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Different Types of Depression

When a patient comes to my practice complaining of depression, it is important to distinguish the kind of depression that is presented. Depression can be situational, genetic or biological, or a combination of both.

Situational depression occurs when there is a triggering event which is distressing and creating a downward spiral. This can be a loss of a loved one, illness, rejection, abandonment, blow to one’s self esteem, a sense of failure in an important endeavor or trigger from past traumatic experience or event. All of us react to such events with deep sadness, but sometimes, it turns into feelings of depression which are associated with hopelessness, feelings of aloneness, lack of energy, sometimes guilt and shame.

Sometimes the depth of these feelings indicates a possible biological component as well. Situational depression can be treated and resolved with psychotherapy alone. Insight oriented therapy combined with a good therapeutic relationship can be enough. EMDR can also be very helpful as most causes of a situational depression have origins in past traumatic events. If the depression does not respond to therapeutic interventions, it may be a good idea to have a consultation from an experienced psychopharmacologist.

When a patient comes in with a depression that is more or less chronic with various degrees of severity and with no apparent trigger or precipitating event, there may be a biological cause. While psychotherapy is helpful, in these cases it is useful to consult a psychopharmacologist to explore options for antidepressant medication. A good psychiatrist is usually able to figure out the right medication which will alleviate the distressing feelings and lift the depression.