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Types
and Symptom of Depression
- In major depression, sometimes referred to as
unipolar or clinical depression, people have some or all of
the symptoms listed below for at least 2 weeks but frequently
for several months or longer. Episodes of the illness can occur
once, twice, or several times in a lifetime.
- In dysthymia, the same symptoms are present
though milder and last at least 2 years. People with dysthymia
are frequently lacking in zest and enthusiasm for life, living
a joyless and fatigued existence that seems almost a natural
outgrowth of their personalities. They also can experience major
depressive episodes.
- Manic-depression, or bipolar disorder, is not
nearly as common as other forms of depressive illness and involves
disruptive cycles of depressive symptoms that alternate with
mania. During manic episodes, people may become overly active,
talkative, euphoric, irritable, spend money irresponsibly, and
get involved in sexual misadventures. In some people, a milder
form of mania, called hypomania, alternates with depressive
episodes. Unlike other mood disorders, women and men are equally
vulnerable to bipolar disorder; however, women with bipolar
disorder tend to have more episodes of depression and fewer
episodes of mania or hypomania.5
A thorough diagnostic evaluation is needed if three to five
or more of the following symptoms persist for more than 2 weeks
(1 week in the case of mania), or if they interfere with work
or family life. An evaluation involves a complete physical checkup
and information gathering on family health history. Not everyone
with depression experiences each of these symptoms. The severity
of the symptoms also varies from person to person.
Depression
- Persistent sad, anxious, or "empty" mood
- Loss of interest or pleasure in activities, including sex
- Restlessness, irritability, or excessive crying
- Feelings of guilt, worthlessness, helplessness, hopelessness,
pessimism
- Sleeping too much or too little, early-morning awakening
- Appetite and/or weight loss or overeating and weight gain
- Decreased energy, fatigue, feeling "slowed down"
- Thoughts of death or suicide, or suicide attempts
- Difficulty concentrating, remembering, or making decisions
- Persistent physical symptoms that do not respond to treatment,
such as headaches, digestive disorders, and chronic pain
Mania
- Abnormally elevated mood
- Irritability
- Decreased need for sleep
- Grandiose notions
- Increased talking
- Racing thoughts
- Increased activity, including sexual activity
- Markedly increased energy
- Poor judgment that leads to risk-taking behavior
- Inappropriate social behavior
5 Leibenluft E. Issues in the treatment of women
with bipolar illness. Journal of Clinical Psychiatry (supplement
15), 1997;58:5-11.
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