The spectrum of depressive illness includes specific traits that define the type of depression being experienced. These include:
Major Depressive Disorder (MDD)
Major Depressive Disorder is the most common type of depression, and is also referred to as clinical depression. MDD falls within the defined FDA guidelines that allow for insurance to cover TMS for depression treatment. MDD is episodic, with each episode lasting at least two weeks, but can last months or years. MDD is frequently co-occurring with anxiety, which TMS therapy can also help to alleviate.
Persistent Depressive Disorder (PDD)
PDD is also referred to as dysthymia or chronic depression, characterized by a continuous, but usually less severe than MDD, form of depression. Both PDD and MDD share common traits, such as both causing overall low mood and a lack of interest in hobbies and activities once enjoyed. Both can also make normal daily activities and tasks difficult to perform. Because PDD and MDD can be difficult to differentiate, those who have been diagnosed as PDD may actually satisfy the criteria for MDD, thus satisfying the insurance coverage criteria for TMS treatment. Because of this, it is important to pursue a second opinion, if necessary, in order to determine the best depression treatment plan.
Bipolar Disorder
For years, this was more commonly known as manic depression or manic-depressive illness. That’s because it consists of the following two mood states: mania and depression. Symptoms are typically quite severe in both categories and are not to be confused with typical mood swings many people experience on a day to day basis. Bipolar disorder includes extreme lows with difficulty or inability to function, as well as extreme highs with racing thoughts or high-risk behavior. The following are the several different forms of Bipolar Disorder:
- Bipolar I Includes manic or mixed states (depression and mania together) lasting at least 7 days and depressive episodes that occur for 2 weeks or more
- Bipolar II Consists of what is called hypomania, episodes that are not as extreme as full-blown mania. Also includes depressive episodes
- Bipolar Disorder Not Otherwise Specified (BP-NOS)–symptoms include mania and depression but are not as extreme or do not meet the criteria for Bipolar I or II
- Cyclothymic Disorder—episodes of hypomania and mild depression that last for at least two years with milder symptoms than those listed above
- Rapid-Cycling Bipolar Disorder—typically seen in people who have an earlier onset of bipolar disorder, sometimes mid to late teens, with episodes that quickly switch between mania and depression or both at the same time
Postpartum Depression
Postpartum depression affects 10-15% of new mothers in the 12 months following the birth of a child. Symptoms last more than two weeks and include feelings of sadness, hopelessness, and guilt. Those afflicted may feel irritated and angry, have difficulty sleeping or eating, and have problems concentrating or staying focused. Sometimes these new mothers feel disconnected and can’t seem to bond with their baby. Many who suffer from postpartum depression are reluctant to seek help, out of fear of having their child taken from them. Postpartum depression treatment can be achieved through TMS that can help ease or alleviate depression before and after pregnancy, including through the breastfeeding phase, where antidepressants would not be permitted.
Psychotic Depression
Also called depressive psychosis, it combines a major depressive episode (MDD or bipolar) with psychotic symptoms. The psychotic symptoms consist of delusions and/or hallucinations. Delusions include themes such as guilt, shame, punishment, and low self-esteem. The hallucinations are typically auditory, visual, olfactory, or tactile (involve the sense of touch).
Seasonal Affective Disorder (SAD)
To date, the cause of Seasonal Affective Disorder is unknown. The symptoms of SAD typically begin in the fall and last through the winter months, with the most severe symptoms during the darkest months. SAD is thought to be caused by reduced sunlight, which changes brain chemicals and leads to the depressive symptoms. Factors such as high melatonin levels, low serotonin levels, and low levels of vitamin D are associated with the disorder. Symptoms include fatigue, trouble concentrating, apathy, loss of interest in sex, decreased activity level, overeating, insomnia, anxiety, and crying spells.