|The Range of Depressive Disorders|
|Depression comes in a variety of intensities. Everyone experiences moments of feeling 'down' or 'under the weather.' These experiences of depression are not clinically significant, and people are able to pull out of these moods without difficulty. There are other, deeper kinds of depression though, that are not so easy to escape. The spectrum of depressive disorders that a mental health expert can help you with is outlined below, in order of increasing intensity.
Adjustment Disorder with Depressed Mood
An adjustment disorder occurs when you have an intense reaction to a recognizable life stressor. Adjustment disorders are relatively common, and occur in reaction to the typical problems of life. Examples of an adjustment disorder with depressed mood would include: breaking up with your girl or boy friend, lose your job, getting in a car accident and hurting someone. These are typical causes of adjustment disorders. Typically the symptoms develop within three months of the stressor coming into your life.
When depression is chronic -- when it lasts for most of the day, when it occurs on more days than it doesn't occur, and when this state has lasted two years or more -- then we start looking into dysthymia. Dysthymic disorder is obviously a more serious kind of depression than an adjustment disorder. Typically the person with dysthymia has a variety of physical problems associated with the disorder. These can include insomnia, poor appetite or overeating, fatigue, low self-esteem, poor concentration, and problems making decisions. People with dysthymia are often highly self-critical and see themselves as uninteresting or incapable. Because these symptoms are so intertwined with the person's day-to-day activities, and because they have been present for so long, the person often identifies with the depression: "This is just the way I am."
Major Depressive Disorder
This is one of the most serious depressive disorders. Major depression can strike suddenly and without warning or it may come on gradually. A person may experience only one episode or many. It is characterized by severe depression. Sometimes the depression is so severe that the person cannot get out of bed for the entire day, even to go to the bathroom.
Perhaps the most eloquent description of this disorder is found in William Styron's book, A Darkness Visible. This Pulitzer Prize winner was stricken by major depression in his later years. His book described what it is like to experience this major mental disorder.
Bipolar disorder is relatively rare. It has, as one of the poles, a very severe depressive element, similar in intensity to the depression found in a major depressive disorder. In this disorder, though, very deep depression alternates with periods of mania and hyperactivity. Many people think that they must be bipolar because they notice that they alternate between highs and lows. For most of us, this alternation is normal. In bipolar disorder, the swings between the highs and lows are very extreme.
When someone very close to you dies, you will experience a deep grief. Grief can also occur when you lose a job that you closely identified with, or when some common tragedy strikes your community.
Grief is more than a deep sadness. Grief overwhelms you and causes you to rethink your priorities. It is a time of inward turning, and is characterized by feelings of sadness and reflection. Often the person who is grieving has a variety of physical problems associated with this process. These can include insomnia, poor appetite, and weight loss. The grieving person can also have poor concentration and problems making decisions. Sometimes there is regret for things not done, and guilt over having survived ("Why didn't God take me instead?").
Seasonal Affective Disorder
This disorders is linked to the lack of sunlight that is present during the winter months. People with this disorder complain of a distinct lack of energy during the winter months, with a need to sleep more, overeating and weight gain, and a craving for carbohydrates. These symptoms remit when spring comes and more sunlight is available.
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