Monday, 21 September 2009

Other Types of Depression

So if you read the first on depression, you know what clinical depression is, the symptoms and some of the possible causes. But there are other types of unipolar depression too.

Dysthymia (or Dysthymic Disorder) is a form of depression which is less severe than major depression, but which is chronic and persistant. People are diagnosed with Dysthymia if they have felt depressed more than half of the time for at least two years, but their depressed mood is either not severe enough to justify a diagnosis of clinical depression or it only occurs in shorter episodes. However, it's common for Dysthymia to lead to a diagnosis of clinical depression: 75% of people with Dysthymia will go on to develop clinical depression within 5 years of being diagnosed.

The diagnostic criteria are as follows:
A. Depressed mood more than half the time for at least 2 years.
B. When depressed, two or more of the following symptoms are present:
(1) Appetite increased or decreased
(2) Sleep increased or decreased
(3) Fatigue
(4) Poor self-image
(5) Attachment to relatives other than parents
(6) Concentration and decisiveness decreased
(7) Feelings of hopelessness or pessimism.
C. During the 2-year period, symptoms were not absent for 2 months or longer.
D. During first 2 years, the patient has not had a Major Depressive Episode
E. Patient has never had a manic, hypomanic or mixed state.
F. Patient has never met the criteria for Cyclothymia

Seasonal Affective Disorder
Seasonal Affective Disorder (SAD) is a condition which is characterised by normal mental health most of the year, with symptoms of depression only occuring during the winter months. The symptoms normally begin in September and get worse as the winter progresses, starting to go away in early spring. Up to eight in 10 people experience some tiredness, increased appetite or anxiety in the winter months because of the low levels of bright light. When light enters the eye, it stimulates nerve impulses to travel to the hypothalamus - the part of the brain which controls mood, appetite, sleep, temperature and sex drive. So when light levels decrease in the winter, all of those things are affected.

Light therapy has been shown to be effective in up to 85 per cent of diagnosed cases of seasonal affective disorder. It involves sitting in front of a special lamp or light box which is about ten times brighter than normal household lighting. In mild cases just making the effort to spend time outside in the daylight may be of benefit. In severe cases, antidepressants may be used, but this is not ideal because they can make some of the symptom, like sleep problems, worse rather than better.

In some rare cases people experience a form of SAD in the summer months. The symptoms of Summer SAD are pretty much the opposite, including insomnia, weight loss, agitation, reduced appetite, irritability and increased sex drive.

Postnatal Depression
Also known as Postpartum Depression (PPD). PND is a type of depression which affects many women after they give birth. It can start at any time within a year of the birth, but it most commonly starts in the first 4-6 weeks. As many as one in ten new mothers experience PND, often without recognising it, and the longer the illness goes untreated, the longer it's likely to last. PND is a temporary and very treatable condition.

If you have any of the following warning signs, it's vital that you seek medical attention as soon as possible, or report your feelings to your health visitor.
  1. Feeling very sad or low, crying a lot.
  2. Feeling very tired, or 'numb' and not wanting to do anything or not having interest in the baby.
  3. Feeling hopeless and like you can't cope, and feeling very guilty as a result. 
  4. Feeling like you're not attached to your baby, or thinking that you're a bad mother because you don't love your baby enough.
  5. Being unusually irritable, which may make you feel even more guilty.
  6. Having problems sleeping 
  7. Losing your appetite
  8. Losing interest in sex
  9. Being hostile or indifferent to your partner or your baby
  10. Feeling very anxious, worrying constantly about the baby or your own health, or having panic attacks
  11. Feeling unable to concentrate or finding normal tasks overwhelming
  12. Thoughts about death or suicide
Thoughts about death can be very frightening, and may make you feel as if you are going mad or completely out of control. These feelings are common, and they don't automatically mean that you will hurt yourself or your baby, but it is extremely important that you talk about them. Many women are afraid to talk to anyone about their symptoms, out of fear that their baby might be taken away or they may be labelled a bad mother, but it's very important that you do get treatment. Doctors and health visitors deal with PND all the time; they won't judge you for it.

It's now becoming recognised that fathers can also suffer from depression after the arrival of a new baby, especially if the mother is suffering from PND. Having a new baby brings lots of stressful changes, like increased responsibility, worrying about the cost of raising a child, changes in the relationship between the parents, having more stress and jobs to do at home as well as not having as much sleep. Men sometimes feel hostile and angry when they are depressed, and this can lead to guilt, plus home visitors or health workers might be critical of them or see them as potentially violent. Again, symptoms should be discussed with a doctor as soon as possible to prevent harm to the child or to the relationship between father and mother.

The Mental Health Foundation
Internet Mental Health

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