What Are the Types of Depression?

Many times, when people say they have depression, it’s major depressive disorder (MDD). MDD — sometimes known as clinical depression — can cause you to experience:

• a consistently low mood
• sleep disturbances
• decreased interest in activities
• lack of energy
• guilt
• agitation
• changes in appetite
• worthlessness
• thoughts of suicide

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), to be diagnosed with major depressive disorder you need to have at least 5 of the symptoms above for at least 2 weeks.

You also need to experience a depressed mood or low interest in activities that negatively affect your social and work life.

Your doctor will need to rule out other types of depression, or periods of mania, which might indicate a diagnosis of bipolar disorder.

If you’re living with or believe you have MDD, you’re not alone. An estimated 12% of people have MDD at some point during their lifetime.

Persistent depressive disorder (PDD) is what used to be called dysthymia and chronic major depression.

Originally believed to be a personality disorder, the DSM-5 now classifies it as a type of depressive disorder.

To be diagnosed with persistent depressive disorder, you need to experience at least 2 symptoms of depression for at least 2 years, with no more than 2 months of a break in symptoms. PDD only needs to be present for 1 year in people under age 18.

Because of its persistence, and sometimes less severe symptoms, some people consider PDD “high-functioning depression.”

About 3% of U.S. people have persistent depressive disorder.

Many people with PDD feel like this is just “how they are,” but you can always benefit from speaking with a doctor about how you’re feeling. They can help you find a treatment plan and care that helps you feel better.

Premenstrual dysphoric disorder (PMDD) is a depressive disorder that’s similar to premenstrual syndrome (PMS). The difference is the severity of symptoms.

While many people who menstruate will have PMS, not everyone will develop PMDD. This type of depression most likely occurs due to dropping hormone levels following ovulation.

In order for a doctor to diagnose PMDD, you’ll have depressive symptoms during the majority of menstrual cycles, in the week before menstruation starts. The symptoms will improve within a few days of menstruation, and become minimal or disappear in the week after menstruation.

According to the DSM-5, for a diagnosis of PMDD, at least 4 of the following must be present:

• strong, variable emotions, known as affective lability
• increased irritability, anger, or conflict with others
• a depressed mood, feelings of hopelessness, or self-deprecating thoughts
• anxiety, tension, of feeling on edge

The DSM-5 also requires that 5 of the following symptoms are also present:

• reduced interest in your usual activities
• difficulty thinking or concentrating
• tiredness or fatigue
• changes in appetite or eating habits
• sleep problems
• feeling overwhelmed or out of control
• physical symptoms, such as bloating, breast tenderness, or weight gain

According to the Office of Women’s Health, about 5% of women in their childbearing years experience this condition. Many folks dealing with PMDD may also be living with major depression or anxiety.

While clinically known as major depressive disorder with seasonal patterns, many people still know this type of depression as seasonal affective disorder (SAD) or seasonal depression.

Unlike other depressive conditions, mood and behavior changes in this type of depression typically occur during certain times of the year.

For example, you may feel the symptoms starting in fall and winter, and easing in spring or summer. Many people associate SAD with the colder, darker months, but some people do experience symptoms in warmer months.

SAD is a type of major depressive disorder, meaning that it involves the same symptoms, it’s just that symptoms only occur during certain seasons, rather than throughout the year.

Some symptoms may vary depending on the months they appear. If you have summer-onset SAD, you may be more likely to notice:

• lack of appetite and weight loss
• trouble sleeping
• anxiety
• episodes of violent behavior
• restlessness
• agitation

If you experience SAD symptoms during the winter, you may be more likely to notice:

• weight gain
• oversleeping (hypersomnia)
• overeating with a preference for carbs
• withdrawing from socialization

A diagnosis of seasonal depression is based on having:

• symptoms of major depression
• episodes that occur during specific seasons for at least 2 consecutive years (though not everyone has them every year)
• episodes that are much more frequent than other depressive episodes you may have had during other times of the year or your life

Researchers don’t completely understand the cause of seasonal depression. However, serotonin and melatonin levels, as well as sunlight and vitamin D, may all play a role.

About 5% of U.S. adults experience seasonal depression, with symptoms lasting about 40% of the year. The condition also tends to affect more women than men.

Situational depression — officially known as adjustment disorder with depressed mood — occurs when you have behavioral or emotional reactions to a change in your life or particular stressor.

While it’s often referred to as a type of depression, it’s technically a type of adjustment disorder.

According to the DSM-5, symptoms appear within 3 months of the stressful situation, and involve:

• distress that’s out of proportion to the severity or intensity of the stressor, with consideration to cultural or other factors that could influence the reaction
• significant impairment to work, social, or daily functioning

In order to receive a diagnosis, your symptoms must not be the result of another mental health condition or an exacerbation of an existing condition. In addition, after the stressor or its consequences has passed, your symptoms should clear up within 6 months.

If you experience situational depression, your doctor will also specify whether it occurs with:

• depressed mood
• anxiety
• a mix of anxiety and depressed mood
• disturbing conduct
• a mix of disturbed conduct and emotions

A 2017 study estimated that about 11.5% of adolescents and adults experience the condition. If you’re younger, live in an urban setting, are a student, or live alone, you have a higher chance of developing situational depression.

