Have you ever noticed that one of your friends seems really down and negative all the time? Maybe they also seem tired, irritable, and uninterested in things they used to love. When you talk to them, they have negative or bad things to say about life. Sometimes they're really angry. Most importantly, you notice that your friend has been acting like this consistently for over two weeks.
- What are depressive disorders?
- What are the different types of depressive disorders?
- What are the symptoms of depressive disorders?
- What treatments are available for depressive disorders?
The Meaning of Depressive Disorders
Depressive disorders are mental health disorders that negatively impact your life by severely lowering your mood. The four types of disorders that fall into this category are Major Depressive Disorder, disruptive mood dysregulation disorder, persistent depressive disorder, and premenstrual dysphoric disorder. People who experience a depressive disorder struggle in their daily functioning. Specific symptoms of these disorders differ, but they all share an unusually low or irritable mood.
Many people feel sadness throughout their lives, but being diagnosed with a depressive disorder is different. After a break-up, you might feel extremely sad and like your life will not get any better from that point on. As time goes by, you notice that sadness starts to ease up, and life does get better. The sadness and pain you felt at first subside, and you don’t think about that break-up as much anymore. We all have bad moments like these in our lives, but we can eventually move past the sadness. This is not the case for those who have depressive disorders. The sadness, negativity, pain, and low mood continue, even when the person wants to be happy again.
Causes of Depressive Disorders
Research is still being conducted on the exact causes of depressive disorders. A few factors seem to play a part in the risk of developing these disorders.
Genetics are a possible cause of developing a depressive disorder. If you have a close relative who had or has depression, you have a higher likelihood of also developing it. It’s not guaranteed, though; it just means that you have a higher chance of developing it.
Some research states that people who develop depressive disorders have different brain chemistry. The neurotransmitters in our brains are responsible for relaying signals between neurons. If there is a lack of certain neurotransmitters (such as serotonin), the result can be some of the symptoms of depression.
Serotonin is a chemical neurotransmitter in the brain and digestive system that plays a role in digestion, Sleep, sexual arousal, and mood. Serotonin levels that are too high or too low cause problems in functioning.
Hormones are also a possible cause, more so in women. Pregnancy (during and after), menopause, or even changing your birth control treatment can result in hormonal changes. Hormonal changes like these can lead to developing a depressive disorder. Thyroid problems that impact hormones are also linked to depressive disorders.
Risk Factors of Depressive Disorders
Your personality, characteristics of responding to stress, and ability to develop close relationships can all be risk factors for depression. If you struggle with low self-esteem or are naturally pessimistic, you could be at a higher risk of depression.
Another risk factor is your environment: what is happening around you and what has happened to you in the past. If you are a victim of abuse (sexual, physical, or emotional), you are more likely to develop a depressive disorder. Additionally, going through other traumatic events or experiencing extreme stress are risk factors.
Other risk factors include substance abuse, being a member of the LGBTQIA+ community without a strong support system, and other mental health disorders.
Depression and sadness, pixabay.com
Types of Depressive Disorders
Now that we know a little more about depressive disorders in general, we are ready to explore what each condition looks like.
Major Depressive Disorder
You've probably heard of depression, but what is a Major Depressive Disorder? Is there a difference? Think about the major depressive disorder (MDD) as the official name for depression. There are specific DSM-5 criteria that need to be met for a person to be clinically diagnosed with major depressive disorder.
MDD is one of the most prevalent mental health disorders, with around 8 percent of the American population struggling with depression. That statistic doesn't include all those who struggle undiagnosed. About 1 in every 5 Americans experience depression at some point in their lives. Around 3.8 percent of the global population is clinically depressed at a given time. Approximately 15 percent of college students are clinically depressed, which is higher than the national average. Additionally, women are about two times more likely to experience clinical depression than men.
The levels of depression in the United States are higher than the averages of other countries. Why are rates so high in the US? Is it that Americans are just more affected by this disorder? Are Americans sadder in general? It could be that because Americans have more access to mental health care, they are diagnosed more often than people in other countries.
