Types of Depression in Women

These are our current categories according to the DSM V, but understand that the  "types of depression" in women are likely much more complex and occur on a spectrum. I hope this is helpful for you in understanding yourself or someone you love better, but if it makes you feel stigmatized or pathologized disregard it. 

The following  types of depression in women linked to pages where you can learn more. 

Major Depressive Disorder

Major Depressive Disorder is a dramatic departure from the previous functioning of the person experiencing it. People will often notice, and so will you. We usually will call this a depressive episode. 

    A woman with a major depressive disorder will have a depressed mood ( feel empty, hopeless, or tearful) or loss of interest and pleasure nearly every day, most days.

You also technically need four or more symptoms for over two weeks from this list below:

weight loss or gain

    • change in appetite
    • insomnia
    • fatigue or loss of energy
    • Weight loss or gain
    • feeling worthless or excessive guilt
    • Insomnia or hypersomnia
    • decreased concentration
    • thoughts of death or suicide
    • recurrent thoughts of death
    • Psychomotor agitation or retardation
    • Feeling worthless or excessive/inappropriate guilt
    • Decreased concentration
    • Indecisiveness
    • Thoughts of death/suicide

Learn more about the physical symptoms of depression here

For a therapist to diagnose you with Major Depressive Disorder, these symptoms cannot be due to substance use, another mental health condition a medical condition and must cause problems in your functioning in a significant area of your life.

A major depressive episode can happen once or many times during a women's life, and  each time it becomes more likely to happen. 

Major Depressive Disorder (MDD) with Peripartum Onset describes both postpartum depression ( depression that occurs during the first four weeks after delivery)  and depression during pregnancy. Learn about anxiety during postpartum here. 

Depression during pregnancy Antenatal Depression, also known as prenatal or perinatal Depression is present in millions of women. Although in the past we thought that women who had experienced Depression might be protected against relapse by their hormones, evidence and studies over the last twenty years have shown that the opposite is true. Learn about depression and pregnancy here.

Here are some more pages on this website how to deal with all types of depression in women:

Persistent Depressive Disorder 

Persistent Depressive Disorder (PDD) or dysthymic disorder might describe you if you have had low grade depression for a long time.

Though PDD is a less severe departure from your previous functioning than major Depression, it can still be very crippling.  PDD has less symptoms then Major depressive disorder but LASTS at LEAST two years.

PDD in women consists of a depressed mood (feeling sad, empty, hopeless, or tearful) for most of the day, for more days than not, as indicated by subjective account or observation by others, for at least 2 years.

Presence while depressed of two or more of the following:

    • Poor appetite or overeating
    • Insomnia or hypersomnia
    • Low energy or fatigue
    • Low self-esteem
    • Poor concentration
    • Feelings of hopelessness
    • During the two year period, the symptoms have not been absent for more two months at a time.
    • The symptoms are not better explained by another mental health disorder, medical disorder, or substance abuse
    • During the 2 year period of the disturbance, the person has never been without symptoms from the above two criteria for more than 2 months at a time.
    • The symptoms cause clinically significant distress or impairment in important areas of functioning

Manic Episode


A distinct period of elevated expansive or irritable mood and abnormally and persistently goal directed behavior and energy lasting at least a week and present most of the day nearly every day. This mood state must cause some impairment in functioning, a hospitalization, or be accompanied by psychosis.

    • Three or more of the symptoms below accompany this week 
    • or
    •  Four or more symptoms accompany if merely  an irritable mood.
  • Symptoms
    • inflated self-esteem or grandiosity
    • decreased need for sleep
    • more talkative than usual or pressure to keep talking
    • flight of ideas or racing thoughts
    • easily distracted as reported OR observed
    • increase in goal-directed activity
    • psychomotor agitation
    • Excessive involvement in pleasurable or any  activities that have a high potential for painful consequences (gambling, spending money, sexual activity)
    • PER the DSM V  A full manic episode that emerges during antidepressant treatment (e.g., medication, electroconvulsive therapy) but persists at fully syndromal level beyond the physiological effect of that treatment is sufficient evidence for a manic episode and therefore a bipolar I diagnosis.

Depressive Episode

All of the symptoms below must occur most of every day for two weeks.

They must represent a change in how you have been functioning.

The symptoms cannot be due to another medical condition.

  • Symptoms
    • Either a depressed mood (in children, this can be irritability)
  • or
    • No pleasure or interest in previously enjoyed activities or any activities
  • and
  • 4 of the other symptoms are below:
    • Weight loss or gain or decrease increase in appetite
    • Not sleeping or sleeping too much
    • Feeling restless or slowed down.
    • Fatigue or loss of energy
    • Feelings of worthlessness or excessive or inappropriate guilt
    • Impaired concentration or difficulty making decisions
    • Recurrent thoughts of death, thinking of suicide with or without a plan or a suicide attempt.
    • Distress or impairment in functioning
    • It cannot be due to substance use or medicine or a medical condition

Hypomanic Episode

At least four days of the period of elevated, expansive, or (irritable mood if child especially), and abnormal and persistent increased activity and energy that lasts:

At least four days

Are present most of the day and

Nearly every day.

