Depression

• DSM-5 categories of depression

  • Major depressive disorder
  • Persistent depressive disorder
  • Disruptive mood dysregulation disorder
  • Premenstrual dysphoric disorder
• Major depressive disorder

  Severe but often short-term depression
• Persistent depressive disorder

  Long-term or recurring depression, including sustained major depression and what used to be called dysthymia
• Disruptive mood dysregulation disorder

  Childhood temper tantrums
• Premenstrual dysphoric disorder

  Disruption to mood prior to and/or during menstruation
• Behavioural characteristics of depression

  • Reduced activity levels
  • Psychomotor agitation
  • Disruption to sleep and eating behaviour
  • Aggression and self-harm
• Reduced activity levels

  Typically people with depression have reduced levels of energy, making them lethargic. This has a knock-on effect, with people tending to withdraw from work, education and social life. In extreme cases this can be so severe that the person cannot get out of bed.
• Psychomotor agitation

  Agitated individuals struggle to relax and may end up pacing up and down a room
• Disruption to sleep and eating behaviour

  Depression is associated with changes to sleeping behaviour. A person may experience reduced sleep (insomnia), particularly premature waking, or an increased need for sleep (hypersomnia). Similarly, appetite and eating may increase or decrease, leading to weight gain or loss.
• Aggression and self-harm

  People with depression are often irritable, and in some cases they can become verbally or physically aggressive. Depression can also lead to physical aggression directed against the self, including self-harm, often in the form of cutting, or suicide attempts.
• Emotional characteristics of depression

  • Lowered mood
  • Anger
  • Lowered self-esteem
• Lowered mood

  People with depression often describe themselves as 'worthless' and 'empty'
• Anger

  People with depression also frequently experience anger, sometimes extreme anger. This can be directed at the self or others.
• Lowered self-esteem

  People with depression tend to report reduced self esteem, in other words they like themselves less than usual. This can be quite extreme, with some people with depression describing a sense of self-loathing, i.e. hating themselves.
• Cognitive characteristics of depression

  • Poor concentration
  • Attending to and dwelling on the negative
  • Absolutist thinking
• Poor concentration

  The person may find themselves unable to stick with a task as they usually would, or they might find it hard to make decisions that they would normally find straightforward.
• Attending to and dwelling on the negative

  When experiencing a depressive episode people are inclined to pay more attention to negative aspects of a situation and ignore the positives. People with depression also have a bias towards recalling unhappy events rather than happy ones.
• Absolutist thinking

  Most situations are not all-good or all-bad, but when a person is depressed they tend to think in these terms. This is sometimes called 'black-and-white thinking'. This means that when a situation is unfortunate they tend to see it as an absolute disaster.