Depressive Disorders

Sadness is an emotion that we all experience from time to time. When you don’t get a job you wanted or you have a disagreement with your significant other, it’s natural to feel a bit down. However, there’s a difference between sadness and depression.

Depressive disorders (often known collectively as depression) refer to mental health conditions that cause overwhelming negative thoughts and emotions for an extended period of time. Depression can impact every part of your life, including your daily productivity, your ability to maintain healthy relationships and your self-image. It’s the leading cause of disability around the world, impacting approximately 5% of the global population. 

Depression can look and feel different for everyone, depending on the type and severity of the symptoms. Fortunately, there is hope: Every person experiencing a depressive disorder can improve their quality of life with treatment to become the person they want to be.

If you or someone you know is at risk of harming themselves or others, call or text 988 to reach the 988 Suicide & Crisis Lifeline.

Depression is often used as a blanket term for any sort of depressive episode. However, there are actually several different types of depressive disorders that a person can develop throughout their lifetime. They can vary based on cause, duration and severity: 

Major depressive disorder

The most common type of depressive disorder is major depressive disorder (MDD), which is also one of the most prevalent mental health conditions in the U.S. MDD is also known as clinical depression and refers to overwhelming feelings of sadness and hopelessness that lasts at least two weeks. It can impact your ability to regulate your emotions, find motivation to complete your daily routines and maintain interpersonal relationships.

Major depressive disorder is characterized by episodes of depression that can come and go over time. While some people only have one episode in their life, it’s possible to have recurrent depressive episodes.

Persistent depressive disorder

While MDD tends to have severe symptoms over short periods of time, with persistent depressive disorder (PDD), a person experiences mild symptoms over a longer period, and symptoms can last approximately two years. PDD used to be known as dysthymia. Despite having more low-level symptoms, it can still impact your emotional, mental and physical health.

If you have PDD, you may have low self-esteem and feel hopeless for years. People may attribute your negative symptoms to a pessimistic or aloof personality.

Postpartum depression

Having a baby is a significant chapter in a person’s life. Even so, the emotional, mental and physical toll doesn’t always go away after delivery. Postpartum depression is a type of depressive disorder that can develop up to a year after a woman gives birth. It’s characterized by low energy, intense mood changes, loss of appetite and difficulty forming a bond with one’s baby. If left untreated, it can interfere with a person’s ability to care for their child.

Postpartum depression can have many contributing causes, including lack of sleep, overwhelming stress, genetics and intense hormonal changes. There are also risk factors of having other mental health conditions or a lack of a support system.

Premenstrual dysphoric disorder

Even though many women experience premenstrual syndrome (PMS), it’s possible to develop a more severe form of PMS, called premenstrual dysphoric disorder (PMDD). It can cause intense — sometimes debilitating — mental, emotional and physical symptoms before menstruation that affect your ability to carry out your daily activities. 

In addition to regular PMS symptoms, such as bloating and headaches, PMDD can cause intense mood changes, a sudden need to cry and feelings of worthlessness. 

Seasonal depression

It’s possible to have depression symptoms that start and end at the same time every year. Seasonal depression, also known as seasonal affective disorder, refers to feeling persistently low, fatigued and irritable when the season changes. It can also cause changes in your appetite and sleep patterns. It’s most common during the fall and winter, lasting approximately 40% of the year and impacting 5% of U.S. adults. 

It’s widely believed that fewer hours of daylight and less sunlight during the colder months can negatively affect a person’s brain chemistry.

Treatment-resistant depression

Antidepressants are often recommended for managing depression symptoms on a day-to-day basis; however, some people have symptoms that don’t respond to medication. Having treatment-resistant depression means that you don’t experience positive change after trying at least two different prescriptions, or the symptoms keep returning. 

Having treatment-resistant depression doesn’t mean that you should lose hope. Psychotherapy can still make a difference in improving your quality of life. Your doctor can also try other approaches, such as changing the dosage or combining different antidepressants.

Depression disorders, like most mental health conditions, don’t have one specific cause. It’s often the result of a combination of different factors, most of which are out of a person’s control. The following are risk factors that increase the likelihood of developing a depressive disorder:

Biological factors

• Family history of depression
• Brain chemistry imbalances
• Reduced sizes of the brain’s hippocampus and amygdala

Psychological factors

• Past or current mental health conditions
• Neurotic personality traits
• Being self-critical

Environmental factors

• Lack of social connections
• Traumatic or unstable living conditions
• Pollution
• Stressful events

Other factors 

• Substance use
• Medication side effects, such as from corticosteroids or opioids

Depressive disorders go beyond being extremely sad and low energy. It can affect every part of your well-being, from your mental to physical health. Even though symptoms can range in severity for everyone and vary depending on the type, you should be aware of the most common symptoms to determine when you, or someone close to you, may need help.

