Types of depression and how they’re treated

Every year, nearly 30 million people in the U.S. experience a major depressive episode. It’s one of the most prevalent mental health conditions, but did you know there are different types?

There are eight total, and though they might look similar, they each come with their own distinct causes and symptoms. These differences affect not only how the condition impacts you, but also what treatment works best—which is why it’s important to know which one you’re dealing with.

The most common types include major depressive disorder (MDD), persistent depressive disorder (PDD), and premenstrual dysphoric disorder (PMDD). Many depressive disorders share similar symptoms—like low mood and intense sadness—but have distinguishing criteria that affect causes and treatment. Different types of depression demand different treatment approaches, so it can be critical to know what type you have. Psychotherapy, medication, or a combination of both can be used to treat most depressive disorders.

A mental health professional can help you determine whether you have a depressive disorder, identify which one, and work with you to create the best possible care plan. Read on to learn more about the types of depression, how they work, and how they differ from each other.

The Different Types of Depression

As mentioned, there are eight different types of depression listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Though many of them might look similar in terms of symptoms, identifying the specific type of depression is an important part of the treatment process.

“When diagnosing depression, it’s important for me to be as specific as possible so I can fully understand my client and their condition,” says Alex Cromer, a licensed professional counselor at Thriveworks. “The type of depression lets me know what’s causing their depression, which in turn impacts the kind of treatment I suggest, shows me what coping strategies will be most effective, and helps us prevent future occurrences. Information is our greatest tool, so the more specific I can be, the better the treatment outcome.”

Here’s a quick overview of the eight types before we dive into each one in detail.

Quick Reference: Types of Depression

1. Major Depressive Disorder (MDD)

Major depressive disorder, also called major depression or clinical depression, is what most of us think of when we hear or read about depression.To be diagnosed with MDD, you must exhibit at least five of the following symptoms most of the day for longer than two weeks, and severely enough that your personal or professional life is suffering:

• Feelings of intense sadness, hopelessness, despair, emptiness
• Loss of pleasure in most daily activities
• Significant weight gain or loss
• Changes in appetite (eating significantly less or more than usual)
• Disruption of sleep patterns (e.g., insomnia or hypersomnia)
• Changes in activity levels
• Fatigue or loss of energy
• Feelings of worthlessness, guilt, or self-hatred
• Diminished ability to think or concentrate
• Suicidal thoughts

To be diagnosed with MDD, these symptoms also can’t be tied to a recent loss or accompanied by manic episodes.Most of these symptoms are seen in other types of depression as well, though there can be some differentiation in severity, duration, and presentation. MDD symptoms can last anywhere from two weeks to a period of years, though after two years of consistent symptoms, the condition becomes persistent depressive disorder.There are also subsets of this disorder you might be familiar with, such as seasonal affective disorder (MDD with seasonal pattern) or postpartum depression (MDD with peripartum onset). Though they’re called disorders, they’re not listed as stand-alone disorders in the DSM-5, but rather as types of major depressive disorder.

2. Persistent Depressive Disorder (PDD)

Persistent depressive disorder, often called dysthymia or chronic depression, differs from major depression in terms of the severity of symptoms and how long they last. Though PDD and MDD symptoms can look similar, symptoms of PDD are often less severe (though not always). Examples include:

• Mild anxiety
• Lack of motivation
• Negative self-talk
• Expectation of failure
• Impaired concentration
• Unstable mood
• Fatigue
• Insomnia or hypersomnia
• Feelings of hopelessness or worthlessness

PDD symptoms might be less obvious to others, but they still impact a person’s ability to go about daily life.

To be diagnosed with persistent depressive disorder, you must experience symptoms for at least two years. It’s important that those who suffer from this type of depressive disorder seek treatment, as it can persist for an extended period and also lead to intermittent episodes of major depression.

3. Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) affects women one or two weeks ahead of their period in a far more intense way than normal premenstrual syndrome (PMS). These symptoms are intense and interfere with daily functioning. Some of the most notable depressive symptoms frequently seen in PMDD include:

• Mood swings
• Feelings of overwhelm
• Irritability
• Anxiety
• Difficulty concentrating
• Fatigue
• Change in appetite
• Changes in sleeping habits
• Poor self-image
• Diminished sex drive

Along with the above symptoms, common physical symptoms of PMDD include:

• Nausea
• Abdominal cramps
• Backache
• Headache
• Dizziness

Typically, these symptoms end within a few days of one’s period starting. Though PMDD affects up to eight percent of menstruating people, the cyclical pattern of the depressive symptoms can be somewhat hard to track, causing a noticeable diagnosis gap that is slowly starting to close.

“Because MDD can also involve recurrent episodes and long periods without symptoms, PMDD can be one of the hardest types of depression to spot,” Cromer says. “For menstruating people experiencing depressive symptoms, it’s important to try your best to track when your symptoms start and stop occurring so that, if it is PMDD, it can be caught and treated accordingly.”

