What is depression? Types, depressive episodes, risk factors, and more

Depression is one of the most well-known and studied mental health conditions. It’s characterized by feelings of sadness or emptiness, low energy, lack of concentration, and chronic nerve pain, among a myriad of other symptoms. Depressive episodes may even last for months or even years. The different forms of depression are incredibly complex mental health conditions; as such they’re classified separately from other mood disorders as depressive disorders. 

Without proper depression treatment, this condition can be a destructive barrier to stable mental health, one that erodes the sufferer’s quality of life and emotional well-being. Though the effects of depression can be far-reaching and at times may feel overwhelming, mitigating symptoms and finding relief from depressive disorders is possible with professional depression treatment. 

What Is Depression? And What Are the Types of Depression?

Depression isn’t a single condition, but a collection of closely related depressive disorders. It’s estimated that at least 8% of Americans grapple with depression annually. Some of the most commonly recognized depressive disorders include: 

• Major depression: This is what most people think of when they hear the word “depression.” Major depression causes emotional detachment, sadness, hopelessness, and apathy. Those struggling with major depressive symptoms are at high risk of developing chronic physical health conditions alongside what they’re already dealing with emotionally. Major depressive symptoms must be present for more than 2 weeks in order for an individual to be accurately diagnosed by a provider. 
• Minor depression: People with this disorder may go long periods without feeling depressed, so it can be difficult for those with minor depression to recognize that they may have a mental health condition. Minor depression has been routinely identified as a less severe form of major depression, with a higher likelihood of episodic periods, as opposed to longer stretches of depressive symptoms seen in major depression. Minor depressive symptoms must be present for more than 2 weeks in order for an individual to be successfully diagnosed by a provider. 
• Persistent depressive disorder (PDD): Persistent depressive disorder is also commonly referred to as high-functioning depression. This depressive disorder presents common depressive symptoms (low energy, poor mood, lack of motivation), but must continue for 2 years or more in order for a provider to make a professional diagnosis. PDD may go on for more than 2 years before being diagnosed, simply because people may learn to cope with their condition partially, but often without being able to cease the cycle of depressive episodes that they’re caught in.
• Bipolar disorder (manic depression): Bipolar disorder, also known as manic depression, is not a depressive disorder but can cause depressive episodes due to the mood swings that it creates. Those with bipolar disorder may feel extremely happy for a minute, and furious or dejected in the next. Manic depressive states may begin with anger but sink into sensations of hopelessness, sadness, and dejection. Manic depressive states may also catapult the sufferer into temporary periods of elation, productivity, and bliss, but untreated, a depressive episode is inevitable. 
• Seasonal affective disorder (SAD): SAD is a form of depression caused by seasonal shifts in daylight hours and temperature. Though SAD is more commonly a condition that develops in the winter, summertime SAD is also recognized, as well. The diagnostic criteria for SAD are the same as major depression, but in addition, a client’s depressed mood and loss of interest must dissipate with the arrival of a change in season, such as passing from winter to spring. An individual must have also experienced their seasonal depressive pattern for two years or more. While it’s not unheard of for those with SAD to experience depressive episodes outside of their seasonal episodes, there must be a significantly lower amount.
• Psychotic depression: This disorder is a subtype of major depression, but with features of psychosis—including visual and auditory hallucinations, inability to move, and an altered sense of time. Psychotic depression is perhaps the most serious of all depressive disorders because the potent combination of derealization and poor mood can increase the risk of self-harming behaviors or further psychosis. 
• Peripartum depression (formerly known as postpartum depression): Peripartum depression affects women who’ve given birth; those who underwent caesarian sections or had a miscarriage are at higher risk. This disorder can onset immediately or months after childbirth and is associated with chemical imbalances which may take some time to reset post-childbirth. Childbirth is also incredibly taxing on a woman’s body, and the changes in appearance and energy levels may affect their self-esteem and confidence, too. 

These different types of depression each create significant mental health challenges for those who are suffering from them. The corrosive chemical effects of depression on the body release cortisol and other harmful compounds into the bloodstream, which increases bodily inflammation. Depression can affect the body and mind in many different ways, including but not limited to: 

• Increased inflammation
• Difficulty concentrating (depression and ADHD may be comorbid disorders) 
• Increased fatigue, or conversely, difficulty sleeping
• Poor mood—specifically overwhelming sadness, apathy, or a dull sense of anger
• Anxiety, which is often linked to neglected duties or responsibilities as a result of being depressed
• Decreased libido and other types of sexual dysfunction

Depression also has a chemical basis, meaning that some people may develop symptoms of depression due to a brain chemistry imbalance. For others, being depressed may actually contribute to a deficiency in the chemical compounds that help regulate mood within the brain. The chemical nature of depressive disorders (as well as other mood disorders) means that depression treatment involves addressing not only the emotional fall-out but the physical effects, too. 

What Is High Functioning Depression?

High-functioning depression (also known as persistent depressive disorder) is a state in which the individual suffering from depression has somewhat learned to cope with their depression, whether healthily or not. High-functioning depression isn’t a singular condition; instead, it’s a term for a client or untreated individual who has managed to stave off the worst potential symptoms of depression but is still suffering. It’s called “high-functioning” depression because the individual is able to accomplish their daily tasks and responsibilities, despite what they may be enduring. 

People with high-functioning depression may not want to nor see the need to access professional depression treatment, but a therapist or provider’s help is the only sure-fire method for curing or managing depressive disorders. 

Signs of high-functioning depression include: 

• Poor eating and sleeping habits
• Low self-esteem 
• Lack of desire to connect socially with others
• Fatigue or even insomnia
• Feelings of hopelessness, self-harm, or anger
• Difficulty concentrating
• Turning to drugs or alcohol to cope with emotional distress

Additionally, DSM-5 criteria mandates that symptoms must be present for at least 2 years in order for an individual to be diagnosed with persistent depressive disorder.

