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Types of Depression

Mild depression
The person typically experiences tiredness, some early morning wakening, indecision, impaired concentration and loss of confidence. However the person will not necessarily feel depressed.

Moderate depression

Most of the symptoms of depression as listed above are present: the person feels depressed, is extremely fatigued, has marked sleep disturbance and appears to others to be depressed.

Severe depression
In addition to the symptoms of moderate depression, the person's judgement is impaired in a severe depression - i.e. they have an extremely negative and pessimistic view of their own self-worth and future prospects. Strong suicidal thoughts (or intent) will also be present.

Someone suffering a severe depressive episode may have delusions or false beliefs (e.g. that they are evil, wicked, bankrupt or terminally ill) or may suffer from hallucinations (hearing voices or having visions) with similar themes. When delusions or hallucinations are present, the depression is referred to as a psychotic episode. A small proportion of people with severe depression may have psychotic symptoms.

Bipolar disorder
Bipolar disorder involves both depressive periods and their opposite, which are known as elations or manic periods. Symptoms of the depressed phase are the same as those of unipolar depression described above:
  • Feeling sad, anxious or bored
  • Low energy, feeling tired or fatigued
  • Under- or over-sleeping, or waking frequently during the night
  • Poor concentration, thinking slowed down
  • Loss of interest in hobbies, family or social life
  • Low self-esteem and feelings of guilt
  • Aches and pains with no physical basis, e.g. chest/head/tummy pain associated with anxiety or stress
  • Loss of interest in living, thinking about death, suicidal thoughts

The symptoms of elation (mania) are:


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  • Feeling elated, enthusiastic, excited, angry, irritable or depressed
  • Increased energy, 'never felt as well', over-talkative or over-active
  • Reduced need for sleep and marked difficulty in getting off to sleep
  • Racing thoughts, 'pressure in the head', indecision, jumping from one topic to another, poor concentration
  • Increased interest in pleasurable activities, new adventures, sex, alcohol, street drugs, religion, music or art
  • Excessive and unrealistic belief in one's ability, or having grandiose plans
  • Being unaware of the physical symptoms of illness such as asthma, having muscle tension at the back of the head or round the shoulders
  • Thinking that one can live forever, taking reckless physical risks or, if angry or distressed, feeling suicidal.

Post natal depression
8 out of 10 women get what's known as the 'baby blues', often beginning within a few days of the birth, and common symptoms include bursting into tears for no reason, or feeling fantastic one minute and miserable the next. Fortunately, the symptoms only last for a short time.  However if these symptoms last for longer than a wek you may have post natal depression.

Postnatal depression affects1 in 10 new mums. You have a greater risk of developing postnatal depression if:
  • you’ve been depressed in the past,
  • there's a family history of postnatal depression or depression during pregnancy,
  • you've had a difficult pregnancy, or problems with your baby’s health,
  • you feel isolated, with nobody close to talk to,
  • you've had a recent bereavement,
  • you have little money or nowhere settled to live, or
  • you have twins or triplets, mainly because of the additional stress of caring for more than one baby.  

But postnatal depression can happen to anybody, no matter what your circumstances, and no matter how much you love your baby.

Signs to look out for
Often  postnatal depression starts within six months of the birth, but can occur any time upto a year. 

Symptoms can include:
  • crying a lot,
  • difficulty sleeping,
  • thinking you’re a bad mother,
  • not being able to cope, and blaming yourself,
  • anxiety and panic attacks,
  • being overwhelmed by even the smallest tasks,
  • feeling anxious or guilty,
  • feeling tense and irritable,
  • an inability to make decisions, and
  • poor concentration.

Getting help
If you or your family think you might be suffering from depression, it’s important to get help as soon as possible. Talk to your midwife, health visitor or your GP and explain how you're feeling. Don't wait for them to visit you.

What can they do?
Your health visitor may be able to make extra visits, so that you can talk. Sometimes the health visitors may run groups where mums who've had depression can get together and make new friends.

You can see your GP. Guidelines from the National Institute for Health and Clinical Excellence (NICE) state that you may be offered an exercise programme, psychological therapies, counselling or an antidepressant. It depends on the severity of your depression and whether you've had depression before. There are antidepressants that are safe for breastfeeding mums. Over time, with the right support and, if necessary, treatment, you'll recover.

Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder is a type of depression that has a seasonal pattern. It is characterised by episodes of depression that recur at the same time each year. SAD is sometimes known as 'winter depression' because the symptoms are more apparent during the winter.

As with other kinds of depression two of the main symptoms of SAD are a low mood and a loss of interest in ordinary things. Other symptoms of SAD include:
  • being less active
  • putting on weight
  • sleeping more

As SAD most commonly happens in winter, the symptoms are worse in the winter months. SAD sometimes affects people in the summer, although this is rare.

The symptoms of SAD often start as the days begin to get shorter in the autumn. They are worst during December, January, and February. For most people with SAD, the symptoms start to improve by spring time, then disappear.

How common is SAD?
In the UK, it is thought that SAD affects around 7% of people. It tends to affect mainly younger people, especially those in their twenties. In general affects twice as many women as men.

Outlook
Like any type of depression, SAD can be a difficult condition to live with. Symptoms can make you feel tired, stressed and unhappy. However, a number of treatments and medications are available, including:
  • light therapy: treatment with bright light
  • talking therapies: such as cognitive behavioural therapy (CBT)
  • antidepressants: medication to treat depression

Also see:-
  What is Depression?
  Causes of Depression
  Treatment for Depression


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