On average, and all else being equal, the more traumatic a person’s childhood, the more likely it is that s/he will experience depression at some point in his/her life.
I list below fifteen different categories of depression. A person can fit into more than one category at any one time.
THE FIFTEEN CATEGORIES OF DEPRESSION :
1) AGITATED DEPRESSION – with this type of depression the person suffering from it is constantly restless, intensely worried and deeply anxious/fearful (I suffered this type of depression and was often incapable of even staying seated).
2) RETARDED DEPRESSION – this type of depression causes the person suffering from it to very significantly slow down both mentally and physically (this is technically referred to as PSYCHOMOTOR RETARDATION). There will also be great difficulty in concentrating. In its most extreme manifestation, the afflicted individual cannot move, speak or eat which carries with it the risk that s/he will starve to death. This state of complete inactivity is sometimes referred to as CATATONIA.
3) PSYCHOTIC DEPRESSION – with this type of depression the individual may lose touch with reality and may suffer from delusions (outlandish false beliefs) or hallucinations (seeing or hearing things which are not there). It can be treated with antipsychotic medication.
4) NEUROTIC DEPRESSION – (this term is now falling into disuse and is being replaced with the term ‘mild depression). It is a less severe form of depression than psychotic depression (see above) and the person’s mood may fluctuate from day to day and also during the day (often, for example, feeling bad in the morning but improving in the evening). The person suffering from it may have symptoms of irritability and disrupted sleep (finding it hard to go to sleep and frequent waking during the night; however, with this type of depression there does not tend to be early morning waking which is a hallmark of other types).
5) ORGANIC DEPRESSION – this type of depression has a physical cause and can manifest itself as a result of side effects of medication. For example, the British comedian Paul Merton suffered a serious depression, for which he needed to be hospitalized, as a complication of taking anti-malaria tablets.
6) DYSTHYMIA – this is a relatively mild but persistent type of depression. Its main symptoms are low self-esteem and difficulties in making decisions. It often responds better to psychotherapy than to treatment with drugs.
7) BRIEF RECURRENT DEPRESSION – this term is relatively new and refers to serious depression which comes and goes but tends only to last for a few days at a time.
8) MASKED DEPRESSION – this is also sometimes referred to as ‘smiling depression’. Whilst the individual who has this type of depression will report that they DO NOT feel depressed, they will, nevertheless, have some of the symptoms of depression. Indeed, the symptoms will often respond well to anti-depressant medication.
9) BIPOLAR DISORDER – this used to be referred to as ‘manic-depression’. With this disorder, the person vacillates between feelings of elation and periods of despair. During their highs (the ‘manic’ phase) there will be a reduced need for sleep, excessively high energy levels often leading to frenzied activity, racing thoughts and a ‘flight of ideas’, reduced need to eat and possible delusions (e.g. believing they are the reincarnation of a Roman Emperor, are next in line to the throne or have special, superhuman powers) and hallucinations.
Often, too, judgment will be extremely impaired leading to, for example, massive gambling losses, vast overspending or investing huge amounts of money in doomed business ventures. Also, the individual suffering from such mania is likely to feel ‘invincible’ and that s/he ‘can achieve anything.’ However, these periods burn themselves out and are replaced by depression which may be so severe the sufferer considers or attempts suicide.
The depression may be made worse due to the lack of judgment s/he experienced during the manic phase and the self-destructiveness this may have involved (e.g. s/he may have taken on enormous debts).
10) SEASONAL AFFECTIVE DISORDER (S. A. D.) – this is a form of depression which only strikes in the winter months due to the lowered amount of sunlight during this period. Symptoms can include an increased need for sleep and carbohydrate cravings.
11) UNIPOLAR DEPRESSION – this is, by a very long way, far more common than bipolar depression – only low mood is experienced; there are no highs/manic episodes.
12) REACTIVE DEPRESSION – sometimes called ‘endogenous depression’. This type of depression occurs as a reaction to a stressful event, such as being made redundant; it is normally relatively short-lived and often responds well to counselling or family support.
13) RECURRENT DEPRESSION – any period of depression which is not the first one the person has experienced is called ‘recurrent depression.’
14) CHRONIC DEPRESSION – the word ‘chronic’ means long-lasting (some people misuse the word when what they actually mean is ‘severe’). Doctors refer to depression as being ‘chronic’ if it has gone on for at least two years.
15) TREATMENT RESISTANT DEPRESSION – this refers to a depression which does not improve with anti-depressant drugs. This was the type of depression I had/have. In such cases, if the depression is very severe and life-threatening (due to self-neglect or high suicide risk) electroconvulsive shock therapy (ECT) may be used as a last resort. I myself had to undergo ECT on a number of occasions over the years (although unfortunately, this had no positive effect whatsoever in my own case; however, for some, it can be life-saving).
David Hosier BSc Hons ; MSc ; PGDE(FAHE).