Types of depression
Depression can be divided into different types, which may be treated differently, as summarised below. More details about treatments, as well as lifestyle changes, you can make yourself, are given in other parts of this website.
The term ‘major depression’ is used for symptoms ranging from the minimum needed to meet the diagnostic criteria, (see ‘How is depression diagnosed’) through to all the symptoms of depression. Major depression can be split into mild, moderate and severe, according to how many symptoms you have and how much it is interfering with your life (see below). Dysthymia is a less severe condition which doesn’t meet the criteria for major depression, but goes on for a long time.
Types of major depression
In mild depression you may have only the minimum number of symptoms for your doctor to make the diagnosis. You may still be able to do your usual activities, although it takes a lot of effort. Mild depression still feels bad and affects your quality of life — it’s worth getting help.
Treatment approaches: psychological therapies (also called talking therapies) are more effective than antidepressants for mild depression, and are usually tried first.
In moderate depression, you have more than the minimum number of symptoms to make the diagnosis, and you have difficulty functioning normally.
In severe depression you have most or all of the symptoms to make the diagnosis and have great difficulty (or inability) to go about your daily activities. For example, you may not be able to work or care for your children or even leave your home. Some people with severe depression may be diagnosed as having ‘melancholia’, which has characteristic physical symptoms.
Treatment approaches: antidepressant therapy and talking to your doctor are the usual first steps. Psychological therapies may be added later once the antidepressants have started to have an effect. People who are very severely depressed may find it too hard to start psychological treatments in the beginning. Electroconvulsive therapy (ECT) may be used for severe depression that doesn’t respond to other treatments.
Other types of depression
This is depression that occurs after the birth of a baby. Read more about postnatal depression.
Psychological therapies, counselling and support services are often helpful. Antidepressants can also be useful, but talk to your doctor or pharmacist about the risks and benefits of these medicines if you are breastfeeding.
Depression is often accompanied by anxiety, and, depending on which symptom is worse, the diagnosis could be depression or anxiety. ‘Mixed depression and anxiety’ can be diagnosed if the symptoms are below the threshold for either disorder.
Both depression and anxiety are helped by antidepressants. Psychological therapies, either alone or with antidepressants, are useful for people with anxious depression. Cognitive behavioural therapy (CBT) is effective for anxiety.
Dysthymia or dysthymic disorder
This is a mild depression that lasts for at least 2 years, often longer, but is not severe enough to be called major depression.
The effectiveness of antidepressants is unpredictable in dysthymia, although there is some evidence from clinical trials that they can help. There have not been many trials of psychological therapies in dysthymia, but there is some evidence that they can be helpful.
Seasonal affective disorder
This type of depression usually begins in autumn or winter and gets better in spring. It is thought to be brought on by the shorter hours of daylight in these seasons. ‘Affect’ is another term for mood or emotion, so ‘affective disorder’ means a disorder that affects moods and emotions.
Bright light therapy can be helpful, as can antidepressants. Psychological therapies have less evidence to show that they help in treatment of seasonal affective disorder.
In bipolar disorder (formerly known as manic depression), periods of depression alternate with periods of mania (feeling high, elated and able to do anything). Bipolar disorder is often undiagnosed, as the length of time between cycles of mania and depression can vary considerably. For more information about bipolar disorder, see
People in a depressed phase of bipolar disorder are usually treated with an antidepressant plus a mood stabiliser, such as lithium or valproate. Using antidepressants on their own is not recommended for people with bipolar disorder because they can bring on a manic episode. Sometimes an antipsychotic medicine is also used.
This is a mixture of severe depression and psychotic symptoms, such as hallucinations (seeing or hearing things that are not there) or delusions (believing things that are not true).
People with psychotic depression are usually treated with a combination of antidepressant and antipsychotic medicines, or ECT.
For more information
- Children and depression
- Teenagers and depression
- Older people and depression
- Treatment for depression
- Medicines for depression: antidepressants
- Psychological therapies
- What to do next if you feel depressed
- Ellis P; Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Depression. Australian and New Zealand clinical practice guidelines for the treatment of depression. Aust N Z J Psychiatry 2004;38:389–407. (accessed 9 February 2012).
- National Collaborating Centre for Mental Health. Depression: the NICE guideline on the treatment and management of depression in adults (updated edition). London: National Institute for Health and Clinical Excellence, 2010. (accessed 9 February 2012).
- Boyce P, Barriball E. Circadian rhythms and depression. Aust Fam Physician 2010;39:307–10. (accessed 14 February 2012).