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Overview of Depression

There are several different types of depression delineated in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. They all cause obvious distress and interfere with a patient's ability to function well at work, at school, and at home. Here's how the three major types of depression are defined in the DSM:

Major Depressive Disorder or Clinical Depression - the patient feels sad and lacks interest in previously pleasurable activities. This mood lasts almost all day, every day for two weeks orlonger. In addition, the patient suffers from four or more of the following conditions:

  • trouble sleeping or excessive sleeping
  • a dramatic change in appetite, often with weight gain or loss
  • fatigue and lack of energy
  • feelings of worthlessness, self-hate, and inappropriate guilt
  • extreme difficulty concentrating
  • agitation, restlessness, and irritability
  • inactivity and withdrawal from usual activities
  • feelings of hopelessness and helplessness
  • recurring thoughts of death or suicide.

Dysthymic Disorder or Dysthymia ' the patient experiences persistent depression for two or more years although, in some cases, sadness may seem to lift for a time. Still, he or she is in an almost constantly depressed mood and experiences two or more of these symptoms:

  • a decrease or increase in eating
  • difficulty sleeping or increase in sleeping
  • low energy or fatigue
  • lack of self-esteem
  • difficulty concentrating or making decisions
  • feelings of hopelessness.

Manic Depression (also called Bipolar Disorder) ' the patient experiences mood swings between two extremes, depression and mania. Some patients may only experience mania which is felt as either euphoria or irritability. Manic episodes last for at least one week during which the patient exhibits at least three (four if the maniac state is an irritable mood) of these symptoms:

  • inflated self-esteem or self-importance
  • decreased need for sleep
  • more talkative than usual or compelled to keep talking
  • racing thoughts or ideas
  • easily distracted
  • increased goal-oriented activity (social, work, sexual) or excessive movement
  • excessive involvement in potentially risky pleasurable behavior (e.g. over spending, careless sexual activity, unwise business investments).

If these symptoms are severe enough or include psychotic aspects such as hallucinations and delusions, hospitalization may be necessary to prevent the patient from hurting themselves and others.

Merln Hurd PhD; BCN, QEEGT

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merlynh@nyneurofeedback.com
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PVKelsey, LICSW

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Center for Personal Growth

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