Everybody hurts sometimes.
R.E.M.'s 1992 song "Everybody Hurts" struck a chord with adolescents and adults alike with its simple acknowledgment that everyone knows the what it's like to feel depressed. Depression in and of itself is not a psychiatric condition. But for a significant portion of the population, depressed mood and its accompanying symptoms can significantly interfere with day-to-day functioning. The World Health Organization reports that depression is responsible for a greater number of years of potential life lost (because of early death and nonproductivity during life) than any other medical or psychiatric disease.
Major Depressive Disorder, Single Episode
The Diagnostic and Statistical Manual of Mental disorders, the book that provides standard diagnosing guidelines for mental health practitioners, identifies several types of depressive disorders. Major Depressive Disorder is a mood disorder defined by at least one major depressive episode. A major depressive episode is defined as a period of at least two weeks of fairly constant depressed mood or loss of interest in most or all activities, accompanied by symptoms such as appetite or weight change, sleep changes, physical agitation or sluggishness, feeling worthless or guilty, concentration or decision-making problems, and thoughts of death or suicide. Major Depressive Disorder, Single Episode is diagnosed when there is a history of only one depressive episode.
Major Depressive Disorder, Recurrent
When there have been two or more episodes, Major Depressive Disorder, Recurrent is diagnosed.
Mild, Moderate, or Severe Without Psychotic Features
A diagnosis of Major Depressive Disorder, either Single Episode or Recurrent, is qualified by the severity of the most recent depressive episode. Episodes are evaluated for the intensity of their interference with daily functioning.
Severe With Psychotic Features
At its worst, depression can be accompanied by psychotic symptoms. These may include hallucinations (hearing or seeing things that aren't there) or delusions (thoughts that are irrational and that the person would not likely believe when not depressed). According to the American Psychiatric Association, the theme of the hallucinations or delusions is usually consistent with a depressed mood. Hallucinations are usually auditory rather than visual, with more patients hearing rather than seeing things that aren't there. Auditory hallucinations might include hearing voices criticizing the patient's character or behavior or telling her that she should commit suicide.
Postpartum Depression
Major Depressive Disorder with Postpartum Onset is diagnosed when a woman experiences a depressive episode within four weeks of giving birth. According to the Mayo Clinic website, about half of new mothers experience depressive symptoms after giving birth, while approximately 10 percent can be diagnosed with Major Depressive Disorder.
Dysthymic Disorder
The symptoms of Dysthymic Disorder are less intense than Major Depressive Disorder, but they last much longer. Symptoms of Dysthymic Disorder last for at least two years and include depressed mood, appetite and sleep changes, low energy and self-esteem, concentration problems, and hopelessness. None of these symptoms are severe enough to diagnose Major Depressive Disorder. The DSM-5 Task Force of American Psychiatric Association is considering changing the name from Dysthymic Disorder to Chronic Depressive Disorder. The new Diagnostic and Statistical Manual of Mental Disorders is scheduled for publication in 2013.
References
- American Psychiatric Association DSM-5 Development
- "Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition (DSM-IV)"; American Psychiatric Association; 1994.
- MayoClinic.com
- World Health Organization
