Types of Depression and How to Recognize Them

Medically Reviewed by Jabeen Begum, MD on July 11, 2024
Written by Debra Fulghum Bruce, PhD, Angela McPhillips
10 min read

It's normal to feel down once in a while, but if you're sad most of the time and it affects your daily life, you may have clinical depression. It's a condition you can treat with medicine, talking to a therapist, and making changes to your lifestyle.

There are many different types of depression. Events in your life cause some, and chemical changes in your brain cause others.

Whatever the cause, your first step is to let your doctor know how you're feeling. They may refer you to a mental health specialist to help figure out the type of depression you have. This diagnosis is important in deciding the right treatment for you.

The following are some of the common types of depression:

You may hear your doctor call this "major depressive disorder" or "clinical depression." You might have this type if you feel depressed most of the time for most days of the week. Major depression is the most common and severe type of depression.

Some other symptoms you might have are:

  • Loss of interest or pleasure in your activities
  • Weight loss or gain
  • Eating more or less than usual
  • Feeling sleepy all the time or having trouble falling asleep
  • Feeling restless and agitated, or very sluggish and physically or mentally slow
  • Being tired and without energy
  • Feeling worthless or overly guilty
  • Trouble concentrating or making decisions
  • Thoughts of suicide, attempting suicide, or having a plan to end your life

Your doctor might diagnose you with major depression if you have five or more of these symptoms on most days for 2 weeks or longer. At least one of the symptoms must be a depressed mood or loss of interest in activities.

Major depression looks different in different people. Depending on how your depression makes you feel, it could be:

Anxious distress. You feel tense and restless most days. You have trouble concentrating because you’re worried that something awful could happen, and you feel like you might lose control of yourself.

Melancholy. You feel intensely sad and lose interest in the activities you used to enjoy. You feel bad even when good things happen. You might also:

  • Feel extremely hopeless and sad, especially in the morning
  • Lose weight and have little to no appetite
  • Sleep poorly and have early morning wake-ups
  • Have suicidal thoughts

Mixed. You feel uneasy most of the time. You may also:

  • Talk a lot
  • Move for no reason, such as fidgeting with your hands and pacing around the room
  • Act impulsively

Talk therapy, also called psychotherapy, can help. You'll meet with a mental health specialist who will help you find ways to manage your depression. Medications called antidepressants can also be useful. Treating depression with both talk therapy and medication is more effective than either treatment alone.

When therapy and medication aren't working, other options your doctor may suggest are:

  • Electroconvulsive therapy (ECT)
  • Transcranial magnetic stimulation (TMS)
  • Vagus nerve stimulation (VNS)

ECT uses electrical pulses, TMS uses a special kind of magnet, and VNS uses an implanted device. All are designed to stimulate certain areas of brain activity. This helps the parts of your brain that control your mood work better.

If you have depression that lasts 2 years or longer, it's called persistent depressive disorder, or PDD. This term is used to describe two conditions previously known as dysthymia (low-grade persistent depression) and chronic major depression.

You may have symptoms such as:

  • Change in your appetite (not eating enough or overeating)
  • Sleeping too much or too little
  • Lack of energy, or fatigue
  • Low self-esteem
  • Trouble concentrating or making decisions
  • Feeling hopeless

You may be treated with psychotherapy, medication, or a combination of the two.

Someone with bipolar disorder, which is also sometimes called "manic depression," has mood episodes that range from extremes of high energy with an "up" mood to low "depressive" periods.

When you're in the low phase, you'll have the symptoms of major depression.

Medication can help bring your mood swings under control. Whether you're in a high or a low period, your doctor may suggest a mood stabilizer, such as lithium.

The FDA has approved three medicines to treat the depression phase:

  • Latuda
  • Olanzapine-fluoxetine combination
  • Seroquel

Doctors sometimes prescribe other drugs "off label" for bipolar depression, such as the anticonvulsant lamotrigine or the atypical antipsychotic Vraylar.

