Types of depression

"Depression" is not just one illness. Doctors use the word for a group of mood conditions. They share a low mood or a loss of interest in life. But they differ in how long they last, when they show up, and what else comes with them.¹

Knowing the type matters because it can change the treatment. For example, depression that is part of bipolar disorder is treated differently from other depression.⁸ This page explains the main types in plain words, so you can talk with your doctor about what fits.

Major depression

Major depression is also called major depressive disorder or clinical depression. It is the type most people mean when they say "depression."¹

To be diagnosed, a person has symptoms most of the day, nearly every day, for at least 2 weeks. One of them must be a low or sad mood, or a loss of interest or pleasure in most things.¹ Other symptoms can include changes in sleep or appetite, low energy, trouble focusing, feeling worthless, and thoughts of death. Doctors look for at least five symptoms in total, and they must get in the way of daily life.¹⁰ Our page on signs and symptoms explains each one.

Major depression is common. In 2021, about 21 million U.S. adults, or about 1 in 12, had at least one episode in the past year.¹² Over a lifetime, about 1 in 8 people have it, and it is nearly twice as common in women as in men.¹⁰

Some people have one episode in their life. Many have more than one. Doctors may add a description, such as depression "with anxious distress" or "with a seasonal pattern," to say more about how it looks for you.

Persistent depressive disorder (dysthymia)

Persistent depressive disorder (PDD) is a long-lasting, low-grade depression. Its older name is dysthymia. The symptoms are often milder than in major depression, but they last much longer.¹

For adults, a doctor looks for:⁷

• A low mood on more days than not, for at least 2 years (1 year for children and teens)
• At least two other symptoms, such as poor appetite or overeating, sleep problems, low energy, low self-worth, poor focus, or hopelessness
• No break from these symptoms longer than 2 months at a time

Because PDD lasts so long, people may think, "This is just who I am." It is not a personality trait. It is a treatable condition. Some people with PDD also have periods of major depression on top of it. Doctors sometimes call this "double depression."⁷ Treatment with therapy, medicine, or both can help, and combining the two may work better than either alone.⁷

Seasonal affective disorder (depression with a seasonal pattern)

Seasonal affective disorder (SAD) is depression that comes and goes with the seasons. Symptoms usually last about 4 to 5 months each year.² Doctors now often call it major depression "with a seasonal pattern."

There are two forms:²

To diagnose SAD, a doctor looks for a seasonal pattern for at least 2 years in a row.² SAD is more common in women and in people who live farther north, where winter days are short. It often begins in young adulthood. It is also more common in people who have bipolar II disorder.²

For the winter pattern, treatment can include bright light therapy (sitting near a special light box each day, usually in the morning), a type of talk therapy called CBT, and antidepressant medicines.² See bright light therapy to learn more. Talk with your doctor before you start using a light box.

Perinatal and postpartum depression

Perinatal depression is depression during pregnancy or after the birth of a baby. When it starts after birth, it is called postpartum depression.³ About 1 in 8 women who recently gave birth report symptoms of postpartum depression.⁵

It is important to know the difference from the "baby blues":³

Most postpartum episodes start within 4 to 8 weeks after birth.³ Signs include crying more than usual, anger, feeling distant from the baby, and doubting you can care for your baby.⁵ Risk is higher with a past history of depression or bipolar disorder, depression in an earlier pregnancy, and high stress.³ It is never the mother's fault.

Treatment can include talk therapy and antidepressants.³ In August 2023, the FDA approved zuranolone (Zurzuvae), the first pill made just for postpartum depression in adults. It is taken for a short course. It carries a boxed warning (the FDA's strongest warning) that it can make driving unsafe, even when the person feels fine.⁴ If you are pregnant or breastfeeding, talk with your doctor about the benefits and risks of any medicine.³

Postpartum psychosis is rare but very serious. Signs include seeing or hearing things that are not there, false beliefs, confusion, paranoia, or acting very "high" or out of character. It is an emergency. Call 911 or go to the nearest emergency room.³

Depression with psychotic features

This is a severe form of depression. Along with depression, the person has psychosis, which means losing touch with what is real.^1,9 This can include:

• Delusions: strong false beliefs. In depression, they are often dark, such as being sure you have a terrible disease, have done something unforgivable, or have lost all your money.
• Hallucinations: seeing, hearing, or feeling things that are not there.

