Do you feel sad all the time? Let's talk about the types of depression.

It's normal to feel sad and a little down at times in our lives. It's different for everyone. But if this sadness and anxiety are persistent, if you feel sad for most of the day, and if it affects you to the point where you can't do your daily activities, it may be something more than just normal sadness. In medicine, we call this condition Clinical Depression. This is a condition that can be well controlled with medication, psychotherapy, and lifestyle changes.

There are different types of depression. Some can be triggered by events in our lives. Others can be caused by chemical changes in our brains. Whatever the cause, the first step if you're feeling this way is to talk to your doctor. He or she can refer you to a mental health specialist. Identifying exactly what type of depression you have is important to determine the best treatment for you.

Major Depression

This is the most severe and common type of depression. You may have heard your doctor call it 'Major Depressive Disorder' or 'Clinical Depression.' If you feel sad or anxious most of the day, most of the time, most of the day, most of the time, you may have this condition.

These are some of the common symptoms seen in major depression.

If five or more of these symptoms persist for two weeks or more, a doctor may conclude that you have major depression.

Subtypes of major depression

The way this condition can be experienced by each person can vary, and there are several subtypes of it:

• Anxious distress: Feeling restless and anxious most of the day. Fearing that something bad will happen and feeling out of control.
• Melancholy: An unbearable sadness, with a feeling of longing for everything you once loved. You can't be happy even with good things. You feel very heavy, especially in the morning. You may lose weight and lose your appetite.
• Mixed features: Along with sadness, there is a high level of activity. Talking a lot, moving around, and acting impulsively.

Psychotherapy and antidepressants are used as treatments. Combining these two methods can achieve very good results. Sometimes, in severe cases that are not controlled by these methods, doctors may recommend specialized treatments such as `Electroconvulsive therapy (ECT)` and `Transcranial magnetic stimulation (TMS)`.

Persistent Depressive Disorder (PDD)

If you have persistent depressive symptoms for two years or more, we call it PDD. Simply put, it's like a chronic sadness. It was previously called `dysthymia.` Although it's not as severe as major depression, it can last for a long time and can take away your enjoyment of life.

A person with PDD may experience symptoms like:

• Changes in appetite (eating less or more)
• Sleep changes (sleeping too much or too little)
• Lack of energy, constant tiredness
• Low self-esteem
• Difficulty concentrating, making decisions
• A feeling of hopelessness about the future

This is also treated with psychotherapy and medication, either together or separately.

Bipolar Disorder

Some people also call this 'Manic Depression'. A person with this condition experiences mood swings between two extremes. That is, at one time they are in a high state of mania with high energy and happiness, and at the next time they suddenly fall into a state of severe depression.

During the depressed phase, that is, during the depressive phase, they have the same symptoms of major depression that we discussed earlier.

To control this state of mind, medications called `mood stabilizers` are given. There are several specific medications to treat depressive episodes. In this situation, general antidepressants are used with great caution, because sometimes they can worsen the `high' phase of the mind (mania).

Disruptive Mood Dysregulation Disorder (DMDD) in childhood and adolescence

This is a depressive disorder that occurs in childhood (ages 6-18). These children have frequent, uncontrollable outbursts of anger. They are also very irritable and restless at other times. This behavior is so severe that it has a significant impact on home, school, and even relationships with friends. DMDD is diagnosed when these symptoms are present for 12 months or more. Treatment for this includes psychotherapy and, if necessary, medication.

Seasonal Affective Disorder (SAD)

This is also a form of major depression. It occurs with changes in weather. It often occurs in the winter, when the days are shorter and the sunlight is less. It disappears when the summer comes again, when the sun is brighter.

It is believed that this is due to changes in the hormones `Serotonin` and `Melatonin`, which control our sleep and mood. When sunlight decreases, our body produces more `Melatonin` and reduces `Serotonin`. This change is what causes sadness, sleepiness, and behavioral changes. Antidepressants, psychotherapy, and especially light therapy are used as treatments for this.

Psychotic Depression

People with this condition also exhibit "psychotic symptoms" in addition to the symptoms of major depression.

• Hallucinations: Seeing or hearing things that are not really there.
• Delusions: Strong beliefs about things that are not true.
• Paranoia: The mistaken belief that others are trying to harm you.

This is a very serious condition. For this, antidepressants and antipsychotics are used together.

Prenatal and Postpartum Depression

Prenatal Depression

Hormonal changes during pregnancy can cause some women to experience severe sadness and anxiety that lasts for more than a few days. This is not normal and requires treatment. This risk is especially high in women who have a history of mental illness, who have experienced stressful events during pregnancy, and who do not have support from their partner or family.

Postpartum Depression (PPD)

This is what many people call "postpartum depression." Feeling a little sad for a few days after having a baby (the baby blues) is normal. But if you have severe sadness, hopelessness, and anxiety that lasts for more than two weeks, it could be PPD. These feelings can be so intense that it can make it difficult for the mother to bond with her baby or even function in her daily life.

The most severe and rare condition is 'Postpartum Psychosis'. In this case, the mother may experience hallucinations and thoughts of harming herself or the baby. This is a medical emergency. Immediate medical attention should be sought at a hospital's Emergency Treatment Unit (ETU).

Other depressive conditions

• Premenstrual Dysphoric Disorder (PMDD): This is a condition in which women experience severe depressive symptoms and other symptoms (such as intense anger and anxiety) in the week or two before their menstrual period. It is much more severe than regular PMS.
• 'Situational' Depression: This is not an official medical term. However, this term is used to describe a state of sadness that occurs as a result of a stressful event in our lives (e.g., death in the family, loss of a job, divorce, failure in exams). Counseling can be a great way to help us recover from this situation.
• Treatment-Resistant Depression: Some people have difficulty managing their depression even after trying several treatments. This doesn't mean you can't be cured. It just means you need to work a little harder with your doctor to find the treatment that works best for you.