In detail

Depression, types, signs, symptoms and treatment

Depression, types, signs, symptoms and treatment

“Your emotions should not be paralyzing.
They should not defend themselves. They shouldn't stop you from being everything you can be. ”
Wayne W. Dyer

Depression is a serious disease that involves a loss of mind, uncontrolled crying, deception of ruin, loss of interest and sometimes suicidal thoughts. These are a part of the varied symptoms that accompany depressive states. Depression is to psychopathology what the cold to medicine; it affects us all, but to a greater extent women (the proportion is 3 women for each man) although the highest incidence of completed suicides corresponds to men. The prevalence is higher in married women than in single women. It has been shown that women react more anxiously than men to face the conflictive situations of life.

When we suffer depression, we feel sad; any little effort tires us; We lose the sense of humor and the desire to do even what usually excites us most. But these moods tend to be transitory and soon have remitted. However, when we talk about depression with the severity that this label imposes, this state is permanently established in us as if little by little we were immersing ourselves in a bottomless pit from which it is impossible for us to leave.

The depressed person often perceives strong feelings of dislike of oneself; He feels useless and guilty of his inadequacies. Cry attacks, weight loss and insomnia may begin to occur. The food does not taste good, sex is not exciting and all interest in people emotionally linked to it is lost. The depressed person may begin to have suicidal desires. As their intentions become more serious, sporadic ideas become desires; He will even prepare a plan and implement it. There are few psychological disorders that are so debilitating and none that produce as much suffering as severe depression..


  • 1 Types of depression
  • 2 Symptoms of depression
  • 3 Types of depression
  • 4 Depression and suicide
  • 5 Depression treatment

Types of depression

We will consider several types of depression grouped under the category of affective disorders

  • Reactive or neurotic depression
  • Endogenous depression
  • Organic depression
  • Psychotic depression

Symptoms of depression

All three have the following factors in common:

  • Depressive mood
  • Loss of pleasure and interest
  • Uselessness and guilt
  • Low self-esteem
  • Inability
  • Suicidal thoughts
  • Anxiety
  • Difficulties to think
  • Obsessions and paranoia
  • Time sense disturbance
  • Depersonalization (in more serious cases they may feel detached from reality, as if they were simply observers without emotionally participating)
  • Loss of energy
  • Slowness and agitation
  • Appetite and weight disorders
  • Sleeping problems
  • Libido reduction (lack of desire in women)
  • Body symptoms (migraines, nausea, various pains, cramps etc ...)

All these symptoms may or may not be present in the depressed person, these are a consensus of all those observed throughout the experience.

So that you can classify yourself within one of the three types of depression mentioned we will define them in more detail.

Types of depression

Reactive depression

Reactive depressions are the most common and the type that is familiar to all of us. They do not have regular time cycles, usually they do not respond to physical therapies (drugs) they are not genetically predisposed and if they respond to cognitive behavioral therapy.

This type of depression usually seems to coincide with an adverse event in life, such as the death of a loved one, divorce, marital disagreements, economic problems or unemployment problems. The onset of depression does not have to occur immediately after the event, but sometimes after a few weeks or months. The first occurrence occurs, usually in early adult life and is characterized by varied physical and psychological symptoms. It is a more benign and non-psychotic state, although, to some extent, recovery is influenced by personality factors.

Endogenous depression

This type of depressions they are a response to some unknown endogenous or internal process. These depressions are not triggered by any external event; they simply pounce on the affected person. They usually have regular time cycles and can be bipolar or unipolar. The bipolar is called manic-depressive (the individual repeatedly goes from despair to a neutral mood, from here to a hyperactive and superficially euphoric manic state, to return to despair, going through the neutral state). The unipolar consists of a regular alternation of despair and neutrality, without the appearance of mania.

Endogenous depressions often respond to drug treatment and may have a hormonal origin. They may also be genetically predisposed (eg if the mother is depressive and the alcoholic father is possible that the offspring become depressive. It has been said that in men alcoholism is the equivalent of depression in women) and their symptoms usually be more severe than those of reactive depressions.