Disruptive Mood Dysregulation Disorder
Disruptive mood dysregulation disorder (DMDD) is characterized by severe irritability and disruptions in the mood. Based on that description alone, you might know many people you could diagnose with this disorder. Just like major depressive disorder is not just being sad for a couple of weeks, DMDD isn't just being regularly annoyed at a sibling.
Outbursts
People diagnosed with DMDD experience outbursts of anger and frustration multiple times a week for a significant period of time. In addition to these outbursts, those with DMDD are irritable or angry even when not experiencing an outburst. Minor events or annoyances can cause someone with DMDD to have an outburst.
You probably have seen or know some small children who throw temper tantrums. DMDD is different. Most small children throw a temper tantrum every so often. Children with DMDD have these outbursts more frequently and intensely. They are also angry or irritable all the time, even when they are not throwing a tantrum. Think of DMDD as someone who is constantly frustrated or angry, and that anger builds up and explodes often.
Angry outbursts, pixabay.com
Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder (PMDD) is a specific type of depression connected to the menstrual cycle. Symptoms begin around 1-2 weeks before a period, start to get better once the period begins, and are gone once the period is over. Many women experience premenstrual symptoms (PMS) like cramps, bloating, and increased emotionality. Those with PMDD experience symptoms like these in addition to symptoms of depression (and sometimes also anxiety).
PMDD and PMS
PMDD symptoms must be severe enough to negatively impact life through things like social difficulties, lowered self-esteem, and decreased productivity at work. The main symptom of PMDD is depression. If you don't experience depression as part of your menstrual cycle right before and during your period, you may be experiencing PMS rather than PMDD.
Symptoms of Depressive Disorders
Two symptoms are the same in all 4 of the depressive disorders. The first is that the symptoms you are experiencing cannot be attributed to a different mental health disorder. Many disorders have symptoms that overlap with depression or behaviors that look similar to depression. It is up to the clinician to thoroughly understand all of your symptoms and make a proper diagnosis based on those. The second is that the symptoms cannot be attributed to a substance. This substance could be a drug of abuse or misuse (such as recreational drugs and alcohol) or a prescribed medication.
Symptoms of Major Depressive Disorder
Most of us are familiar with depression, but do we actually know the symptoms required to be diagnosed with major depressive disorder?
Symptoms include:
Depressed mood during most of the days in a week
Lowered interest in daily activities
Major weight loss or weight gain
Low energy/feeling tired
Difficulty concentrating
Suicidal ideation
These symptoms must negatively impact the person's life, but the person doesn't have to experience all of them. The symptoms have to be present almost every day for at least two weeks to be diagnosed with major depressive disorder. That 2-week timeframe is critical, but symptoms can also last for much longer.
Symptoms of Disruptive Mood Dysregulation Disorder
DMDD is characterized by an irritable mood that leads to frequent, uncontrollable outbursts.
Symptoms include:
Extreme temper outbursts, physical or verbal, that do not match the situation at hand
The outbursts happen multiple times a week, and in between, the person experiences a persistent irritable mood
The mood and outbursts are uncharacteristic of the person's age
Symptoms have to last for at least one year
These outbursts can happen anywhere, not just at home. Additionally, a diagnosis of DMDD is only applicable if the person is older than 6 and younger than 18. Only children and teens ages 6-17 can be diagnosed with DMDD. Notice the timeframe requirement: 1 year. A few months of these symptoms is not enough to qualify for a diagnosis.
Ted is 12. He's always irritable and often outright angry. He has a hard time getting along with anyone, no matter how old they are. Today, Ted saw that his favorite food was listed on the cafeteria's menu. He started looking forward to having his favorite food for lunch. When he got to the cafeteria, the workers told him that they had to change the menu. Ted became verbally and physically angry. He slammed his food tray, threw himself down on the floor, and started screaming and kicking.
