Primary and secondary depression
There are many different types of depression. Over the years experts have drawn up international guidelines to help classify different ‘mood disorders’. Within the heading of mood disorders fall different levels of depression which will be treated differently. Doctors can distinguish these by assessing the signs and symptoms the person is experiencing, the person’s personality features and life events, and also medical history.
Reactive depression is an extension of the normal feelings people have following a major life upset. The person’s state of sadness is an appropriate and expected response to a situation. Someone with reactive depression will feel low, anxious, irritable and perhaps angry. They will be preoccupied with what has happened. Usually they will have difficulty sleeping. Many people will find that continuing with life as normal helps to distract them from their feelings of upset. However, some people may be preoccupied with their sadness and can resort to self-destructive acts.
Some people are particularly prone to reactive depression. Those who are unable to manage the problems of everyday life in an emotionally efficient manner may experience repeated episodes of reactive depression. These moods are often referred to as neurotic depression. People with certain personality traits are at a disadvantage when it comes to coping with adverse events in life. Those who are perfectionists, tend to be anxious and attention-seeking and who lack assertiveness are particularly at risk.
Endogenous depression (unipolar depression) on the other hand, comes from within. It is a chemical or biological depression but may have been triggered by a life event. Unexplained tiredness can be an early symptom. Other symptoms include anxiety, hopelessness and despair, self-doubt, low self-esteem, poor concentration, loss of interest, aches and pains, and inability to sleep.
It is important that the person seeks help for their depression. In particular, the more severe forms carry with them a major risk of suicide if the person is overcome with their negative feelings and hopelessness.
What makes bipolar (manic) depression different from unipolar is that the person also has periods of elation or mania alternating with their periods of depression. Often people who are affected by this illness may not be aware of the problem because they feel energetic and full of life. A characteristic of people in this state is that they are talkative, full of energy and may be involved in many plans and events. Their thoughts can be racing so much that they will be ready to face the day after only a few hours sleep. While someone like this may at times be productive, often their energy and lack of realism can lead them to make bad decisions. This often includes activities such as over-spending, heavy drinking, extra-marital affairs and bad decisions generally.
If a person has only ever had episodes of depression they are described as having unipolar affective disorder.
If they have had at least one period of elevated mood or mania as well as depression, then they are described as having a bipolar affective disoder.
The treatment for bipolar disorder is more complicated than that of unipolar depression, with a combination of drugs needed to stabilise mood.
Primary and secondary depression
With primary depression, the illness is not as a result of any other medical or psychological cause.
In secondary depression, the illness has come about as a result of a medical condition (eg. Parkinson’s disease or thyroid problems). Depression can occur as a result of other psychiatric illnesses like schizophrenia.
The usefulness of classifying depression in this way is that the underlying causes can be dealt with as well as the depression.
This is a prolonged depression lasting at least two years but less intense. A feeling of low mood and two symptoms of depression are signs for a diagnosis of dysthymia. People with dysthymia are at increased risk of developing a fully blown depressive illness.
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