Three Types of Depression

November 8th, 2011
By Cynthia W. Lubow, MS, MFT, Depression Topic Expert Contributor

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I want to mention three more types of depression experiences in this series describing the variety of ways people can experience depression. They are:

• The low joy, low satisfaction type
• The self-medicating type
• The purely brain-chemistry type
  

Low joy, low satisfaction type—People say things like, “stop and smell the roses,” and, “it’s the small joys that make life wonderful.” These are people who are blessed with an abundant capacity to feel joy. However, there are other people who just don’t have (I believe the brain chemistry, or perhaps the permission for) this. People who don’t have the capacity for much joy have to plan the ultimate Saturday night, or vacation, or weekend—filled with guaranteed pleasure after pleasure. This is what it takes for them to feel some joy or sense of satisfaction that others feel with simple events such as when their stomachs are full, or they’re looking at a sunset. Those without much capacity for joy know that one movie won’t do it. Two movies, an amazing dinner out, some chocolate and sex might. To people around them, this is a great deal of pressure and demand. When people with low joy don’t get what they need to feel some pleasure or satisfaction, they are disappointed and depressed, and others can feel like they failed, or feel guilty for feeling good.

Sometimes people with low joy are seen as negative or critical, because of their inability to be satisfied. Without adequate brain chemistry, people can actually physiologically lack the ability to feel the emotion of satisfaction. So imagine, if you cannot feel satisfied, how would that affect your life? You might not feel satisfied no matter what you eat, so you are driven to eat more and more—trying to get that feeling of satisfaction we all expect from eating. You might not feel satisfied sexually, no matter how hard your partner tries to satisfy you, so you might need sex to last much longer and happen much more often than your partner needs. You might turn to addictive chemicals or activities to try to feel some pleasure and satisfaction you can’t find any other way. And when people asked you if you enjoyed a movie or a meal or an adventure, your response might honestly be “not really.” If you didn’t know what was going on, your mind might turn to ways it could have been better, so that you could have said “yes.”  But then all you would have to say is criticism, and that’s not usually what people want to hear when they’ve enjoyed something and ask their companion if they’ve also enjoyed it. So the lack of ability to feel much joy and satisfaction can have very destructive, and far-reaching effects for a person suffering this way.

Self-medicating type This includes anyone who uses a substance or activity to boost their low mood, low pleasure, low motivation, etc. Sometimes self-medicating becomes addiction, and then the benefit is outweighed by the negative consequences. People can use anything that positively boosts the availability of the “pleasure chemicals” in the brain, such as serotonin, dopamine, beta-endorphins, nor-epinephrine, etc. Of course, anti-depressant medications do this without causing addiction, but people often try their own methods, using food/sugar/chocolate, alcohol, street drugs, prescription opiates, gambling, shopping, sex, falling in love, video games, Facebook, other internet activities, and many others. Usually self-medicating works in the beginning and it may even obscure that fact that depression exists. Usually, though, self-medicating causes highs and lows. The lows stimulate the need to do more self-medicating, and more and more is needed over time to create the same effect. As people self-medicate more and more, negative consequences pile up. They get into debt; they gain a great deal of weight, or lose health; they have affairs and lose their primary relationship; they disengage with the world to lose themselves in video games or internet activities; they have to steal to maintain drug supply, or lose jobs to being drunk.

The point is that self-medicating experiences of depression may look and feel like addiction—and indeed be addiction, but may have started as unrecognized depression that is undoubtedly still lurking underneath the self-medicating methods or addictions.

Underneath the self-medicating type is often low joy, or excessive pain types –or probably any of the other types, but it can be impossible to tell what’s going on under the addiction, until it’s not active—then another type or types may emerge.

Purely brain-chemistry

There are people who get depressed despite having had loving, responsive parents, and/or have healed their emotional wounds. Most of the time they can feel powerful, joyful, self-accepting, energetic, and hopeful, but periodically episodes of depression strike for no reason from events in their lives, or internal emotional conflicts. It just hits like the flu hits. This is probably a relatively small group, but it does seem to exist. People with this kind of depression can often be helped with medication or ECT treatment, but psychotherapy has minimal effectiveness, because it’s not the person’s problems, or childhood, or traumas or self that needs to be healed—it’s simply their brain. Well, we don’t understand much about all of this, so it’s probably not “simple,” but it’s not complicated so much by life, as other experiences of depression are. That is, until the depression itself affects the person’s life by disabling them, and creating problems in their lives.

So in the past eight blog entries, I’ve covered most of the experiences people have of depression. When people have several of these at the same time, they can be diagnosed with depression. When they only have one of these experiences, they may not meet the medical criteria for depression, but they may still be suffering tremendously. If you recognize yourself in any of these experiences, find a good therapist to help you figure out where the suffering is coming from, and what you need to get relief. Most depression is treatable.

Related Articles:
The Irritable or Angry Experience of Depression
The Hopeless Experience of Depression
The Anxious or Agitated Experience of Depression

©Copyright 2011 by Cynthia W. Lubow, MS, MFT, therapist in El Cerrito, CA. All Rights Reserved.

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