Organic depression

When a diagnosis of depression is made it is important to discard the organic bases, since the effect and depressive behavior are often associated with a brain injury or the action of certain drugs.

Depression and suicide

The psychiatric disease with the highest risk of suicide is depression (between 10% and 15%). The moments of the disease with more risk are when the inhibition and melancholy decreases (they begin to improve) or when depression begins. The three symptoms of depression related to suicide are:

  • Increase in insomnia
  • Greater abandonment of personal care
  • Increase in cognitive impairment

There are several opinions about the significance of psychiatric symptoms in the suicidal patient, although most reviews indicate that in a proportion of the 70%, suicide attempts have a depressive condition that is easy to recognize. Endogenous depressants are at greater risk than reactive depressants, suicide attempts are impulsive, can be decided an hour earlier.

Suicide attempts They are especially common among women under 35 (more between 15 and 24 years), men do it in more advanced age. By social classes it is more common in the lower, but more effective among the upper classes and professional groups of high economic status.

Factors associated with suicide risk

  • Women under 35, men over 40
  • Separation, divorce or death of spouse
  • Imminent loss of a loved one
  • Loneliness and social isolation
  • Economic problems, recent unemployment or retirement
  • Bad health
  • High status occupation
  • Depression (especially endogenous)
  • Terminal disease
  • Problems with alcohol and / or drugs
  • Previous suicide attempts
  • Previous history of affective disorders
  • Family history of affective disorders, suicide, alcoholism
  • Suicidal signs (suicidal notices or conversations)
  • Preparations (making a will, insurance, suicide note)

Usually Suicidal patients are willing to talk about their intentions and for some the need to let off steam with someone who takes them seriously is therapeutically positive. When there is a possibility of suicide, you should be encouraged to talk about it and try to use time in the future to continue talking about the issue, which can facilitate temporary admission to a psychiatric unit and / or provide the necessary help to mitigate the circumstances that cause the suicide attempt.

Depression Treatment

The pharmacological treatment of depression is carried out under strict medical monitoring with oral antidepressants, the most commonly used are Tricyclics or Tertracyclics. IMAO (Monoamine oxidase Inhibitors) and SSRIs (Selective Serotonin Reuptake Inhibitors) are also used. The therapeutic response to medication usually appears 4 or 6 weeks after the start of treatment, and maintenance should be done for about 6 months to prevent a relapse. New, more selective medications with fewer side effects than traditional ones are appearing on the market.

Cognitive therapy

It is based on the change in the interpretation style of the world by the patient affected by depression. This type of therapy tries to change the beliefs and thoughts that lead the person to have this disease, encouraging logical and rational thinking about their situation and their possible exits.

This treatment can be combined with the use of antidepressant drugs.

Interpersonal therapy

The main objective is to alleviate the symptoms through the resolution of the current interpersonal problems of the patient, thus reducing stress in the family or work and improving interpersonal communication skills. The therapist works with the patient training his social skills. It can also be combined with the administration of antidepressants.

Psychodynamic therapy

This therapy promotes a personality change through the understanding of unresolved childhood conflicts. Try to discover the origin of the conflict through the patient's stories and try to reinforce their adaptive abilities, it goes beyond simple symptomatic improvement. It is a very long lasting treatment.

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World Health Organization. ICD 10. Tenth Revision of the International Classification of Diseases. Mental and Behavioral Disorders: Clinical Descriptions and Guidelines for Diagnosis. Madrid: Meter; 1992.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), fifth edition. 2013

Beck, A.T., Rush, A.J., Shaw, B.F. and Emery, G. (1983). Cognitive therapy of depression. Bilbao: Editorial Desclée de Brouwer

Bowlby, J. (1993). Affective loss Sadness and depression. Barcelona: Paidós

Polaino, L. (1998): "Depression." Ed. Martínez Roca. Barcelona.

Hernández, L. (1997): "Depression and suicide". Monograph of Degree in Psychology National University Federico Villarreal. Lime





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