The 12 Ways of Depression

December is a weird month. Even if you don’t participate in given cultural, religious, or social traditions, there always seems to be MORE of things: noise, people, pressure, deadlines, questions.

That latter one came up quite a bit for me over the holiday season: questions, that then transmuted into assumptions about how my professional career is going and whether my research is progressing and when will I be done with this latest degree and oh, wait, you have to delay things or add on time because you’re ill? What do you mean, you’re ill? You don’t look ill!

Which brings about some form of the following as a tag-on:

• But you’re just depressed, surely that doesn’t require you to put off your degree/life/people/things/eating/breathing.
• Oh, yes, my mother/grandmother/cousin/ex-husband was depressed, did you try a salt lamp/weighted blanket/acupressure mat? Worked wonders!
• You know, I was depressed for a while, and through exercise/changes in diet/meditation/CBD oil, I beat it! You’ll be fine!

This reminded me, yet again, how really terrible we are at talking about, let alone understanding, the extremely complicated world of depressive disorders. The difficulty is understandable, but that doesn’t mean it’s acceptable: those who don’t grasp the contexts and nuances of how someone suffers and struggles can cause incredible harm with their assumptions and false equivalencies.

So: given that we’re not very good at talking about this, I’m going to go for broke and try to explain 12 variants of “depression” we often hear of, experience, and/or encounter. And I’m going to try to do each in no more than three sentences and a gif.

(Necessary disclaimer: this means a lot of generalization and some inaccuracy as a result, but I’m willing to sacrifice these in the interest of keeping this focused on being a handy reference/easy-read guide to link to, a sort of polite “I’m exhausted by explaining this shit to people, educate yourselves” nudge for family gatherings.

Or for any gatherings.)

I’d hoped to get such a list written in the 12-Days-of-Christmas before the 25th, per the title. But then, ironically: depression thwarted me.

Then I remembered that the 12 Days of Christmas actually follow after the 25th, so. Here’s to helping get on toward Epiphany. Which is today. For some people.

(Intentional theological pun, there. I was raised Catholic. I remember some things.)

1. Depressed

I’ve never heard someone who experiences clinical depression or depression as a disease referring to themselves as “depressed”. Generally, depressed is a stopgap word we use when there are a lot of really good options to use instead. Let’s bring back “melancholic” or “filled with ennui” as alternatives, or hell: let’s just stop being afraid to use the word “sad”.

2. Depressing

Depressing is an adjective; it’s describing something. Again, it’s got a whole host of gorgeous synonyms, but it’s also pretty effective on its own. Likewise, also not something I’ve ever heard someone with depression as a medical condition use to contextualize their symptomology—but maybe my depression is depressing?

3. Situational / Reactive Depression

This is the kind of depression that is most likely to “go away” or be “beat” (which is a terrible way to talk about depression so please stop saying “I beat depression”, because a lot of people find that offensive but that’s a whole other post so we’ll leave it there for now). Per the descriptions themselves (and meriting a gif AND a static image), Situational or Reactive Depression is a depressed mood and/or other symptoms of clinical depression that are almost entirely experienced as a reaction to a situation. As such, ‘beating’ it correlates with working through, adapting to, or remedying the situation itself.

4. Seasonal Depression

Also known as Seasonal Affective Disorder (SAD), this can happen with either extreme season (summer OR winter). Usually, it’s a manifestation of some symptoms of depression that wax and wane with the change in seasons and the change in elements of one’s environment that come along with. Summer SAD and Winter SAD are different, too, with different typical symptoms.

5. Clinical Depression

Clinical Depression refers to a medical condition, an illness, a disease that existing on a spectrum of severity. Depression, as a term, arguably best describes the variations that exist under this banner. If a doctor has told you you’re depressed, and it’s a chronic condition? Clinical Depression.

6. Agitated / High-Functioning Depression

This one goes by lots of names, and whether or not it’s an “official” diagnosis is probably up to the practitioner and how much you like whichever version of the DSM they’re favoring. High-Functioning Depression often plagues the people who “don’t look like they’re depressed!”, manifests in keeping occupied to the point of overcommitment, and reacts with agitation or anger. It may or may not occur with other variations of depressions, but comorbidity or no, it’s still a bitch.

7. Unipolar / Bipolar Depression

For the sake of simplification: Unipolar Depression is usually just called “clinical depression” or “depression”. It goes one way: down. Bipolar Depression goes two ways: dangerous highs and dangerous lows.

8. Bipolar I Depression

Bipolar Type I goes between two poles, as noted above: depression and mania. Mania is usually characterized by risk-taking, whether that’s external or internal. Risking in ways like gambling or overshopping (thus destabilizing/“risking” finances) to risking your own wellbeing physically (pushing oneself professionally, over-exerting, irresponsible sex) can be manifestations of mania.

9. Bipolar II Depression

Just like Bipolar I Depression, but Bipolar II Depression doesn’t get as “high” in the mania department. Instead, it oscillates between depression and hypomania, which is a more subdued form of manic behavior. Exceptionally high productivity is one way this often manifests.

10. Rapid-Cycling Depression

Applicable to Bipolar Depression, the cycle of said depression is the amount of time it takes to go from high to low: mania/hypomania to depression. This is typically seen on a month-to-year spectrum, but when it flips more quickly, it can become more dangerous because it inherently becomes more unstable. The longitudinal cycle can shorten, in such cases, down to weeks, days, or even hours.

11. Treatment-Resistant Depression

Here’s where the whole “beating depression” thing becomes offensive. Because depression is still something we’re trying to figure out, not just because we only started talking about it within the last century, but also because we don’t fully understand that most-important organ it consumes: the brain. Point being: some forms of depression don’t respond to medication, or stop responding to medication, or don’t have an established treatment—and even if they do, those don’t work for everyone.

12. Atypical Depression

I already gave that caveat about generalization and incompleteness and inaccuracies-of-omission, but this one’s actually a thing. Again, because we don’t know all that much about depression on the whole, much as we try, and treating depression is, in fact, often a trial-and-error process? Atypical Depression is what we call the things that fall outside the lines we’ve tried to draw so far.

So, in short: atypical, with poles, for forever, or not? The best we can do is listen to Carrie Fisher, really. She was brilliant AF.