Who Is Most at Risk for Developing Depression?

Those who are at most risk of developing depression include: 

• People with a family history of mental health conditions, especially depressive disorders
• Individuals who are already suffering from another type of mood disorder
• People with a past history of trauma or abuse
• Those with chronic physical ailments such as COPD or diabetes
• People who have suffered a brain injury or have imbalances in their brain chemistry
• Those with low self-esteem or chronic anxiety 
• People with a history of self-harm, especially teens 

Additionally, individual factors or life circumstances or transitions may make someone more susceptible to developing depression. The best way for people of all walks of life to gauge their full risk of developing a depressive disorder is to talk with a mental health professional who can evaluate and diagnose them. 

What Are the 3 Levels of Depression?

The three levels of depression refer to the severity of an individual’s depressive symptoms. The three levels of depression are typically classified as: 

Mild: The lightest depression symptoms typically appear at the beginning stages of depression, and include low self-esteem, fatigue, sadness, and irritability. Mild symptoms can also occur during depressive episodes, or either at the beginning or end. Mild symptoms may seem less concerning, but over time they can cause significant emotional and physical harm if left untreated. 

Moderate: These types of symptoms may be presented as somewhat disruptive to everyday functioning and quality of life. Moderate depression symptoms include chronic pain, fatigue, poor mood, and lack of social engagement. Moderate symptoms have also likely had more than 2 weeks to develop. 

Severe: The most invasive and disruptive symptoms are classified as severe. Severe depression may manifest as extreme lack of appetite, complete disregard for personal hygiene, and loss of daily functioning, resulting in job loss or breakdown in personal relationships. 

Depression treatment can also vary, depending on the 3 levels of depression. 

Depression symptoms, especially if moderate or severe, may lead to an increased risk of: 

• Cardiovascular disease
• Nerve damage
• Dementia 
• ADHD
• Chronic nerve pain
• Unhealthy weight loss or weight gain, outside of an individual’s healthy body mass index
• Gastrointestinal issues
• Joint pain
• And many other issues

Research into depression has continued to draw a link between depressive symptoms and physical ailments. The correlations and long-term effects make the need for professional depression treatment all the more urgent. 

What Happens During a Depressive Episode?

A depressive episode occurs when someone suffers a dramatic dip in their emotional state, which results in a depressed mood. A depressive episode will often vary in severity and length and can be the result of any of the depressive disorders listed above. Many of those who have suffered a depressive episode report experiencing: 

• Difficulty concentrating or remembering things
• Shifts in sleep patterns (oversleeping or insomnia)
• Intrusive thoughts related to self-harm or fantasies involving death
• “Ghost” pains that do not seem to have a physical cause
• Intense sadness, feelings of being overwhelmed, or numb
• Uncharacteristic irritability or frustration
• Loss of interest in hobbies, socializing, or sexual activity

Depressive episodes should be taken seriously, as untreated depression can severely harm a person’s emotional well-being, physical health, and ability to support themselves financially. Even though concerned onlookers may not know what to say to someone who is depressed, and may believe that a depressive episode is something that can be “walked off” or “powered through”, the truth is that depression is both a physical and emotional experience. As such, healing requires professional treatment, like any other health condition.

Do I Have a Type of Depression?

If you’ve noticed any of the above symptoms for longer than 2 weeks, you could be suffering from a form of depression. You might benefit from talking with a mental health professional about what you’re experiencing, as well. The first step of professional depression treatment is an initial evaluation, in which you’ll be screened for depressive symptoms, and will work with your provider to answer a questionnaire.

Psychologists most often help those with depression by: 

• Using talk and behavioral therapies to implement coping strategies for clients 
• Creating a professional, more conversational connection with their client to better understand their depression 
• Serving as a verbal and emotional buffer and empathetic outlet for those burdened by this mood disorder

Psychiatrists, on the other hand, are: 

• Medical doctors who are also licensed to conduct therapy sessions 
• Able to use helpful prescription medicine to assist people in mitigating their depressive symptoms
• May also use therapeutic techniques as needed 

Depending on your circumstances, your friends, romantic partners, or family members may also be asked to provide details about your past experience with depressive episodes. Your initial evaluation may be conducted with a therapist or psychiatrist; but depending on the severity of your symptoms, you may either continue to receive depression treatment from the same provider, or be referred to someone with a different clinical background, or a specialist.

Why Do Humans Get Depressed?

There’s no clear or single definitive answer to why humans get depressed. But what is notable is that depressive disorders are significantly more common in first world countries than in third world countries. Some research also indicates that our modern lifestyle doesn’t offer the natural forms of stress relief and emotional release that humans used to have, alongside increasing levels of pollution, processed foods, and urban crowding. These factors may contribute to increased rates of depressive disorders and other conditions widely seen in countries around the globe. 

Besides evolutionary factors, life events or circumstances may contribute to someone developing depression, such as: 

• The death of a family member, friend, or romantic partner
• Being diagnosed with a terminal or chronic illness 
• The loss of a job or relationship
• A partner’s infidelity
• Unhealthy family dynamics
• A toxic work environment
• Bullying (in children and adolescents)
• Loneliness

Humans may become depressed due to an array of issues—and the same event or situation may affect one individual far differently than the next, and vice versa. Depression is a serious mental health condition that requires professional care. Without proper treatment, the risk of self-harm, job loss, relationship deterioration, and physical health issues increases each day. 

Though each type of depressive disorder varies in severity and its causes, treating each of them revolves around the same goal: To restore a client’s quality of life and help them to minimize the potential harm that depressive disorders may cause while learning to cope in healthy and effective ways.