A noticeable change in previous behavior

During these days also 3 of these symptoms ( 4 if only an irritable mood is current)

    • Inflated Self Esteem
    • Decreased Need for Sleep
    • More talkative than usual
    • Flight of ideas or feeling like thoughts are racing
    • Easily distractible
    • Increased goal-directed activity or agitated physically
    • Excessive involvement in activities that have the potential for painful consequences
    • This is observable by others
    • Indicates a departure from normal functioning
    • It does NOT CAUSE significant impairment in functioning to necessitate hospitalization. If there are psychotic features, it is manic.
    • It is not caused by substances or medication. If caused by treatment and persists beyond treatment, it is indicative of hypomania.

Bipolar Disorder

 Bipolar disorder is a mood disorder that goes from severe highs (mania) to extreme lows (depression). During lows or Depression, the same symptoms of Major Depression apply. Mood swings from manic to depressive can be gradual or abrupt. Each woman has a different pattern, and this can change throughout the illness.

To understand mood disorders in women, you need to understand episodes. Episode criteria are to the right.

Bipolar I

Bipolar I consists of one or more manic episodes.

Technically no depressive episode must be present, but it almost always is.

  • Bipolar I = must equal a manic episode.


Bipolar II

Bipolar type II consists of one major depressive episode and at least one hypomanic episode. A person cannot be diagnosed with Bipolar type II disorder if they have had a manic episode.

Bipolar II = must equal a Major Depressive Episode + must have had a Hypomanic episode.

There are many pages on bipolar disorder on this website. Learn more here:

  • Alcoholism and bipolar
  • alternative treatments for bipolar
  •  memory and bipolar
  • self injury and bipolar disorder
  • the diagnosis of bipolar disorder
  • Being in a relationship with someone with bipolar disorder
  • And check out this page for information on child bipolar

  • Cyclothymia

    Cyclothymia is a mood disorder that consists of two years of episodes of hypomania and low-grade Depression. To be diagnosed with cyclothymia, you cannot have had a major depressive or manic episode during the first two-year period.

    All forms of depression can have seasonal components.

    Learn about seasonal and reverse seasonal depression here and light therapy. and causes of seasonal depression

    Premenstrual Dysphoric Disorder ( PMDD)

    PMDD criteria

    Diagnostic Criteria for Premenstrual Dysphoric Disorder (PMDD) according to the DSM 5

    Timing of symptoms 

    A)In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the beginning of menses, and become minimal or absent in the week post menses

    Symptoms

    B) One or more of the following symptoms must be present:

    • 1) Marked affective lability (e.g., mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection)2)
    • 2) Marked irritability or anger or increased interpersonal conflicts
    • 3) Markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts
    • 4) Marked anxiety, tension, and /or feelings of being keyed up or on edge

    C) One (or more) of the following symptoms must additionally be present to reach a total of 5 symptoms when combined with symptoms from Criterion B above

    • 1) Decreased interest in usual activities
    • 2) Subjective difficulty in concentration
    • 3) Lethargy, easy fatigability, or marked lack of energy
    • 4) Marked change in appetite; overeating or specific food cravings
    • 5) Hypersomnia or insomnia
    • 6) A sense of being overwhelmed or out of control
    • 7) Physical symptoms such as breast tenderness or swelling; joint or muscle pain, a sensation of “bloating,” or weight gain

    Severity

    D) The symptoms are clinically significant distress or interference with work, school, usual social activities, or relationships with others.

     E) Consider Other Psychiatric Disorders The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia) or a personality disorder (although it may co-occur with any of these disorders).

    Confirmation of the disorder

    F) Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles (although a provisional diagnosis may be made before this confirmation)

    Exclude other Medical Explanations

    G) The symptoms are not attributable to the physiological effects of a substance (e.g., drug abuse, medication or other treatment) or another medical condition (e.g., hyperthyroidism).

    One of the reasons that PMDD diagnosis is so rare is that PMDD cannot be diagnosed if a woman has a diagnosis of Depression or Bipolar Disorder. If that is the case, the woman is diagnosed with Pre Menstrual Exacerbation (PME).

    Adjustment disorder with Depression

    Women who have an adjustment disorder with depression have increased a stressor within three months of the signs of Depression. The symptoms of Depression are usually thought to be in excess to the stress and are usually expected to resolve themselves within six months. Adjustment Disorder with Depression cannot be diagnosed if better accounted for by another diagnosis or a worsening of a mental health condition you already have. These symptoms are normally expected to resolve within 6 months of the stressor going away

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders  (5th ed.). https://doi.org/10.1176/appi.books.9780890425596


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    Medical information obtained from this website is not intended as a substitute for professional care. If you have or suspect you have a problem, you should consult a healthcare provider.