Traditional antidepressants are not always recommended as standard treatments for bipolar depression. That's because there's no proof from studies that these drugs are more helpful than a placebo (a sugar pill) in treating depression in people with bipolar disorder. Also, for a small percentage of people with bipolar disorder, some traditional antidepressants may increase the risk of causing a "high" phase of illness or speeding up the frequency of having more episodes over time.

Psychotherapy can also help support you and your family.

Disruptive mood dysregulation disorder (DMDD) is a childhood depressive disorder in which children and adolescents (age 6 to 18 years) have frequent, intense anger outbursts and ongoing irritability.

The symptoms are so severe they cause problems at home and school. Getting along with peers is difficult. Symptoms usually start between the ages of 6 and 10 years. A child must experience these intense symptoms for 12 months or more to be diagnosed with this condition.

DMDD is generally treated with:

Psychotherapy, or talk therapy. Forms include cognitive behavioral therapy and parent training. Your doctor might recommend treating your child (aged 6-12) with psychotherapy, followed by medication if needed.

Antidepressants. Treatment for adolescents (aged 12 to 18) is usually a combination of antidepressants and psychotherapy.

Seasonal affective disorder (SAD), also known as major depressive disorder with seasonal pattern, is a period of major depression that happens when seasons change. Most people experience SAD during the winter months, when the days grow short and you get less and less sunlight. It typically goes away in the spring and summer.

You're more likely to have this disorder if you live further from the equator, such as in northern areas like Alaska or New England. Although, it’s difficult to know just how many people experience SAD because it is often undiagnosed and unreported.

Serotonin and melatonin are hormones, or chemical messengers, that help your body regulate its daily sleep-wake rhythm. Problems with these hormones are thought to cause SAD. Less sunlight during the winter months causes your body to make too much melatonin and too little serotonin. These hormone changes make it difficult for your body to adjust to shorter days and lead to sleep, mood, and behavioral difficulties.

If you have SAD, antidepressants and light therapy may help. During light therapy, you'll need to sit in front of a special bright light box for about 15-30 minutes each day. Your doctor may also recommend psychotherapy or vitamin D, which may increase your serotonin level.

People with psychotic depression, or depressive psychosis, have the symptoms of major depression along with "psychotic" symptoms, such as:

  • Hallucinations (seeing or hearing things that aren't there)
  • Delusions (false beliefs)
  • Paranoia (wrongly believing that others are trying to harm you)

A combination of antidepressant and antipsychotic drugs can treat psychotic depression. ECT may also be an option.

Prenatal depression happens during pregnancy and causes ongoing or extreme sadness. Your hormone levels change during pregnancy. These changes can affect your mood leading to depression symptoms that last longer than a few days. You'll need treatment to improve your symptoms. 

This condition is most common in people who:

  • Have a history of mental illness.
  • Are dealing with stressful life events on top of pregnancy.
  • Have an unsupportive partner, no partner, or general lack of support.
  • Have an unexpected/unplanned pregnancy.
  • Are carrying a child with a health problem or special needs.
  • Are expecting twins or triplets.
  • Had trouble getting pregnant due to infertility.

Symptoms of prenatal depression include:

  • Loss of appetite and weight changes not due to pregnancy
  • Loss of interest in activities you enjoy
  • Irritability
  • Feelings of sadness or hopelessness
  • Anxiety
  • Physical symptoms (not from a health problem), such as headaches, muscle aches, or nausea.

Lifestyle changes may help. Things such as exercise, good nutrition, and plenty of sleep may improve your symptoms of prenatal depression. Your doctor may also recommend psychotherapy and medications.

People assigned female at birth who have major depression in the weeks and months after childbirth may have postpartum depression (PPD), also called peripartum or postnatal depression.

PPD is much more severe than baby blues, which are normal feelings of worry and sadness that last only a few days after giving birth. If you feel very sad, hopeless, or anxious for longer than 2 weeks after having your baby, you may have postpartum depression. These feelings are so intense that you may have trouble bonding with your baby and going about your everyday life. Don’t ignore these symptoms. Your doctor can help you get the treatment you need.