Symptoms of Premenstrual Dysphoric Disorder
Symptoms of PMDD need to be present consistently for at least two menstrual cycles. These symptoms need to be present before the period starts, and they may also be present during the beginning of the period. The symptoms must get better once the period is over. If the symptoms persist past the end of the period, they may meet the criteria for a different disorder.
Symptoms include:
Mood swings
Low or depressed mood
Negative self-affect
Typical PMS symptoms: breast tenderness, cramps, bloating, etc.
Lack of desire to participate in daily activities
Feeling tired or lethargic
Unusually angry or irritable
Feeling more anxious than normal
Suicidal thoughts or ideation
Meriana is 21 and generally a really happy person. About a week and a half before her period begins each month, Meriana's mood changes. The change is gradual but noticeable. She becomes depressed, anxious, and easily irritated, which is very unlike her. She also becomes exhausted during the day and struggles to get through the week. She experiences typical PMS symptoms, but she also becomes very negative towards herself and life in general. Sometimes she even thinks about suicide during this time. As soon as her period starts, she starts to feel a little bit better. By the time her period is over (3-5 days), she is pretty much back to her usual self.
Sofia Aleja, pixabay.com
Persistent Depressive Disorder
Did you notice that we skipped over one of the four depressive disorders? What about the persistent depressive disorder (PDD)? Formally known as dysthymia, PDD is very similar to MDD. The main difference is that PDD lasts longer: at least two years to meet the criteria for diagnosis. PDD is a potentially lifelong type of depression.
PDD is also milder than MDD. The symptoms are similar: loss of interest in life, fatigue, changes in Sleep, low energy, and low self-esteem. None of these symptoms is as intense or severe as they are during episodes of MDD, though. An estimated 2.5 percent of American adults experience PDD at some point during their lives. PDD is a newer diagnosis that combines two older diagnoses: chronic major depressive disorder and dysthymic disorder.
You can think of PDD as chronic, mild depression that lasts a long time. Someone under age 21 diagnosed with PDD is considered early-onset, and someone diagnosed after age 21 is considered late-onset.
Symptoms include:
Depressed mood, during most days for the majority of the days in a week
Low energy
Low self-esteem
Trouble sleeping
Low appetite or eating too much
Increased difficulty making decisions
Symptoms persistent for at least two years, with no maximum number of years
Someone can be diagnosed with both MDD and PDD. Someone might temporarily experience severe symptoms that align more with MDD. If someone experiences MDD for two whole years, they would be diagnosed with PDD with a persistent major depressive episode subtype.
Treating Depressive Disorders
Feeling like life is hopeless is common in depression. There are many treatments available for depressive disorders. Therapy is an excellent treatment option. There are different forms of therapy, and you might respond to one type better than another. Multiple studies report an increase in mood after attending therapy.
Selective serotonin reuptake inhibitors (SSRIs) and a common treatment method for depression and other disorders. SSRIs are prescription medications that increase the available levels of serotonin in the body. There are many types of SSRIs available, but a common one is Fluoxetine (Prozac). Since there are different kinds of SSRIs available, if the first one you try doesn't work well for you, you can try a different one! There are also other kinds of prescription antidepressants.
Depressive Disorders - Key takeaways
- There are four depressive disorders: major depressive disorder, persistent depressive disorder, premenstrual dysphoric disorder, and disruptive mood dysregulation disorder.
- MDD is one of the most prevalent mental health disorders, with around 8% of the American population struggling with depression.
- The symptoms have to be present almost every day for at least two weeks to be diagnosed with major depressive disorder.
- Disruptive mood dysregulation disorder (DMDD) is characterized by severe irritability and disruptions in the mood.
- Only children and teens ages 6-17 can be diagnosed with DMDD.
- Premenstrual dysphoric disorder (PMDD) is a specific type of depression connected to the menstrual cycle.
- Symptoms begin around 1-2 weeks before the start of a period, start to get better once the period begins, and are gone once the period is over.
- Formally known as dysthymia, PDD is very similar to MDD. The main difference is that PDD lasts longer: at least two years to meet the criteria for diagnosis and is a chronic, milder form of depression.
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