Emotional symptoms

• Overwhelming sadness
• Emptiness or hopelessness
• Heightened irritability or anger
• Loss of interest in activities you used to enjoy (anhedonia)

Cognitive symptoms

• Concentration issues
• Difficulty making decisions and solving problems
• Slow processing speed when hearing information
• Memory problems

Behavioral symptoms

• Social withdrawal or isolation
• Increased substance use
• Reduced productivity 
• Decreased hygiene 

Physical symptoms

• Change in appetite
• Sleeping too much or struggling to get enough sleep
• Nausea 
• Muscle pains

If you’re experiencing symptoms that you believe could stem from a depressive disorder, talk to your primary doctor about your concerns. They can diagnose you with the proper assessments, or they may refer you to a psychiatrist or psychologist. 

Here are the three steps involved in diagnosing depression:

Clinical interview & mental status exam

Your provider will ask you questions about how you’re thinking and feeling as well as what symptoms you’re recognizing in yourself. They’re going to use these questions, as well as related exams, to determine your mental well-being and how you may fit a diagnosis of a depressive disorder.

Physical exam & lab tests

Your doctor will complete an examination to determine if there are potential physical issues that are causing or contributing to your potential depression symptoms, such as a thyroid condition. They will also ask you to complete several lab tests for the same reason, such as blood or urine tests.

Diagnostic criteria

To receive a diagnosis of a depressive disorder, your provider will compare your reported symptoms and tests with the criteria of a depressive disorder diagnosis as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). The criteria will vary depending on the type of depressive disorder you’re being screened for, but they usually involve experiencing a certain number of symptoms for the majority of several weeks.

Treatment for depressive disorders is usually a combination of multiple approaches. Therapy is at the core of all depression treatment, and you may need medication to manage your symptoms on a day-to-day basis. You’ll collaborate with your providers to determine the safest and most effective options based on your needs.

Treatment options for depressive disorders include:

Psychotherapy

Talking to a therapist can help you understand the root causes of your depression, navigate difficult situations that are contributing to your symptoms and develop the skills you need to get through them. Psychotherapy helps you to look at your depression from every angle to take back control over your mental health and reach your goals.

Medication

If you have severe depression symptoms that you’re having trouble managing on your own and they’re affecting your everyday life, you may be prescribed medication, such as an antidepressant. The goal of this medication is to adjust the neurotransmitter levels in your brain that impact your mood regulation and cognitive functioning.

Transcranial magnetic stimulation

Some providers may recommend transcranial magnetic stimulation, or TMS, especially for people who have depression symptoms that haven’t been improved by other options, such as psychotherapy and medication. The magnetic pulses stimulate nerve cells and change the chemistry in the parts of the brain that contribute to symptoms.

At Guidelight, we create a comprehensive, individualized treatment plan to reduce your depressive disorder symptoms and improve your overall well-being. Our programs use a combination of multiple approaches, including:

Cognitive behavioral therapy (CBT)

CBT focuses on the connection between your thoughts, feelings and behaviors. The goal is to adjust your negative thought patterns that contribute to depressive emotions and actions. This often includes acknowledging and replacing a negative thought pattern with a more positive, helpful one. 

Dialectical behavior therapy (DBT)

Depression can make you feel intense negative emotions, like sadness and anger, that can impact your relationships as well as your outlook on life. DBT works to help you manage those feelings and thoughts to reduce depressive symptoms and improve your interpersonal relationships. It involves learning emotional regulation, distress tolerance and mindfulness.

Acceptance and commitment therapy (ACT)

Trying to avoid or judge your negative thoughts and feelings can make it difficult for you to effectively work through your depression symptoms. ACT helps you to learn how to think flexibly and accept negative feelings as they occur instead of having intense reactions to them. It helps you gain a deeper understanding of your feelings and learn how to take action in response to them in a way that reflects your true values.

Mindfulness

Stress management and relaxation techniques can go a long way in alleviating depressive symptoms. Mindfulness helps you focus on the present by acknowledging how your body and mind are feeling at the moment. Mindfulness exercises include mindful breathing and walking in nature. 

For depression, mindfulness helps you to let your negative thoughts go through your mind without judgment. It reduces ruminating on negative thoughts and improves emotional regulation.

Expressive therapy

Creative activities, such as dancing or painting, can be used for you to not only express your feelings but also to gain a better understanding of them. Expressive therapy focuses on using art, dance and music therapy to help people with depression find a safe way to show their feelings in a way that also encourages self-awareness and confidence.

At Guidelight, we provide higher levels of care for depression beyond outpatient therapy sessions. We use evidence-based modalities that prioritize skills-based training to help you manage your symptoms.

We offer the following levels of care:

Intensive Outpatient Program (IOP)

Our IOP allows you to continue your daily life activities while prioritizing your depressive disorder treatment with one-on-one and group therapy sessions. It lasts an average of six weeks, with programming taking place three days a week.

Partial Hospitalization Program (PHP)

Our PHP provides an intensive level of care for clients with depression through medication management and highly specialized individual and group sessions. It allows you to return home each weekday after at least five hours of programming. It takes place over approximately two weeks.

Everyone has a seat at Guidelight. Contact our team today for more information or to schedule an initial evaluation.