“PMDD can be one of the hardest types of depression to spot, since MDD can also involve long periods without symptoms.”

4. Substance/Medication-Induced Depressive Disorder

This type of depression involves experiencing depressive, anxious, or some manic symptoms as a result of medication or substance use.

Abusing substances like alcohol and drugs can cause this type of depression, but prescribed medications can cause these symptoms to occur as well. They can also occur during use or withdrawal. Symptoms of substance/medication-induced depressive disorder are the same as MDD, but happen directly after a substance or medication was taken or during withdrawal.

For some, drugs or alcohol seem like a way to self-medicate, but this fix often backfires, making symptoms worse over time. If you’re using substances daily, you may experience the “lows” as a hangover, tiredness, or the grayness of being without the substance, and might not think of it as depression. But along with whatever pain and craving you feel, your mood is depressed—there’s no question.

When treating substance/medication-induced depressive disorder, medical intervention is especially important. Talk therapy is an important part of treatment, and some medications may be used as well on a case-by-case basis, but due to the physical consequences of taking (and stopping taking) substances, your care team will likely include both a mental health professional and a medical provider.

5. Depressive Disorder Due to Another Medical Condition

Many illnesses, including Parkinson’s disease and thyroid disorders, can cause you to feel depressed. Medical conditions can serve both as a direct cause of depression or put individuals at risk of developing depression.

Diseases that can directly cause depression might include:

• Parkinson’s: Parkinson’s causes changes in brain chemistry, impacting your brain’s ability to create serotonin and regulate your mood, causing symptoms of depression and anxiety.
• Thyroid diseases: Thyroid issues, particularly hypothyroidism, can influence mood, causing increased fatigue and depressive symptoms due to an underactive thyroid.
• Head injuries: Head issues, including conditions like strokes and traumatic brain injuries, can affect brain function, causing mood swings and other emotional issues.

Diseases that put you at higher risk of developing depression include:

• Chronic illnesses: Conditions that consistently hinder your ability to live and go about daily life can wear down your mental health over time. Illnesses like diabetes, GI issues, and epilepsy can each be traced to depression.
• Chronic pain: Being in constant pain, unable to function or live as you would want, can be incredibly mentally and emotionally taxing, opening the door for depressive symptoms to develop. This pain can be associated with many conditions, including diseases like cancer, multiple sclerosis, and endometriosis.
• Life-threatening illnesses: Living with a life-threatening illness, such as cancer, heart disease, or AIDS/HIV, can bring all kinds of worry, fear, and hopelessness. Without finding ways to bring meaning into your life, depression can quickly take hold.

Chronic illnesses, chronic pain, and life-threatening illnesses can all take a serious toll on an individual’s mental health, allowing depressive symptoms to appear and worsen over time. The depressive symptoms caused by these illnesses are similar to what’s been noted for major depressive disorder.

Reminder: It’s important to report depressive feelings to your doctor, even if these feelings aren’t your primary problem and you believe them to be a symptom of another condition. If you can get any sort of relief from your depression, it will make whatever illness you have easier to manage.

6. Disruptive Mood Dysregulation Disorder (DMDD)

Disruptive mood dysregulation disorder (DMDD) is a new addition to the DSM-5 and is a depressive disorder that occurs in children and adolescents. This disorder causes tantrums, irritability, and emotional outbursts that are disproportionate to what’s happening.

These outbursts go beyond regular moodiness—they occur in multiple areas of a child’s life and are intense enough to impact their daily functioning. They’ll stand out from the moodiness of their peers, likely considered inappropriate for the child’s age group.

Signs include:

• Intense temper tantrums (verbal or behavioral) happening about three times or more per week
• Outbursts and emotional behavior has been happening regularly for at least a year
• Consistently irritable or angry most of the day, nearly every day
• Trouble functioning due to irritability in multiple environments, such as at home, in school, or with friends

7. Other Specified Depressive Disorder (OSDD)

Individuals receive an OSDD diagnosis when they show symptoms of depression but don’t quite fit the criteria for any specific depressive disorder. In other words, a clinician assessing them might see their symptoms as intense enough to warrant a diagnosis, even though they might be missing key diagnostic factors for other types of depression.

Examples of scenarios that could be described as OSDD include:

• Recurrent, brief depression: Depressed mood and at least four other symptoms of depression for two to 13 days, once a month or more (not related to menstrual cycle), for at least a year
• Short-duration depressive episode: Depressed mood and at least four other symptoms of a major depressive episode, with clinically significant distress or impairment that lasts for four to 13 days
• Depressive episode with insufficient symptoms: Depressed mood and at least one other symptom of a major depressive episode, with clinically significant distress or impairment that lasts for at least two weeks

In each of these cases, it’s important to note that none of these episodes can meet the criteria for any other depressive disorder, bipolar disorder, or psychotic disorder.