If your symptoms do not resolve after 6 months, and if the event you experienced involved trauma — defined by the American Psychological Association as “an emotional response to a terrible event like an accident, rape, or natural disaster” — you might be experiencing symptoms of post-traumatic stress disorder (PTSD).

Formerly known as manic depression or manic-depressive illness, bipolar disorder is not actually considered a type of depression or depressive condition.

Bipolar disorder is a separate condition that involves extreme moods and changes in energy levels.

People with bipolar disorder may experience depressive episodes. The symptoms of these are the same as episodes in major depressive disorder.

There are three main types of bipolar disorder:

• Bipolar I disorder: People with this condition have at least one episode of mania. Many have both manic and depressive episodes.
• Bipolar II disorder: This type of bipolar disorder is marked by a pattern of depressive periods and hypomanic episodes.
• Cyclothymic disorder: Also called cyclothymia, it involves periods of mood symptoms lasting at least 2 years that don’t match the full criteria for episodes of depression or hypomania.

An estimated 4.4% of U.S. adults experience bipolar disorder at some point in their lives.

According to the Office of Women’s Health, it’s normal to feel sad or blue in the days immediately after giving birth. This feeling should pass within 3 to 5 days.

If depression, emptiness, or hopelessness doesn’t go away within 2 weeks, you may be experiencing postpartum depression, also known as major depressive disorder with peripartum onset. These feelings can interfere with your daily life and parenting.

Postpartum refers to the time period immediately following pregnancy. You may also experience peripartum depression, which refers to the time before, during, and following delivery.

There’s no consensus among organizations about how long the postpartum period is. The DSM-5 states onset of mood symptoms occurs during pregnancy or in the 4 weeks after delivery, while the World Health Organization (WHO) defines it as 6 weeks after delivery.

Symptoms of postpartum depression include:

• feeling hopeless, overwhelmed, or sad after giving birth
• not feeling connected to the baby
• low energy or motivation
• little interest in the baby
• crying frequently
• changes in eating habits
• problems with memory or decision-making
• thoughts of harming your baby or yourself
• persistent aches and pains, stomach issues, or headaches
• losing interest in activities
• withdrawing from family or friends
• feeling worthless, guilty, or like a bad mother

Your body undergoes massive physical and hormonal changes in the first few months after delivery. Research indicates that different factors can trigger postpartum depression, including:

• changes in your hormone levels following the birth of your child including drops in estrogen, progesterone, and thyroid hormones
• increased stress levels
• having complications during pregnancy and labor
• delivering a child with low birth weight
• being under age 19 when you deliver
• lack of emotional and financial support
• employment status
• level of education
• lack of sleep
• access to nutritious food
• amount of exercise

If you’re feeling sad, overwhelmed, or just not like yourself following the birth of your child, remember that this does not make you a bad parent.

About 1 in 9 people experience postpartum depression after giving birth for the first time. You may benefit from speaking to your OB-GYN about potential treatment options to help you start feeling better again.

The DSM-5 uses specifiers to provide further clarity on a condition. Specifiers help make a diagnosis more specific, which can help healthcare professionals figure out your best treatment options.

For example, you may be diagnosed with major depressive disorder, but if you experience psychosis, the diagnosis would be “major depressive disorder with psychotic features.”

The DSM-5 lists several specifiers for depression. They include:

• anxious distress: the presence of 2 or more symptoms such as tension, worry, trouble concentrating, fear of something bad happening, or restlessness
• mixed features: you meet most or all the criteria for both depressive and manic episodes, with several symptoms of depression during a manic episode
• melancholic features: a depressive mood with psychomotor changes — such as slowed or agitated movements — that are noticeable to others
• atypical features: depressive episodes occur, but exposure to positive stimuli improves your mood; specific symptoms, like increased appetite, increased sleep, and sensitivity to rejection are present
• psychotic features: you have hallucinations or delusions, often related to your depressed feelings
• catatonia: you experience depression and are unresponsive to events around you, neither moving nor speaking
• peripartum onset: another name for postpartum depression, this occurs during pregnancy or in the 4 weeks after giving birth
• seasonal pattern: another name for seasonal depression, symptoms occur due to seasonal changes

The DSM-5 also specifies diagnoses by how severe they are — mild, moderate, or severe — and if the symptoms are in partial or full remission.

There are several other mental health conditions that often occur with depression, or with similar symptoms. These include:

• anxiety disorders
• post-traumatic stress disorder (PTSD)
• complex trauma
• obsessive-compulsive disorder (OCD)
• substance use disorders

There are various treatment options for depression. You can work with your doctor or mental health team to find a plan that works best for you.

Some treatment options include:

• psychotherapy or counseling
• antidepressants
• in severe cases, hospitalization

Certain lifestyle changes and self-care techniques can also be helpful for managing your symptoms.

If you’re living with any type of depression, you’re not alone. More than 264 million people are living with depression worldwide.

There are many ways to find support and manage your condition.

You may want to start by reaching out to a doctor or healthcare professional for diagnosis or treatment options. A support group can also connect you with people who understand.

You can use the Depression and Bipolar Support Alliance’s search tool to search for local support groups near you. They also offer online support groups if that better fits your needs.