Types of Depression – Depression caused by anxiety

All of us feel worried or depressed at least sometimes during life. Loss of someone you love, going through a divorce or a break up, change of job or place of living all these can be the reason for a person to feel unhappy, isolated, anxious and even depressed. These are normal feelings faced by all of us in everyday lives. But there are some people who experience these feelings of depression frequently and regularly for somewhat no obvious reason, making it hard for them to go on with everyday lives and activities. These people are suffering from depression.

Depression is defined as a condition when an individual feels disheartened, hopeless, uninterested, and helpless with life in general. If these feelings last for a short period of time it is not a case to concern however when such feelings of hopelessness with life last for a long period say more than a month and when such feelings start to disturb everyday activities in a an individual’s life like work and family, it’s to be treated as a major depressive episode.

Depression caused by anxiety

Depression caused by anxiety

Any type of depression is a curable disorder that disturbs the way an individual thinks, feels, behaves, and how he performs his activities. There are three key types of depressive disorders major depression, persistent depressive disorder, and bipolar disorder and all of them can be combined with anxiety disorders.

Major Depression

Major depression affects a person for a longer period of time. It has specific symptoms like sleeplessness or Excessive sleeping, losing appetite or excessive eating, Anxiety, nervousness, and general feeling of   disinterest in life. Major depression can be caused by anxiety or any traumatic activity in the past, a breakup of a relationship or losing of a loved one. Some people with major depression may even feel that life is not worth living for them and some will attempt to self-harm or take away their own lives after a major depressive episode. Such people need to be taken care of a proper medical professional.

Persistent depressive disorder

This type of depression was formerly called dysthymia that commonly lasts for a period of more than two years. Even though it is less severe and serious than major depression, It involves the similar symptoms, mostly causes the individual to have very low energy. It can be expressed by a person as stress, tetchiness and inability to derive pleasure from any activity. People with this disorder often suffer from anxiety disorder as well.

Bi polar disorder

It is a rare type of disorder that a person suffers from two opposing types of feelings at different types called mania and depression. During periods of depression a person is likely to suffer from depression caused by anxiety and very likely to attempt self-harm.

Anxiety disorder is a type of mental health issue that occurs when a person is affected adversely during anxiety. It is not unusual for an individual suffering with an anxiety disorder to also suffer from any type depression or vice versa. Nearly half of the individuals detected with depression are regularly also diagnosed with an anxiety disorder. Both of these disorders are different, symptoms are very often similar such as anxiety, irritability, nervousness, restlessness, loss of interest in all activities and problems sleeping and concentrating. But both of these disorders have its own reasons and separate demonstrative and behavioral symptoms. Fortunately both the disorders are treatable, separately and together.

Persistent Depressive Disorder, Dysthymia, and Chronic Depression: Update on Diagnosis, Treatment

Since the classic descriptions, depression has been conceived as an episodic and recurrent illness. Depressive episodes with clear onset and offset and sharp contrast with one’s usual mood and behaviors are perhaps the most conspicuous feature of severe mood disorders. However, systematic studies of unselected samples have been telling a different story: a large proportion of individuals suffer from low mood, lack of interest, and other symptoms of depression chronically, with some fluctuations but no clearly demarcated episodes.1 Chronic patterns of symptoms are often under-recognized and undertreated in the community.2

This article provides an update on the diagnosis, causation, and treatment of chronic depressive problems, with a focus on the recently introduced diagnostic category of persistent depressive disorder (PDD).

Diagnosis

In DSM-III and DSM-IV, the protracted forms of depression have been conceptualized as dysthymia and by the chronic specifier of major depressive episodes. Dysthymia was characterized by milder symptoms not fully meeting criteria for MDD, but lasting 2 years or longer and meriting clinical attention because of the cumulative burden of long-standing symptoms. The symptomatic criteria for dysthymia differed in part from those for major depressive episode, with an emphasis on low self-esteem and hopelessness.

In DSM-III and DSM-IV, dysthymia was trumped by MDD and was only diagnosed if the threshold for a major depressive episode was not met in the initial 2 years of symptoms. Major depressive episodes could be specified as chronic if the full criteria were continuously met for 2 years or longer.

The validity of dysthymia and its separation from MDD has been repeatedly discussed and questioned.3 When individuals with dysthymia were followed over long periods, it became clear that most of them also developed major depressive episodes, which suggests that dysthymia and major depressive episodes are phases of the same disorder rather than separate conditions.4 Dysthymia and MDD also run in the same families and respond to the same treatments. On the other hand, both dysthymia and chronic depression are associated with more impairment, comorbidity, and suicide risk than less persistent forms of depression.5

Chronic depression and dysthymia were merged into PDD in DSM-5. This new division of depressive disorders gives more weight to duration than to severity of symptoms. DSM-5 defines PDD on the basis of the set of symptoms for dysthymia, with the assumption that most individuals who meet the full symptoms for MDD also meet criteria for dysthymia. However, because of differences in symptomatic criteria, some individuals with chronic major depressive episodes will not meet the DSM-5 criteria for PDD.6

While the merger of dysthymia and chronic depression into PDD is well justified by their strong sequential comorbidity and similar implications for prognosis and treatment, several aspects of the new diagnosis are not well supported by evidence and may not be useful. Why do we need 2 different sets of symptomatic criteria for MDD and PDD? The reliability and validity of the dysthymia criteria has not been formally tested, prompting concerns about the value of the new diagnosis.3

The assumption that most individuals with chronic depression also fulfill the dysthymia criteria may not hold consistently enough—it creates a group of individuals who suffer from chronic depression but do not receive the PDD diagnosis. While it is undisputable that prolonged duration and nonepisodic character are relevant, there is no good justification for the 2-year cutoff. In fact, some of the work used to justify the validity of persistent depression is based on a duration of 1 year or longer.7 For clinical and prognostic purposes, it is important to emphasize that duration of depressive symptoms is important both below and above the 2-year mark regardless of whether the depression or dysthymia/PDD criteria are met.