A person with psychotic depression may not see that their beliefs are not true. Family members are often the first to notice. This type needs prompt care from a psychiatrist. Doctors may add an antipsychotic medicine to an antidepressant.¹⁰ Electroconvulsive therapy (ECT) is another option. It uses a brief, controlled electric current while the person is under anesthesia (fully asleep). It is used for severe depression, including when psychosis is severe or a fast response is needed.^10,11 Learn more on our page about TMS, ECT and other brain stimulation.

Bipolar depression

Bipolar disorder causes big shifts in mood and energy. People have periods of depression and periods of mania or hypomania.⁸

• Mania is a high or very irritable mood with a lot of energy, little need for sleep, racing thoughts and risky choices. In bipolar I, it lasts at least a week or is severe enough to need hospital care.⁸
• Hypomania is a milder form. It can feel good or productive, so the person may not notice it. Family members often do.⁸

The depression in bipolar disorder can look just like major depression. Many people, especially those with bipolar II, only seek help when they feel low, so the diagnosis can take years.⁸ This matters because antidepressants used alone can set off mania or fast mood swings in people with bipolar disorder. Doctors treat bipolar depression with mood stabilizers or certain antipsychotic medicines, and add an antidepressant only for some people.⁸

If you have ever had a stretch of days with very high energy, little sleep and unusual behavior, tell your doctor, even if you felt fine at the time. Read more about types of bipolar disorder and the signs of mania and hypomania.

Premenstrual dysphoric disorder (PMDD)

PMDD is a severe form of premenstrual syndrome (PMS). It causes strong irritability, depression or anxiety in the week or two before a period. Symptoms usually ease within 2 to 3 days after the period starts.⁶ It affects up to 5 in 100 women of childbearing age.⁶

Symptoms can include sadness or hopelessness, anger, mood swings, crying, anxiety, trouble focusing, low energy, sleep changes, food cravings, and body symptoms like bloating and breast tenderness. Some people have thoughts of suicide.⁶ To diagnose PMDD, a doctor usually asks you to track your symptoms on a calendar for a few cycles.⁶

Treatment can include certain antidepressants (some are FDA-approved for PMDD), a specific birth control pill, stress management, exercise and diet changes.⁶

Other forms of depression

Doctors also describe depression linked to other causes:

• Depression around menopause (perimenopausal depression) can start during the change to menopause.¹
• Depression caused by a medical condition, such as an underactive thyroid. Long-term illnesses like heart disease, diabetes and cancer often come with depression, and each can make the other worse.⁹ See depression with heart disease, stroke, diabetes and pain.
• Depression caused by a medicine. Some medicines can cause symptoms that look like depression.⁹ Never stop a medicine on your own. Talk with your doctor or pharmacist first. See medicines that can affect mood and memory and what causes depression.

Grief is not the same as depression. Sadness after a loss is normal and comes in waves. But grief and depression can happen together. If deep sadness, hopelessness or trouble functioning goes on for a long time, ask for help. See our pages on grief and prolonged grief disorder.

How the types differ at a glance

Depression in later life

Depression is not a normal part of aging. Older adults can have any of the types above. In later life, depression is often tied to medical illness, medicines, loss and isolation. It may show up as tiredness, aches, poor sleep or memory trouble more than sadness. See depression in later life and, for people living with dementia, apathy and depression in dementia.

When to get help

See a doctor if low mood, loss of interest, or other symptoms last 2 weeks or more, or if they come back with the seasons, after a birth, or before each period. You do not need to know your type. Finding it is the doctor's job. Our page on getting checked for depression explains what to expect, and the check-in can help you put your feelings into words before the visit. When you know your type, see treatment for depression.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.