Depression: many faces

Sadness does not even begin to describe what depression is all about. The emotionality, thought processes, irritability and changes in daily lifestyle transform the individual in totality. Known devils are better than unknown ones. You can prepare for their arrival and combat them better when they do! Knowing the faces of depression helps identify emotions better and deal with them appropriately.

Major (typical or unipolar) Depression

The classic depression we know; hence the term ‘typical’. Also ‘major’ because it’s the most severe form of depression. It’s also expressed as ‘unipolar’ because that differentiates it from bipolar disorder in which depression forms one pole and mania the other. Unipolar depression does not alternate with mania. 

What really happens

Here we see sadness and lack of interest in most daily activities. It is usually accompanied by changes in the sleep pattern (decreased sleep usually or unrested sleep) and appetite changes (usually diminished hunger) along with loss of weight. People with this variety of depression usually wake up very early in the mornings and cannot go back to sleep. The sleep cycle becomes biologically different due to alteration in the brain neurotransmitter levels. There is decreased concentration, distractibility and pessimistic ideas; also suicidal thoughts are not uncommon. 

It's not just fleeting sadness

All this is not situational; it’s persistent and may last for several months together. There is no desire to perform daily usual activities. Loneliness and lonesomeness form a vicious cycle; people withdraw, disconnect from friends and yearn for solitude. Nothing seems exciting; life appears dull, sounds bland and colors grey. 
Atypical (Bipolar) Depression

This is the opposite of typical or unipolar depression. There is sadness but definitely more irritation and frustration than the usual depressed mood. Sleep may actually be more than usual. Appetite may increase. Inertia sets in, people usually feel lazy, and lack of desire to do much with their time and life. The penetrating sluggishness and pessimism disallow any activity and one may even get labeled as lazy.

Other changes in the body

Sometimes there may be a dull non physiological body ache or pain anywhere in the body along with a frequent heavy feeling in the legs that makes one not want to move at all. The mood gets shoddier through the day. Sadness pervades of course; but irritability may be more evident. Exciting events can lift the mood transiently unlike the typical depression where nothing lightens the sad mood. Emotional reactivity becomes high here and people go off their handle often. 

Bipolarity

The depressed mood may alternate with ‘high’ episodes of mania or irritability which then makes this a bipolar disorder (2 poles). The person may switch between the poles every few months, weeks, days or even hours. This process is called ‘cycling’ of the moods in bipolar disorder. The high and the low pattern makes life quite jumpy and disruptive. Bipolarity is harder to treat but it does have good prognosis with apposite management. 
Dysthymia (Dys=Bad and Thymus=Mood)

Dysthymia literally means bad mood. And that is how people seem to the world round. Always in a ‘bad mood’. People with dysthymia are not as relentlessly depressed as in major depression. They feel a little low, sense dejection and sadness, but may or may not have alteration in sleep and appetite and other bodily functions. 

Mood in dysthymia

The mood of course stays gloomy for the longest period of time, sometime even a few years together; and people don’t do much about it because the sadness is not as deep and debilitating as in major depression. There is persistent distractability and lack of focus. Such people never enjoy life and may end up worsening the moods of those around them too. 

Is it better to have?

Dysthymia is a worse condition in a way because it gets overlooked since it’s not so incapacitating. However it is draining enough and prevents one from leading a full and productive life. People get labeled as irritating, complaining, and unexciting. And the labeling affects interpersonal relationships and general living in extremely negative ways.
Double Depression

This essentially is a description of a severe episode of major depression that occurs on a background of dysthymia. The dysthymia probably gets too enervating and the person actually has a breakdown into depression wherein the mood, sleep, appetite, work, relationships all get affected, and it seems like infinite suffering. The symptoms are essentially those of major depression on a continual background over a few years of a very low and sad mood. 

Knowing what is wrong is the first and best step towards making it right

Meeting the correct people who understand the problem is an essential step towards solving it. Antidepressant medication is beneficial in most cases. Counseling, cognitive therapy, emotive therapy; all of which involve challenging their negative thoughts is the mainstay of management. Environment change and enrichment helps. Good family support, good social standing, suitable employment, availability of people who can notice the change in moods and take steps to help the people suffering from it; is the key to transforming negative beliefs to positive outlooks.