Alliance on Mental Illness: “Situational Symptoms or Serious Depression: What’s the Difference?”

Mayo Clinic: “Atypical Depression.”

Singh, T. Atypical Depression. Psychiatry, published online April 2006.

National Network of Depression Centers: “Treatment Resistant Depression.”

Ayuso-Mateos J.L. From Depressive Symptoms to Depressive Disorders: The Relevance of Thresholds. The British Journal of Psychiatry. April 2010.

Child Mind Institute: “DMDD: What Is It?”

Reviewed by Joseph Goldberg, MD on January 09, 2018

This tool does not provide medical advice. See additional information.

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.