Types of Depression
Depression is not one single condition. It shows up in different forms, each with its own pattern, triggers, and treatment needs. What this really means is that the right care starts with the right understanding.
At Bright Horizons Psychiatry, we focus on evidence based diagnosis and treatment for depressive disorders. We do not treat bipolar disorder. This page covers the types of depression we commonly evaluate and treat in clinical practice.
If something here sounds familiar, that is a signal, not a label. A proper assessment matters.
Major Depressive Disorder
Major Depressive Disorder is what most people mean when they say depression. It involves persistent low mood and loss of interest that lasts at least two weeks and affects daily functioning.
Common signs include
- Ongoing sadness or emotional numbness
- Loss of interest in work, relationships, or hobbies
- Fatigue and low energy
- Changes in sleep or appetite
- Trouble concentrating
- Feelings of guilt or worthlessness
This condition can be mild, moderate, or severe. Some people experience one episode. Others have recurrent episodes across life.
Treatment depends on severity and history. Options may include therapy, medication, TMS, or ketamine based treatments when appropriate.
Persistent Depressive Disorder
Persistent Depressive Disorder, also called dysthymia, is a long term form of depression. Symptoms feel less intense than major depression, but they last much longer, often years.
People often describe it as
- Feeling low most days
- Low self esteem
- Chronic fatigue
- Reduced motivation
- Feeling normal only in brief moments
Because symptoms develop slowly, many people assume this is just their personality. It is not. Long standing depression is still treatable, but it requires a thoughtful plan.
Seasonal Affective Disorder
Seasonal Affective Disorder follows a seasonal pattern, most often starting in fall or winter when daylight drops.
Typical features include
- Low mood during specific seasons
- Increased sleep
- Low energy
- Increased appetite or carb cravings
- Social withdrawal
This is not simply disliking winter. It is a biologically driven depressive condition linked to light exposure and circadian rhythm changes.
Treatment may involve light therapy, medication, therapy, or advanced options when symptoms are severe.
Postpartum Depression
Postpartum depression can occur during pregnancy or after childbirth. It goes beyond normal stress or mood changes.
Symptoms may include
- Persistent sadness or anxiety
- Feeling disconnected from the baby
- Irritability or anger
- Guilt or shame
- Fear of being a bad parent
This condition deserves prompt care. Early treatment helps both parent and child and reduces long term impact.
Atypical Depression
Atypical depression does not mean uncommon. It describes a symptom pattern.
Key features include
- Mood improves briefly with positive events
- Heavy feeling in arms or legs
- Increased sleep
- Increased appetite
- Sensitivity to rejection
Because mood can lift temporarily, people are often told they are fine. They are not. This is a recognized depressive subtype and responds well to proper treatment.
Situational Depression
Situational depression develops after a major life stress such as loss, illness, relationship changes, or career disruption.
Symptoms may overlap with major depression but are closely tied to an identifiable event. Some cases resolve with time and therapy. Others deepen and require medical treatment.
Assessment helps determine the right level of care.
Depression With Anxiety
Many people experience depression and anxiety together. This combination often feels worse than either condition alone.
Common signs include
- Constant worry with low mood
- Physical tension and fatigue
- Restlessness with loss of motivation
- Sleep disruption
Treating both conditions together leads to better outcomes than addressing one in isolation.
Why Accurate Diagnosis Matters
Depression is not one size fits all. Mislabeling leads to poor results. A careful evaluation looks at:
- Symptom pattern
- Duration
- Triggers
- Past treatment response
- Medical and family history
This is how treatment becomes effective, not trial and error.
How We Treat Depression
Treatment plans are individualized and may include
TMS Therapy
Transcranial Magnetic Stimulation, or TMS, is a non invasive treatment that uses magnetic pulses to activate areas of the brain involved in mood control. These areas often remain underactive in people with treatment resistant depression. TMS targets them directly without affecting the rest of the body.
- FDA cleared for depression
- Non invasive, no surgery
- No anesthesia or sedation
- You remain awake and alert
- No systemic medication exposure
Esketamine (Spravato) Nasal Spray
Esketamine is an FDA approved nasal spray used for treatment resistant depression. It works on glutamate pathways in the brain, which play a key role in mood regulation. Esketamine is administered in a clinical setting under medical supervision.
- FDA approved for treatment resistant depression
- Nasal spray administered in clinic
- Supervised dosing and observation
- Used alongside an oral antidepressant
- Structured treatment schedule
IM Ketamine Therapy
Intramuscular, or IM-ketamine is administered by injection in a controlled clinical setting. Like esketamine, it works on glutamate pathways, but dosing and delivery are tailored to the individual. IM-ketamine is often considered when depression is long standing or highly resistant.
- Administered by trained medical professionals
- Individualized dosing
- In clinic monitoring during treatment
- Evidence supported for resistant depression
- Not dependent on daily medication use
Advanced treatments are considered when standard approaches have not helped.
When to Seek Help
If symptoms last more than two weeks, affect work or relationships, or feel unmanageable, it is time to talk to a professional. Waiting often makes treatment harder, not easier.
You do not need to know which type fits you. That is our job.