Major Depressive Disorder (MDD)
Defined as a depressed mood or loss of interest and pleasure in almost all activities for at least a period of two weeks. Several other symptoms must also be present. These include sleep disturbances, appetite disturbances, change in energy levels, difficulties thinking and concentrating, and sexual difficulties. These symptoms interfere with usual behaviour and functioning.
Many of the same symptoms as those for a MDD are present, but they tend to be less severe and interfere less with immediate functioning. They are, however, chronic and may continue for years so that the sufferer seldom feels really happy and cannot enjoy life. Due to the long-term impairment of functioning, many do not realise their full potential. Dysthymia can therefore have severe long-term consequences and be severely disabling.
Used to be called manic depression. This is much less common than the two previously mentioned depressive disorders with about 2.5% of the population affected. Males and females are affected equally. This type of depressive disorder involves episodes of depression and episodes of mania/euphoria.The switches between these two states may be fairly sudden and dramatic, but are more commonly gradual in onset.
Both mood states may co-exist – mixed bipolar disorder. During episodes of mania, judgement is often impaired and this can result in socially embarrassing behaviour, sexual indiscretions, excessive spending and unwise business decisions. Bipolar disorder tends to be a chronic, recurring condition and is generally considered to have a poorer long-term outcome than Major Depressive Disorder.
Other types of depressive illness include:
Minor Depressive Disorder
Same duration, but less severe symptoms than MDD.
Recurrent Brief Depressive Disorder
Same symptoms as MDD, but episodes last less than two weeks.
Premenstrual Dysphoric Disorder
Experiencing depressive symptoms that occur during the last week before menstruation for at least one year.
Depression following childbirth, more severe and of longer duration than transient "Baby Blues".
Depressive Disorders may also be related to drug and alcohol abuse as well as to prescription drug usage (Substance Induced Mood Disorders) and to medical illnesses (Mood Disorder Due to a General Medical Condition.
Types of anti-depressants
Reviewed by Zane Wilson, South African Depression and Anxiety Group (SADAG), March 2015.
(Previously reviewed by Dr Stefanie van Vuuren, Psychiatrist, MB ChB (Stell), M Med (Psig) (Stell), FC (Psych) SA, May 2011.