Chapter 2 : Atypical, Psychotic Depression and Dysthymia
Topics covered in this snack-sized chapter:
Atypical Depression is a type of depression that can have some symptoms that are similar to those of major depression, but it does not have the number of symptoms needed for a diagnosis of major depression.
Common symptoms of atypical depression include increased appetite or weight gain, sleepiness or excessive sleep, and feeling extremely sensitive to rejection.
Atypical Depression symptoms include:
Increased Appetite:
- Unlike other types of depression in which people may lose interest in food, if you have atypical depression you may have a craving for comfort foods.
- Weight gain is a common sign.
Increased Sleep:
- Unlike other types of depression in which people have trouble getting enough sleep, people with atypical depression feel like sleeping all the time.
Leaden Paralysis:
- This term refers to a sense of heaviness in the arms and legs that people with atypical depression experience.
- They may feel extremely tired, as though their physical movements have slowed down.
Overly Sensitive:
- People with this type of depression tend to have a personality trait of increased sensitivity.
- They may expect that other people will not like them or not approve of their behavior.
The common causes and risk factors of atypical depression:
- Long- term use of certain medications, such as some drugs used to control high blood pressure, sleeping pills and birth control pills.
- A family history of depression.
- Biological causes, such as hormones and different levels of neurotransmitters.
- Pregnancy or stressful life events, such as the loss of a loved one or a job.
- Chronic illness, such as heart disease, stroke, diabetes, cancer or Alzheimer’s disease.
The development of newer antidepressant medications and mood-stabilizing drugs has improved the treatment of depression.
Medications can relieve symptoms of depression.
Psychotherapy can also be useful in some cases.
Electroconvulsive Therapy remains one of the most effective yet most stigmatized treatments for depression.
Eighty to ninety percent of people with severe depression improve dramatically with electroconvulsive therapy.
Exercise regularly.
Psychotic Depression occurs when a severe depressive illness has a co-existing form of psychosis.
The psychosis could be hallucinations, delusions or some other break with reality.
Psychotic depression affects roughly one out of every four people who is admitted to the hospital for depression.
Anxiety
Insomnia
Agitation
Psychosis
Constipation
Hypochondria
Suicidal ideation
Outbursts of anger
Intellectual impairment
The common causes and risk factors of Psychotic Depression:
- Family tendency (heredity)
- Side effects of certain drugs
- Abnormal thyroid function
- Human immunodeficiency virus
Psychotic depression requires immediate medical care and treatment.
Treatment usually involves antidepressant and antipsychotic medication.
You may only need antipsychotic medication for a short period of time.
Electroconvulsive Therapy can help treat depression with psychotic symptoms. However, medication is usually tried first.
Dysthymia is a mild, but chronic, form of depression.
Dysthymia symptoms usually last for at least two years, and often for much longer than that.
Dysthymia can actually affect your life more seriously because it lasts for so long.
With dysthymia, you may lose interest in normal daily activities, feel hopeless, lack productivity and have a low self-esteem.
People with dysthymia are often thought of as being overly critical, constantly complaining and incapable of having fun.
The symptoms of dysthymia are the same as those of major depression but not as intense and include the following:
- Persistent sad or empty feeling.
- Difficulty sleeping (sleeping too much or too little).
- Insomnia (early morning awakening).
- Feelings of helplessness, hopelessness and worthlessness.
- Loss of interest or the ability to enjoy oneself.
- Loss of energy or fatigue.
- Difficulty concentrating, thinking or making decisions.
- Changes in appetite (overeating or loss of appetite).
- Observable mental and physical sluggishness.
- Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment.
- Thoughts of death or suicide.
Experts are not sure what causes dysthymia.
This form of chronic depression is thought to be related to brain changes that involve serotonin, a chemical or neurotransmitter that aids your brain in coping with emotions.
Major life stressors, chronic illness, medications and relationship or work problems may also increase the chances of dysthymia.
Because dysthymia is a chronic depression, it can require longer treatment times than major depression.
Both medications for depression (antidepressants) and Talk Therapy are used to treat dysthymia.
Until a few years ago, Talk Therapy was the preferred treatment course for dysthymia.
Now, more and more studies are showing that antidepressant medications can be very helpful in treating dysthymia.