Other types of depression

Some forms of depression have unusual presentations or are only seen in special situations and groups. They may resemble other diseases and thus be difficult to identify. Listed below are a number of these special forms of depression.

Melancholy
Melancholy is a type of depression in which the physical symptoms are particularly prominent.
With melancholy you suffer from pronounced sleep disturbances and typically wake up early in the morning. Your energy and mood are clearly affected and you feel awful. Your libido is reduced as well as your appetite. This may result in significant weight loss.

Atypical depression
In some cases the symptoms of a depression can be different from the usual symptoms. This is an atypical depression. For example
• instead of losing your appetite you become a compulsive eater and start gaining weight
• instead of having difficulties sleeping you sleep a lot more than you normally do
• you have a reversed daily rhythm, where you mood is best early in the day and then deteriorates towards the evening
• you become more irritable and perhaps even aggressive instead of sad and passive (applies particularly to men)

Agitated depression
With an agitated depression you are depressed but not passive or without energy, which you commonly are when depressed. The following are some of the symptoms:
• You are anxious, restless and cannot keep yourself calm.
• You complain about your condition but you find it hard to articulate your problems.
• You find it hard to express yourself.
• You may be restless. You may wring your hands nervously, sigh continuously and repeat the same complaints again and again.

Depression with Somatic symptoms
Depression doesn't always manifest itself by a depressed mood. Depression can be hidden or masked behind other physical (somatic) symptoms such as
• tiredness
• headache
• muscle pain
• stomach pain and indigestion
Double depression
If you are suffering from dysthymia and then develop a major depressive episode, you are said to have a double depression.

Male depression
Many believe that there is a form of depression specific to males, which in particular affects middle aged men. Here the symptoms can be a feeling of emptiness and being burned out, stress, irritability, frustration, aggression (possibly even violent behaviour), restlessness, risk taking behaviour and alcohol/drug abuse. Men are often reluctant to seek help for these symptoms and as a result many men with depression go undiagnosed, and consequently untreated. Job stress is thought to be an important trigger in male depression and risks are higher in circumstances such as: shift workers, working excessive overtime, excessive time spent away from home, ill-defined responsibilities, lack of job security and conflict with colleagues.

Dysthymia
This is not a sequal to a well-defined episode of major depression. Instead it is classically reported by patients saying they have ‘always’ been depressed, pessimistic and ‘gloomy’. Although symptoms do overlap with those of major depressive disorder, one does not see the marked changes in appetite and libido or the psychomotor retardation or restlessness in patients with dysthymia.