8. Unspecified Depressive Disorder

Unspecified depressive disorder has no specific diagnostic criteria, as it’s applied when there isn’t enough information to confirm the presence of a specific disorder. The individual can present a variety of general depressive symptoms, but in the current moment, nothing concrete can be determined with the available information.

It’s often a temporary diagnosis, sometimes used in emergency settings when there isn’t time or resources to perform a full diagnostic test.

Is Bipolar Depression a Type of Depressive Disorder?

Technically, depression caused by bipolar disorder is not its own depressive disorder in the DSM-5. Bipolar disorder, a condition that causes periods of intense depression followed by manic episodes, is a separate condition in the DSM-5 with its own diagnostic criteria.

However, the symptoms and treatments for bipolar disorder can look somewhat similar. The depressive episodes closely mimic those of MDD, and treatment will often involve a combination of therapy and medication, though mood stabilizers will likely be prescribed rather than antidepressants.

How Do Different Types of Depression Get Treated?

Though the nuances of treatment for each type of depression might be slightly different, most depressive disorders will be treated with psychotherapy, medication, or—most commonly—a combination of both.

Therapy

There are a variety of therapy techniques used to treat depression. The ones used to treat your depression will vary depending on your symptoms, their severity, their frequency, and more, with a treatment plan individualized to you.

Cromer says her therapeutic process starts with gathering information. “I try to personalize depression treatment for each client by starting with a thorough examination and collecting as much information as I can from the client regarding their symptoms.”

“Once we’ve assessed the symptoms present, the client and I work to track the symptoms over a period of one to two weeks, a practice that helps me see any patterns and trends in the symptoms while also allowing me to examine and identify any external factors that might be impacting them, such as the client’s environment, habits, etc.”

The two most commonly used approaches to treating depression are:

Cognitive behavioral therapy (CBT)

CBT helps treat depression by changing thoughts and behaviors that contribute to poor mental health. Through identifying these thoughts and behaviors and examining how they impact your emotions, you can begin to change the way you think, see yourself, and see the world, allowing you to gain self-esteem and self-acceptance.

Dialectical behavior therapy (DBT)

Similar to CBT, DBT involves adjusting thoughts and behaviors to help manage emotions, but places specific importance on self-acceptance, distress management, mindfulness, and emotional regulation. It teaches you to be more aware of your thoughts and emotions and how to manage your emotions so that they have less of an impact on your daily life.

“Ultimately, my goal is to help the client gain relief from symptoms as efficiently as I can while providing my clients with specific, personally tailored education and coping skills that will help them manage and regulate their moods more effectively,” Cromer says.

With approaches that are customized to your needs, a mental health professional can teach you to manage your depressive symptoms, using tools to diminish cognitive distortions, practice mindfulness, change the nature of your inner self-talk, and so much more.

Medication

A psychiatric provider can work with you to determine if you might benefit from pharmacological treatment. Different types of antidepressant medications may be prescribed for different depression disorders, the two most common types being:

Selective serotonin reuptake inhibitors (SSRIs)

The most common type of antidepressant, these medications make serotonin more available to the brain, helping to regulate mood and decrease depressive symptoms. Examples include:

• Sertraline (Zoloft)
• Escitalopram (Lexapro)
• Fluoxetine (Prozac)

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

These medications help increase levels of serotonin and norepinephrine (adrenaline) in the brain, easing symptoms of depression. Examples include:

• Venlafaxine (Effexor)
• Duloxetine (Cymbalta)
• Desvenlafaxine (Pristiq)

Medication can help reduce depression symptoms to a more manageable level, but for most, a balance of medication and psychotherapy is required for long-term healing.

How Do You Know What Type of Depression You Have?

While it’s good to do your own research and educate yourself about your symptoms, only a licensed professional can provide you with an official diagnosis for whether you have depression, as well as what type you might have.

If you think you might be showing signs of depression, consider seeking treatment with a mental health professional. They can help you figure out what you’re struggling with and find individualized ways to help you deal with it.

When to Seek Help

If you’re often asking yourself the question, “Am I depressed?”, it’s likely time to consider seeking help. Some other signs that can signal it’s time to get diagnosed include:

• Symptoms like tiredness or low motivation start interfering with daily activities
• You consistently feel hopeless, sad, or empty most days
• Simple tasks like chores or even getting out of bed feel hard to do
• You’re having thoughts of self-harm or suicide

If you’re experiencing thoughts of self-harm or suicide, please reach out for immediate support:

• Call or text the 988 Suicide and Crisis Lifeline at 988
• Text HOME to 741741 to reach the Crisis Text Line
• Call 911 or go to your nearest emergency room

Depression can be subtle and pervasive, slowly worming its way into your life. But fortunately, with the right support and treatment, each type of depression can be overcome, allowing you to live the life you deserve.