What Is Depression?
Clinical depression is a mood disorder in which overwhelming feelings of sadness, loss of pleasure, guilt, and hopelessness interfere with daily life. People with depression also suffer from sleep problems, difficulty concentrating, fatigue and low energy, changes in appetite, and recurring thoughts of death or suicide.
Types of Depression
There are different subtypes of clinical depression. They include:
- Major depression, in which at least five specific symptoms must occur for a period of at least five weeks. Episodes of major depression usually last for about 20 weeks.
- Dysthemia is chronic low-grade depression that can last for years.
- Atypical depression is characterized by the ability to temporarily experience improved mood. It is accompanied by symptoms that may include sensitivity to rejection, oversleeping, and overeating.
- Other types of depression include seasonal affective disorder, postpartum depression, premenstrual dysphoric disorder, bipolar disorder, and psychotic depression.
American Psychiatric Association Updates Treatment Guidelines
In 2010, the American Psychiatric Association released updated guidelines for the treatment of patients with major depressive disorder. Key changes to the guideline include:
- Exercise and other healthy behaviors (good nutrition, sleep hygiene, reducing use of tobacco, alcohol, and other harmful substances) are recommended for helping improve mood symptoms.
- The guidelines recommend considering maintenance drug treatment for patients who have risk factors for depression recurrence. Maintenance treatment should definitely be offered to patients who have had more than three prior depressive episodes or chronic illness
- For patients with treatment-resistant depression, electroconvulsive therapy (ECT) has the strongest evidence as a treatment, particularly for patients who have not been helped by medication. Transcranial magnetic stimulation and vagus nerve stimulation are also possible options.
Review Date: 01/27/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.