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Disorders of Major Depression

Feelings of loss, sadness and guilt can be common when they occur after a family death or major life event. However, a major depressive disorder diagnosis means that such feelings and other symptoms have occurred for longer than normal and are interfering with life. Major depression disorders also have subcategories that emphasize certain mental or physical symptoms.

  1. Diagnosis

    • The DSM-IV specifies the symptoms of depression. These symptoms must be present in a patient for at least two weeks and interfere with normal life. Symptoms include disinterest in life activities, constant feelings of sadness, weight loss, sleeping too long or not enough, extreme or slowed physical movement, energy loss, lack of concentration and recurring suicidal thoughts. To qualify for a major depressive episode, five of nine symptoms must be present and must include either depressed mood or loss of interest. At least one such episode can lead to major depressive disorder diagnosis.

    Dysthymic

    • Dysthymic disorder, also known as dysthymia, is a constant depression that isn't as intense as major depression. The physical symptoms are much like those of major depression, but pessimism, social withdrawal, feelings of inadequacy are the more prominent symptoms in dysthymia. Onset can occur early in life, normally before 21 years old, which can lead patients to think everything is normal. Many patients may not even seek treatment unless there are increased depression symptoms.

    Catatonic

    • Catatonic depression, a major subtype, is mostly physical in nature. Catatonically depressed patients have at least two of the following symptoms: inability to react to one's environment, purposeless excessive movement seemingly unrelated to environmental stimulus, unwillingness to speak or respond to instructions, involuntary repetitive movements, or meaningless repetition of someone's words or movements.

    Melancholic

    • Melancholic depression is another of the major depressive subtypes. In melancholic depression, depressive symptoms are concentrated on disinterest of pleasure in all activities; positive events also receive virtually no response. There are also at least three of the following symptoms present: excessive movement or slowed movement, excessive misappropriated guilt, waking up earlier than normal by at least two hours, significant appetite loss and consistently worse depression in the morning.

    Bipolar

    • Bipolar depression occurs within bipolar disorder, which is a mood-related condition. Bipolar patients experience periods of mania or hypomania that can last for weeks or months. They are followed by a period of balanced mood, and then a depressive episode that can also last for months. Depressive episodes are more chronic in bipolar 2 diagnosis. For the cyclothymic bipolar subtype, depression may only last a few days or weeks, but can return again within two months.

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