Types of Depression: Atypical, Melancholic, Psychotic, and Others

Sometimes a person reads about depression and encounters words that seem to describe different things: atypical, melancholic, psychotic. These are forms of one disorder that differ in their set of features.

What depressive disorder is and why it has different types

Depression is not a few bad days. In depressive disorder, low mood persists for weeks or months and affects thinking, feelings, and daily life: sleep, eating, and work can become difficult, and the cause sometimes remains unclear.

Most often people speak of major depressive disorder, when depressed mood or loss of interest persists for at least two weeks and interferes with daily activities, and of persistent depressive disorder, or dysthymia — with less pronounced symptoms that usually last at least two years. Seasonal affective disorder, which comes and goes with the seasons, and depression in bipolar disorder with sharp mood swings are described separately. Other names are also encountered: clinical, unipolar depression.

Atypical depression: features

Atypical depression is a form in which, along with the typical symptoms of depression, specific features appear: increased appetite, weight gain, increased sleepiness, and emotional reactivity, that is, a stronger than usual reaction to external events. According to DSM-IV criteria, reactivity and at least two features from the list are required.

• increased appetite or weight gain;
• increased sleepiness — in contrast to insomnia in the typical melancholic variant;
• a feeling of heaviness in the limbs;
• increased sensitivity to rejection in relationships, including during remission, which impairs social activity.

Symptoms of atypical depression are often associated with the development of bipolar disorder, especially type II. In ICD-10 it is classified under the heading "other depressive episodes," noting tension, restlessness, or despair without diagnostic significance.

Melancholic depression and how it differs from atypical

Insomnia is described as a feature of the typical melancholic variant, in contrast to increased sleepiness in atypical depression.

Psychotic depression

Depression with symptoms of psychosis is a severe form in which delusions, that is, false beliefs, or hallucinations are added to the depressive symptoms: a person sees, hears, or feels things that are not there.

How a doctor determines the type of depression and when to seek help

The diagnosis is based on a conversation: the doctor asks about symptoms and family history. Symptoms must be present almost every day, for most of the day, and for at least two weeks, and one of them must be depressed mood or loss of interest in most activities.

Examinations are needed to rule out other causes: certain medications and conditions, such as viral infections or thyroid disorders, produce a similar picture. There may be a physical examination, tests, and an assessment of mental state.

If low mood does not go away for weeks, consult a doctor — many put it off for a long time, although the sooner treatment starts, the sooner it becomes easier. Depression is not weakness and not something you can simply "pull yourself together" out of.

Depression by itself is not a reason to call an ambulance; 103 or 112 — if thoughts of death or suicide appear, a feeling that life no longer has meaning, or a direct threat of harming yourself.

This text is for reference: it helps distinguish the names but does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer