An Assortment of Sadness: The Many Faces of Depression

Let’s go over what exactly depression is. Let’s start with what it isn’t. Depression is not just sadness...

To say someone has cancer is a very vague way to describe their condition. Someone with lung cancer will likely have a much different experience compared to someone who has skin cancer. It is easy for doctors to categorize and subcategorize these diseases because there is a better understanding of the physiological manifestations of these conditions. The same categorization happens in the mental health sphere. In our episode with Will Wheaton, we discussed many different types of depression. We’d like to take some time right now to go into a little more depth on some commonly seen forms of depression!

In order to start, let’s go over what exactly depression is. Let’s start with what it isn’t. Depression is not just sadness. Sadness is an emotion and emotions are generally used to describe a more temporary feeling. Depression is much trickier than sadness. The American Psychiatric Association defines depression as a “medical illness that affects how you feel, the way you think and how you act” (2013). Psychiatrists diagnose depressive episodes based on several factors. First, there is a presence of 5 or more of the following symptoms in a period lasting at least 2 weeks:

  1. Depressed mood for most or every day during a period
  2. Diminished interests or pleasure in some, most, or all daily activities
  3. Significant unintentional weight change or change in appetite
  4. Disturbances in sleep (sleeping too much or too little)
  5. Feelings/movements that are agitated (shaky and sped up) or slowed
  6. Lack of energy
  7. Feeling worthless or guilt
  8. Decreased ability to think and concentrate
  9. Suicidal thoughts

Second, these symptoms cause impairment or distress. Third, the depressive episode is not better explained by a different condition (“DSM-V Criteria: Major Depressive Disorder”, n.d.).

Now that we understand how a depressive episode is defined, let's discuss some of the different subtypes of depression:

Persistent Depressive Disorder:

Also called Dysthymia, Persistent Depressive Disorder (PDD) involves a depressive episode that lasts longer than 2 years. I almost think of this as “nagging depression,” the symptoms may lessen or increase, but there is a general underlying depression throughout the time period (Harvard Health Publishing, 2019; NIMH, 2021).

Seasonal Affective Disorder:

Seasonal Affective Disorder (or SAD. Poor choice in acronyms) is a condition that involves depressive episodes that occur seasonally. These episodes usually occur during the fall and winter seasons and current research suggests that the onset has something to do with changes in sun exposure. In fact, light therapy (where individuals receive UV light) has been found to produce meaningful improvements in affected patients (Kurlansik & Ibay, 2021; Mayo Clinic, 2016; NIMH, 2021)!

Postpartum Depression:

Postpartum Depression refers to a depressive episode that occurs in women who recently underwent childbirth (within the past year). This form of depression is thought to affect 10-20% of childbearing women each year (CDC, 2021; Corwin & Pajer, 2008; NIMH, 2021).

Premenstrual Dysphoric Disorder:

This is a condition that consists of short depressive episodes that occurs between ovulation and the start of menstruation. It is thought that this condition is the result of deficits in serotonin due to an atypical bodily response to changes in hormone levels (Harvard Health Publishing, 2019; Johns Hopkins, 2021).

Depression comes in all shapes and sizes and every person’s experience with depression is unique to them. The important thing to know about depression is that it is temporary! With the existing therapeutic and pharmacological innovations depression can be tackled and properly managed. If you or a loved one is depressed, know that you are not alone and there is a future where you will feel happy and well-adjusted again!

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