Psychology Of Depression; Causes, Types and Treatment 

Types of Depression

Bipolar disorder, major depressive disorder, and persistent depressive disorder are the primary types of depression. A person who experiences alternating states of depression and mania (abnormal elevation of mood) or hypomania (distinct, though not necessarily abnormal, elevation of mood) is said to suffer from bipolar disorder. Major depressive disorder is characterized by severe symptoms that disrupt the individual’s daily life, typically with effects on appetite, sleep, work, or the ability to enjoy life. Episodes of major depression can occur at any age and may occur once or multiple times in an affected person’s life. Persistent depressive disorder involves symptoms that last two or more years, sometimes marked by episodes of major depression.

Other types of depression include postpartum depression, psychotic depression, and seasonal affective disorder, each of which develops under specific circumstances. Postpartum depression develops in women in the period following childbirth. Symptoms include anxiety, a lack of interest in caring for the infant, and feelings of sadness, hopelessness, or inadequacy. Postpartum depression is longer-lasting and more severe than the “baby blues,” a common condition among women after childbirth that typically involves mood swings, feelings of sadness, and crying spells. Psychotic depression arises against a background of psychosis, which may involve symptoms of delusions, hallucinations, or paranoia. Seasonal affective disorder is characterized by the onset of depressive symptoms in autumn and winter, which are alleviated with increased exposure to natural light in spring and summer.

Treatments for Depression

There are three main treatments for depression. The two most important—and widespread by far—are psychotherapy and psychotropic medication, specifically antidepressants such as bupropion. Psychotherapy aims to alter the patient’s maladaptive cognitive and behavioral responses to stressful life events while also giving emotional support to the patient. Antidepressant medications, by contrast, directly affect the chemistry of the brain and presumably achieve their therapeutic effects by correcting the chemical dysregulation that is causing the depression. Two types of medications, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs; e.g., fluoxetine [Prozac]), though chemically different, both serve to prevent the presynaptic reuptake of serotonin (and in the case of tricyclic antidepressants, norepinephrine as well). This results in the build up or accumulation of neurotransmitters in the brain and allows them to remain in contact with the nerve cell receptors longer, thus helping to elevate the patient’s mood. By contrast, the antidepressants known as monoamine oxidase inhibitors (MAOIs) interfere with the activity of monoamine oxidase, an enzyme that is known to be involved in the breakdown of norepinephrine and serotonin.

In cases of severe depression in which therapeutic results are needed quickly, electroconvulsive therapy (ECT) has sometimes proved helpful. In this procedure, a convulsion is produced by passing an electric current through the person’s brain. For most persons with depression, however, the best therapeutic results are obtained by using a combination of psychotherapy and antidepressant medication. [ therapeutics.]

Some persons with depression are affected by treatment-resistant depression (TRD), meaning that they are refractory to existing therapies. For those individuals, scientists have been investigating alternative therapeutic approaches, including deep brain stimulation (DBS) and gene therapy. In DBS, experimental research has focused on the implantation of an electrode in a region of the brain known as the nucleus accumbens, which is located in the striatum (neostriatum) deep within the cerebral hemispheres and is associated with emotions and feelings such as fear, pleasure, and reward. Studies of depressed animals and postmortem studies of the brains of patients with depression have revealed that reduced levels of a protein known as p11 in cells of the nucleus accumbens are associated with depression. In depressed animals, increasing p11 levels in the nucleus accumbens using gene therapy has been found to relieve depression-like symptoms. Both DBS and gene therapy, however, are associated with potentially dangerous side effects.