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Decoding Depression- Common Variations

By Girish Banwari, Psychiatrist


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Girish Banwari
Psychiatrist


March 12, 2019

Depression, like most other conditions, can manifest in varying intensity and scope. Depression is of many forms. Generally, we talk about Unipolar Depression or Major Depressive Disorder. Other commonly seen forms of depression are as follows:

Bipolar Depression: This is a major disorder, characterized by extreme mood swings, as the name suggests. A person can move from elation and euphoria to complete withdrawal from all normal activities. During a ‘manic’ episode, they will be on a high – extremely talkative, happy, uninhibited and sexually active. – and then, during the ‘depressive’ episode, they will fall into an all-time low, unable to carry out even routine activities.

Bipolar depression is essentially biological in origin; though stressful life events can aggravate the condition. It is often manifest in highly creative people. The depth of emotions they undergo during their ‘lows’ is given expression during their ‘high’ phases. This has helped reduce the stigma associated with the condition to a large extent, giving it an aura of respectability. However, it should be noted that about 1% of those who suffer from bipolar depression become deranged, making them dysfunctional.

Atypical Depression: Apart from the usual signs like fatigue, restlessness and low moods, this disorder ‘involves several specific symptoms, including increased appetite or weight gain, sleepiness or excessive sleep, marked fatigue or weakness, moods that are strongly reactive to environmental circumstances, and feeling extremely sensitive to rejection’.

Seasonal Affective Disorder (SAD): SAD is a type of depression related to changes in seasons. It usually occurs in winter, though there are people who go through SAD in the spring or early summer. Instead of dismissing SAD as ‘winter blues’ and trying to forge ahead, it is advisable to take steps to keep oneself from feeling low.

Post-Partum Depression (PPD): PPD is a mood disorder that affects women after childbirth due to a combination of physical and psychological factors. The resultant extreme sadness, anxiety, and exhaustion make it difficult for them to even take care of themselves and their newborn child.

Premenstrual Dysphoric Disorder (PMDD): PMDD is a severe and often disabling form of PMS (premenstrual syndrome) that affects approximately 5% of women. The changing levels of hormones (oestrogen and progesterone) during the menstrual cycle trigger physical and psychological changes in women with PMDD. They experience irritability, mood swings (emotional lability), headache, depression, and anxiety a week before the onset of their periods (menses). Physical symptoms include a sense of bloating, breast pain, joint or muscle pain, and weight gain among others.

Depression in Adolescents: The symptoms of adolescent depression vary from those of adults. Missing school, falling grades and clinging to parents are all signs of distress. In older children, depression also manifests in impulsive behaviors including rash driving, sexual promiscuity, and substance abuse. The latter gives them the feeling of confidence they badly need, however transitory and false it is. However, it also perpetuates the existing depression, throwing the child into a vicious cycle they find hard to get out of.

Very often, those who are going through such disorders try to somehow manage their condition rather than approach a professional. This is especially true when it comes to ‘female disorders’ such as PPD and PMDD. “However, self-management is neither helpful nor advisable here. Each of the conditions discussed above is clinically significant, and calls for professional intervention.” Lifestyle modification is a must, but it should happen alongside professional treatment (medication/therapy).

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