Depression Disorder Explained: Symptoms, Severity Levels, Types, and Effective Treatment Options

Depression disorder: Severity levels

There are several degrees of severity of depression, depending on the number of symptoms present and the degree of impairment of the individual’s functionality.

Mild depression

Mild depression is characterized by depressed mood or loss of interest or pleasure accompanied by a few additional symptoms (around 2-3 symptoms). The person experiences some difficulty in carrying out daily or professional activity, but this is usually not interrupted. The symptoms of mild depression include:

• ✔️ Persistent low mood or sadness;
• ✔️ Loss of interest or pleasure in daily activities;
• ✔️ Mild fatigue or low energy;
• ✔️ Slight changes in sleep or appetite;
• ✔️ Occasional feelings of guilt or worthlessness;
• ✔️ Minor difficulty concentrating;
• ✔️ Symptoms present but daily functioning largely maintained.

Moderate depression

It is characterized by a greater number of additional symptoms and a considerable impairment of the person’s functionality. The person will most likely not be able to carry out their professional and daily activity.

• ✔️ Noticeable low mood or sadness most of the day;
• ✔️ Loss of interest or pleasure in most activities;
• ✔️ Fatigue or low energy affecting daily tasks;
• ✔️ Changes in sleep and appetite;
• ✔️ Feelings of guilt, worthlessness, or hopelessness;
• ✔️ Difficulty concentrating or making decisions;
• ✔️ Daily functioning is impacted, but some tasks can still be managed.

Severe depression

Most of the symptoms specific to depression are present and the person is unable to carry out their activity. Suicidal ideation may also be present, along with other symptoms such as: delusions or even hallucinations. Requires hospitalization in most cases.

• ✔️ Persistent and intense sadness or emptiness;
• ✔️ Loss of interest or pleasure in almost all activities;
• ✔️ Significant fatigue or loss of energy, making daily tasks very difficult;
• ✔️ Major changes in sleep and appetite (insomnia, hypersomnia, weight loss or gain);
• ✔️ Feelings of worthlessness, guilt, or hopelessness, often with self-blame;
• ✔️ Severe difficulty concentrating or making decisions;
• ✔️ Possible suicidal thoughts or behaviors;
• ✔️ Daily functioning is severely impaired, requiring immediate professional intervention.

Subtypes of depressive disorder

Depending on the dominant symptomatology, the following subtypes are noted:

Atypical depression

The depressive mood is accompanied by hypersomnia (increased need for sleep), hyperphagia (increased appetite) and a feeling of heaviness, “like lead” in the upper and lower limbs.

Melancholic depression

At least four somatic symptoms are present, accompanied by a particular state of sadness, different from the sadness felt on the occasion of the death of a loved one. The person is also unable to feel joy on the occasion of pleasant events. The guilt felt can be significant.

Catatonic depression

A form of depression characterized by marked psychomotor inhibition. The person may stay in the same position for a long time, refuse to speak, eat, or communicate. Episodes of marked psychomotor agitation may also occur. There is a risk of malnutrition, the appearance of bedsores or pulmonary embolism due to motor inhibition.

Seasonal depression

Represents depression that appears periodically, correlated with a period of the year, mainly in autumn or winter and disappears in the other periods of the year.

Dysthymia

A less severe depressive state, but with a long duration (minimum 2 years).

Depression with postpartum onset

It is a depressive episode that begins within a maximum of 4 weeks of the birth of a child.

Depression with psychotic elements

It.is a severe depressive episode, in which delusional ideas appear (beliefs that the patient considers real, despite their implausibility or evidence to the contrary – for example: the belief that he is responsible for all the troubles in the world) or hallucinations (for example: he hears the voice of God condemning him for various mistakes).

Evolution and prognosis

Untreated, depressive disorder significantly interferes with the individual’s functionality, resulting in decreased professional efficiency, altered social and family relationships, withdrawal of the individual, neglect of personal hygiene and duties, intra-family or marital conflicts that can even lead to divorce, consumption of psychoactive substances. Suicidal ideation and suicide attempts are common in these individuals. 

Approximately 15% of people with depressive disorder die by suicide. Male gender, age over 45, feelings of guilt, self-blame, low self-esteem, a state of suffering and the need to find a solution to resolve emotional suffering are risk factors associated with suicide.

The evolution of depressive disorder under treatment is generally favorable, a significant percentage of patients achieve remission. Relapses throughout life are possible, however. The earlier the diagnosis and treatment are instituted, the more favorable the prognosis of patients with depressive disorder. Compliance with treatment is also very important, compliant patients have increased chances of complete remission of symptoms and a lower risk of relapse.

Depression Disorder Treatment

Therapeutic approaches vary depending on the severity of the disease, individual characteristics (age, sex, associated somatic diseases) and clinical symptomatology. Treatment involves pharmacological therapy and psychological interventions (cognitive-behavioral therapy being the most recommended).

Mild depression generally does not require drug treatment, psychotherapy being sufficient. If psychotherapy is ineffective or insufficient, then pharmacological therapy is resorted to. Moderate and severe forms require drug therapy.