Postpartum psychosis is a rare but severe form of depression that needs immediate treatment. If you experience hallucinations (see things that aren’t there), delusions (firmly believe in something untrue and not real), or thoughts of hurting yourself or your baby, call 911 right away.

If you have postpartum depression, you are not alone. About 1 in 7 mothers experience this disorder. Your doctor may recommend a combination of counseling, support groups, and medications such as antidepressants to treat your symptoms. Hormone therapy is also an effective treatment for PPD.

People assigned female at birth with premenstrual dysphoric disorder (PMDD) have depression and other symptoms the week or two before the start of their period. This mood disorder is more severe than premenstrual syndrome (PMS) and interferes with daily life. But you usually start to feel better a few days after your period starts.

Besides feeling depressed and overwhelmed, you may also have:

  • Mood swings
  • Irritability
  • Severe anxiety
  • Trouble concentrating
  • Fatigue
  • Change in appetite or sleep habits

Antidepressant medication or hormone therapy can treat PMDD. Your doctor may also recommend diet and lifestyle changes, such as regular exercise to improve your mood.

This isn't a technical term in psychiatry. But you can have a depressed mood when you're having trouble managing a stressful event in your life, such as a death in your family, a divorce, or losing your job. Your doctor may call this "stress response syndrome."

Psychotherapy can often help you get through a period of depression that's related to a stressful situation.

This type is different from the persistent sadness of typical depression. It is considered to be a "specifier" that describes a pattern of depressive symptoms. If you have atypical depression, or major depressive disorder with atypical features, a positive event can temporarily improve your mood. This is known as "mood reactivity."

Other symptoms of atypical depression include:

  • Increased appetite
  • Sleeping more than usual
  • Feeling of heaviness in your arms and legs
  • Oversensitive to criticism

Antidepressants can help. Your doctor may suggest a type called selective serotonin reuptake inhibitors (SSRIs) as the standard treatment.

They may also sometimes recommend an older type of antidepressant called monoamine oxidase inhibitors (MAOIs), which have been well-studied in treating atypical depression.

About 1/3 of people treated for depression try several treatment methods without success. If that’s you, you might have treatment-resistant depression. There are many reasons your depression might be treatment-resistant. For example, you might have other conditions that make your depression difficult to treat.

If you’re diagnosed with treatment-resistant depression, your doctor might recommend some less conventional treatment options. Electroconvulsive therapy (ECT) is sometimes helpful in this situation.

ECT is a medical procedure in which small electric currents are sent through your brain. This triggers a short seizure, which causes brain changes that can improve your mood.

Treatment-resistant depression does not mean that your depression can’t be treated. Instead, your doctor will work closely with you to try a few different medication combinations and medical procedures such as ECT. They will also recommend continued psychotherapy with a therapist you click with.

Depression is a mental health condition that is more than feeling sad from time to time. It’s a condition that makes everyday life difficult because of intense feelings of sadness and hopelessness that last 2 weeks or longer. Your doctor will diagnose your specific type of depression and come up with a treatment plan that may include antidepressant medication, psychotherapy, or electroconvulsive therapy. Lifestyle changes such as exercise and good nutrition may also improve your mood.

What is the hardest type of depression?

Your experience with depression is unique. One type of depression is not harder than another; instead, it depends on your individual experience with the disorder. Things that make depression easier to manage are regular follow-up care with your doctor and following your treatment plan. This may include taking antidepressant medication as prescribed, participating in therapy, and making lifestyle changes to improve your mood. Things such as healthy eating, regular exercise, and good sleep can help improve your depression symptoms.

What is the most severe form of depression?

Major depression, also called clinical depression, is the most severe form of depression. Overwhelming feelings of sadness, hopelessness, and guilt make it difficult to live your life. You may lose interest in activities you once enjoyed and have physical symptoms such as weight changes (gain or loss), trouble sleeping (too much or too little), and a lack of energy. There are several options to treat major depression. Treatment will help you manage these severe symptoms and improve your mood and everyday life.