Depression: What Does It Mean to Have a Mood Disorder?
Medically reviewed by Kira Graves, PhD
Depression is a mental health disorder. A depressed mood is a symptom, while depression is a clinical disorder consisting of a constellation of symptoms. Having depression can alter your emotions, behavior, thoughts, and relationships.
There are multiple types of depressive disorders. The most well-known is major depressive disorder (MDD). There are subtypes of MDD, as well as depression, due to comorbidities (co-occurring conditions), life events, hormonal fluctuations, and more.
In this article, learn more about depression and its subtypes.
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Understanding What Depression Is (and Isn’t)
Depression is a common and serious mental health disorder that affects 18.5% of adults in the United States during their lifetime.
Feeling sad and losing interest in previously enjoyed activities are symptoms of depression. However, depression can also affect your behavior and functioning, causing changes in your appetite, sleep patterns, and social interactions.
Symptoms Can Last or Come and Go
Depression is an episodic condition, meaning its symptoms can come and go. A depressive episode lasts an average of six to seven months, although everyone's experience is different. Episodes could be as short as two weeks or last over a year.
Some people experience repeated depressive episodes throughout their lifetime, whereas others only experience one. In some cases, depression may be continuous or chronic (long-lasting).
Sadness and Depression Are Different
Depression is not the same thing as feeling sad. Depression symptoms go beyond emotions; they can affect various areas of your life, such as your relationships, work, and sleep. Unlike fleeting sadness, depression must last a minimum of two weeks and be accompanied by several other symptoms for diagnosis.
Depression can structurally change the brain in areas of the hippocampus, frontal lobe, temporal lobe, thalamus, striatum, and amygdala.
DSM-5 Classification
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the handbook healthcare professionals use to diagnose mental health disorders. "Depressive disorders" is one category within the DSM-5.
To be diagnosed with MDD or another depressive disorder, you must have five or more of the below symptoms for at least two weeks:
Change in appetite or weight loss
Depressed mood
Difficulty concentrating and making decisions
Fatigue
Feelings of worthlessness and guilt
Loss of interest or pleasure
Sleeping too much or too little
Slow movement and/or thoughts
Recurrent thoughts of death or suicide
At least one of the five required symptoms must be a depressed mood or loss of interest.
Related: List of Documented Psychological Disorders
The Causes Are Not Straightforward
There is no one single cause of depression. Rather, it is caused by an interplay of social, biological, and psychological factors and adverse life events (such as bereavement, trauma, and unemployment).
Your physical health can also contribute to depression. Health conditions, such as cancer, chronic pain, and substance use disorder, can influence depression.
Risk factors for developing depression include:
Current (or history of) eating disorder
Lack of social support
Low socioeconomic status
Personal or family history of depression
Serious or chronic illness
Stressful life event
Vitamin D deficiency
Types of Depression
The DSM-5 has a category called "depressive disorders," which includes multiple conditions that share the primary characteristics of depression. You can also have depression as part of another mental health condition or life event. Below are some types of depression to know.
Major Depressive Disorder
MDD—also called clinical depression—is the most common mental health condition in the United States, with about 5.7% of adults having at least one major depressive episode in the last year. You must have symptoms (including depressed mood and loss of interest) for at least two weeks to be diagnosed with MDD.
Persistent Depressive Disorder
Persistent depressive disorder (previously called dysthymia or chronic depression) is another type of depressive disorder, different from MDD.
Compared to MDD, this is a longer-term form of depression. Adults must have symptoms for at least two years, and children for at least one year. The diagnostic criteria for persistent depressive disorder request two or more of the following symptoms alongside depressed mood:
Change in appetite
Difficulty concentrating and making decisions
Fatigue
Hopelessness
Low self-esteem
Sleeping too much or too little
Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder (PMDD) is another type of depressive disorder listed in the DSM-5. This is a severe form of premenstrual syndrome (PMS) and is a mood disorder with symptoms occurring during the end of a person's menstrual cycle (right as menstruation begins).
Mental symptoms of PMDD include mood swings, irritability, depressed mood, hopelessness, anxiety, feelings of overwhelm, and loss of control.
Substance- or Medication-Induced Depressive Disorder
Sometimes, depression can result as a side effect of certain substances or medications. This could happen while taking the medication, while coming off of a medication, while intoxicated, or as a result of withdrawal.
Alcohol is the substance most commonly associated with depressive disorders, followed by cocaine and opioids. Prescription medications can also cause depression. Discuss possible side effects with your healthcare provider.
Depression as a Medication Side Effect
Examples of medications with depression listed as a possible side effect include:
Antiepileptic drugs are drugs to treat seizures. Examples include Neurontin (gabapentin) and Topamax (topiramate).
