Types of depression

Common types of depression

The diagnoses most often made in clinic are major depressive disorder, persistent depressive disorder, and the depressed phase of bipolar disorder. These three account for the large majority of depression diagnoses in adults. The remaining presentations (seasonal pattern, postpartum onset, depression alongside a medical illness, depression with prominent anxiety) are common enough that most clinicians see them every week, and each has its own treatment considerations.

Types at a glance

The table below summarizes the basic shape of each type. It is a starting point, not a substitute for an evaluation. The links lead to the detailed page for each type.

How clinicians tell them apart

The names matter because the treatments differ. The questions a clinician asks are about pattern, duration, and history. Has there ever been a period of unusually elevated mood, racing thoughts, pressured speech, or sharply reduced need for sleep? That history shifts the diagnosis toward bipolar disorder, which is treated with mood stabilizers rather than antidepressants alone. Has the low mood lasted years rather than weeks? That points toward persistent depressive disorder, which often needs longer treatment than a single episode of major depressive disorder. Did the symptoms follow a pregnancy, a season, or a medical illness? Each of those answers brings its own set of evidence-based first steps.

A careful first evaluation usually screens for thyroid disease, anemia, vitamin B12 deficiency, sleep apnea, chronic pain, and substance use, since these can all produce a clinical picture that looks like depression. The Mood Disorder Questionnaire (MDQ) is one common screen for bipolar disorder. The PHQ-9 is the most common screen for the severity of depressive symptoms. The Edinburgh Postnatal Depression Scale (EPDS) is the most common screen during pregnancy and the postpartum year.

Less common subtypes

Several recognized subtypes are seen less often in clinic but worth naming:

• Premenstrual dysphoric disorder (PMDD). A pattern of mood, irritability, and physical symptoms that begins in the week before menses and resolves shortly after onset, present for most cycles in the past year. PMDD is in the DSM-5-TR depressive disorders chapter and is treated with SSRIs (continuous or luteal-phase) and selected hormonal options.
• Disruptive mood dysregulation disorder (DMDD). A childhood diagnosis defined by chronic irritability and severe temper outbursts that are out of proportion to the situation, with onset before age ten. It was added to the DSM-5 in 2013 to reduce overdiagnosis of pediatric bipolar disorder.
• Atypical depression. A specifier of major depressive disorder marked by mood reactivity (mood briefly lifts in response to positive events), increased appetite or weight gain, hypersomnia, leaden paralysis, and a long-standing pattern of interpersonal rejection sensitivity.
• Melancholic depression. A specifier marked by a profound loss of pleasure or response to usually pleasurable stimuli, distinct quality of depressed mood, early morning awakening, marked psychomotor slowing or agitation, anorexia or weight loss, and excessive guilt. Often more responsive to medication and sometimes to electroconvulsive therapy.

Other DSM-5-TR specifiers include depression with psychotic features, with catatonia, and with mixed features. Each has its own treatment considerations and is usually managed with input from a psychiatrist.

When to see a psychiatrist

A primary care clinician can manage many cases of depression well, especially uncomplicated major depressive disorder responding to a first or second medication. A psychiatrist is worth involving when the diagnosis is unclear, when there is a question of bipolar disorder, when two or more medications have not produced response, when symptoms include psychosis or catatonia, when suicidal thoughts are present and not improving, when the depression is in the postpartum period and severe, or when the picture includes substance use that the primary care clinician is not equipped to address. The how to find a therapist or psychiatrist guide walks through what to ask on a first call.

Sources

• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR).
• American Psychiatric Association. Practice Guideline for the Treatment of Patients with Major Depressive Disorder.
• NICE Guideline NG222. Depression in adults: treatment and management. 2022.
• Yatham LN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and ISBD 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018.
• American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 757: Screening for Perinatal Depression. 2018.

Reviewed by Shariq Refai, MD, MBA. Last reviewed March 15, 2026.