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Millions of everyday Americans suffer from depression in one form or another. A milder form of depression known as persistent depression disorder – once referred to as dysthymia – is characterized by sadness, anger, guilty feelings, and a general loss of hope.

Persistent depression disorder affects over one percent of the total U.S. population and encompasses more than 3 million American adults. Only about three out of five adults suffering from persistent depression disorder are receiving any kind of mental health or medical treatment whatsoever.

If left untreated, persistent depression disorder could devolve into more serious conditions like major depressive disorder.

Major depressive disorder affects more 6 persistent of the United States’ adult population making it the leading cause of disability for adults under age 45. Major depressive disorder is marked by persistent, profound sadness and loss of interest in many activities that sufferers previously drew pleasure from.

A general feeling of apathy, discontentment, and comorbid (co-occuring) anxiety are not usual symptoms for sufferers of major depressive disorder to experience while in the throes of the disorder.

Some lesser known symptoms of major depressive disorder are weight gain or extreme weight loss and a diminished appetite. Sufferers might also experience agitation and social isolation.

It’s not uncommon for a sufferer to want to withdraw from friends and even close family members because of feelings of guilt or feelings that their presence is somehow unwanted or “bad” for those around them.

Low-energy levels, issues concentrating, self-esteem issues, and problems falling or staying asleep (insomnia) can characterize both persistent depression disorder and major depressive disorder. Major depressive disorder is sometimes called unipolar depression (as opposed to bipolar depression in which the suffer oscillates between being manic and depressed) and requires a medical diagnosis from a qualified medical professional.

According to the experts there are many different shades of major depressive disorder that can be diagnosed and treated by mental health experts. These include: seasonal affective disorder (common), psychotic depression (less common), post-partum depression (very common), melancholic depression (common), and catatonic depression (less common).

Melancholic depression can be characterized by feelings of guilt, sadness, and hypersomnia or oversleeping. Negative thinking patterns, feelings of disappointment and social withdrawal are characteristic of seasonal affective disorder and melancholic depression alike.

Morbid thoughts and feelings of lethargy or a general decreased energy level might also be accompanying symptoms for sufferers of either melancholic depression or seasonal affective disorder. So, can anything be done?

A doctor may ask you a standard set of questions to determine whether you might suffer from depression in addition to drawing blood and checking for any irregular medical conditions that might mimic or cause the symptoms of depression, according to WebMD. Because you may show different manifestations of depression (e.g., weight gain versus loss or apathy versus irritation) it’s important to consult with a mental health professional or your general practitioner and ask for a depression screening.

Cognitive behavioral therapy is one possible means of treating your depression. Cognitive behavioral therapy takes the view that a depression sufferer’s mood is partly or entirely attributable to maladaptive thoughts. Negative thoughts, thoughts that exacerbate feelings of low self-esteem (“I’m really no good anyway” or “they wouldn’t miss me if I didn’t show up to the party” or “nobody really appreciates me in the end”), and skewed perceptions of the past are common.

Psychotherapy is another route that depression sufferers have taken to tackle the underlying issues of their depression. Antidepressant medications can also be used as a complement to cognitive behavioral therapy or as a standalone treatment for depression among adults.