Corticosteroids are drugs to treat inflammation or autoimmune diseases. Examples include cortisone and prednisone.
Digoxin is a drug sold under the brand names Cardoxin and Digitek that is used to treat heart failure and arrhythmia (irregular heartbeat).
Immunological agents, such as interferon, are a class of drugs to treat hepatitis C, some cancers, and autoimmune disorders. Examples include interferon-alpha, interferon-beta, and interferon-gamma, all injected beneath the skin.
Isotretinoin, whose brand name is Accutane, is commonly used to treat acne.
Orilissa (elagolix) is a medication used for endometriosis pain.
In Mental Health Conditions
Before a healthcare provider diagnoses you with MDD, they must rule out depression resulting from other mental health conditions.
Some mental health conditions that share symptoms of depression include:
From Chronic Pain
Depression and chronic pain are interconnected, and having one can worsen the other. A recent study found that 1 in 20 adults in the United States have chronic pain co-occurring with either anxiety or depression.
Perinatal Depression
Perinatal depression occurs during pregnancy or the first year after childbirth (postpartum depression). This is considered a subtype of major depressive disorder. According to the DSM-5, it must begin within the peripartum period (time shortly before, during, or directly after giving birth) to be considered perinatal depression.
Factors such as hormonal changes, lack of sleep, loss of identity and routine, stress, and body changes contribute to perinatal depression.
Seasonal Affective Disorder
Seasonal affective disorder (SAD) is depression whose symptoms occur in a seasonal pattern. Symptoms typically worsen during the dark winter months, although SAD can happen during the summer months, too.
SAD is considered a subtype of MDD and, in diagnosis, is given the "with seasonal onset" specifier.
Treatment-Resistant
Finally, treatment-resistant depression (TRD) generally is regarded as depression that does not respond to two or more medication treatments.
Scientists consider TRD a possible subtype of MDD. However, it is not yet a diagnosable condition included in the DSM-5. The research on treatment-resistant depression is ongoing.
What Is It Like to Live With Depression?
Living with depression can be extremely challenging. You may feel as if you are living in a fog, unable to feel happy or motivated to do the things you used to love.
Depression can disturb your sleep and eating patterns. You may feel that getting out of bed in the morning, making a meal, getting dressed, or taking a shower are pointless.
Depression also changes how you think about yourself, your relationships, and the world. Many people feel hopeless, guilty, and less worthy and are highly critical of themselves when they have depression.
Living with depression affects your thoughts and day-to-day functioning. While it is a common mental health condition, it is serious and should be treated as such.
Related: Depression Coping Skills: Steps to Managing Symptoms
Depression Treatment Options
Depression can be severe and dangerous. The good news is that it is treatable.
Treatments for depression include:
Psychotherapy: This includes talk therapy to help change your thought patterns and behaviors. Cognitive behavioral therapy, behavioral activation, interpersonal psychotherapy, and problem-solving therapy are effective approaches in treating depression.
Antidepressant medication: A healthcare provider may prescribe medication for moderate or severe depression. Selective serotonin reuptake inhibitors (SSRIs) are the most common type of antidepressant.
Procedures: Some procedures can help severe or treatment-resistant depression, such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS).
Lifestyle changes: Certain lifestyle changes, such as exercise, journaling, and meditation, help reduce depression symptoms.
Social Support and Self-Care With Depression
It is difficult to do so when you're depressed, but it's essential to rely on social support and continue with self-care. It can help to push yourself to do the things you used to love, maintain social connections, and keep up a self-care routine, whether on your own or with a therapist's support.
How to Find Help for Depression
If you are feeling depressed, seek help. Start by consulting with a healthcare provider who can do a depression screening and possibly provide a diagnosis. Together, you will create a treatment plan, which may include therapy and/or medication.
Depression Treatment Without Insurance
Depression can be a life or death situation. And, unfortunately, it can be extra challenging to receive the help you need if you are underinsured or not insured at all. If this is true for you, know that there are resources available.
The Anxiety and Depression Association of America (ADAA) has low-cost treatment recommendations. This includes federally funded treatment centers, treatment locators, and prescription medication assistance programs.
Some therapists offer services on a sliding scale, in which rates are based on income or insurance levels. Teletherapy through phone apps may also be more affordable than traditional therapy models.
Helpline
The Substance Abuse and Mental Health Services Administration (SAMHSA) National Hotline at 800-662-HELP (4357) is another valuable resource for people in crisis or who need general support.
If you are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one is in immediate danger, call 911.
Summary
Depression is a potentially debilitating mental health condition that is much more than just feeling sad. Symptoms of depression last at least two weeks and can affect your mood, sleep, socializing, work, and self-care. There are multiple types of depressive disorder besides major depressive disorder (MDD). Talk to a healthcare provider for a diagnosis and treatment.
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