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Characterized as one of the most common mood disorders, unipolar depression is a subtype of depression that triggers continuous feelings of sadness, gloom, or lack of interest in interacting with others. Up to 7 percent of the U.S. population suffers from an episode of unipolar depression at some point in life. [1] Contrary to bipolar depression, where a person frequently changes mood between mania and depression, unipolar depression has a focal point of negative feelings and emotions. Understanding this psychiatric disorder can help people catch it and manage it in time.
What is Unipolar Depression: A Brief Overview
Also known as major depressive disorder, unipolar depression is a psychiatric disorder condition that targets both physical and mental health. This severe condition includes various symptoms, like persistent low mood, sad feelings, worthlessness, lack of interest in everything, and suicidal ideation.
Some other types of depression that may potentially fall under this “unipolar” umbrella include the following:
- Persistent Depression: Also known as dysthymia, this condition involves mild symptoms of depression that last at least two years without entirely disappearing at any point. In simpler words, persistent depression causes chronic low mood on an ongoing basis.
- Postpartum Depression: This type of depression usually appears post-pregnancy and can cause additional challenges, such as difficulty bonding with the newborn or fear regarding the new parental role.
- Situational Depression: Symptoms of this type of depression pop up within three months following a traumatic or stressful event. Also known as reactive depression, this type of unipolar depression shows up as a response or reaction to a specific stressor.
Unipolar Depression Symptoms and Diagnostic Criteria
According to experts, a person must exhibit at least five of the following symptoms to get a diagnosis of unipolar depression: [2]
- Low Mood: A person should feel depressed or sad most of the day. Additionally, they may feel hopeless, uncertain, empty, or sad about the future. Children may manifest these symptoms as irritability or behavioral issues.
- Loss of Pleasure: A person may get minimum or no pleasure from activities they once used to enjoy.
- Sleep Troubles: Unipolar depression may cause a person to sleep too little or too much.
- Appetite and Body Weight Changes: A person may experience changes in their appetite without trying. Some may start overeating while others restrict their intake, leading to a loss or gain of up to 5% of the body weight.
- Concentration Issues: Difficulty focusing, thinking clearly, or paying attention may also occur in some people. Others may experience brain fog that interferes with their thinking process.
- Thoughts of Suicide/Death: A person may experience intrusive thoughts of harming themselves, dying, or suicide.
- Fatigue: A person may feel emotionally or physically exhausted, sometimes to the extent that it interferes with their daily tasks and motivation levels.
Remember that the criteria for unipolar depression will only be met if the symptoms mentioned below are not due to any health condition or bipolar disorder. Moreover, these symptoms must cause significant distress and must not be expected to any medication use. Furthermore, these symptoms must never be preceded or succeeded by a manic episode.
People diagnosed with unipolar depression often visualize the world and the environment around them through a distorted lens, which directly affects how they feel and think about others and themselves. [3] Consequently, they commonly face low self-esteem, interpersonal conflicts, rejection sensitivity, and other similar issues.
What Causes Unipolar Depression?
While unipolar depression does not have an exact cause, many factors may contribute to its development or heighten the risk of acquiring it at some point. These risk factors can be categorized into the following groups:
Biological Factors
A combination of genetic predisposition and stress alters the chemical balance in the brain, diminishing its ability to stabilize mood and maintain it. Additionally, changes in hormonal balances also increase the possibility of acquiring unipolar depression. Many experts believe that unipolar depression occurs due to a lack of balance in neurotransmitters in the brain and spinal cord. Norepinephrine and serotonin are the two primary neurotransmitters triggering the unipolar depression symptoms.
Psychological Factors
External events can affect individuals in different ways. A person’s response and thoughts to these events determine what they will experience in life. Moreover, these factors also impact their level of happiness and the risk of acquiring a mood disorder, such as unipolar depression.
Their experiences share how a person views the world, and the most critical phase of this process occurs in childhood and early teenage years. Parenting also plays a crucial role in determining a child’s psychological health. For instance, a person who faced an abusive upbringing is likely to view the world for the worse. When such a person faces negative situations later in life, they consider themselves worse, ultimately developing emotional suffering, which predisposes them to mental diseases, such as unipolar depression.
Environmental Factors
It is very common to become victims of unfortunate and stressful events in life, which can trigger the risk of unipolar depression and other mental health disorders. Some of these common environmental triggers include the following:
- Loss of employment
- Moving houses
- Financial struggles
- The passing of a loved one
- A breakup or divorce
- Extended periods of conflicts in a relationship, either with co-workers, friends, or family members
- Social isolation or a lack of socialization
- Health challenges, such as a chronic health issue
- Stress at the workplace due to pressure to perform or conflicts with colleagues
Unipolar Depression Treatments: The Role of Medications and Therapy
The combination of psychotherapy with medication has been deemed highly effective for treating unipolar depression for most people. Psychiatrists and primary care doctors can prescribe appropriate medicines to ease or cure the relevant symptoms. However, for long-term benefits, it is better to see a mental health professional so that they can help patients identify and work through their underlying issues triggering depression.
In cases where symptoms become very severe, a hospital stay may become necessary until the severity reduces.
Medications
Once a patient has been diagnosed as a case of unipolar depression, treatment often commences with a prescription antidepressant medication. Selective serotonin reuptake inhibitors, otherwise known as SSRIs, are the most commonly prescribed antidepressants to help people with unipolar depression. Because such people often lack serotonin, a neurotransmitter responsible for mood and sleep regulation, SSRIs can help them by slowing the breakdown of serotonin and increasing its levels in the brain.
Approximately 40 to 60 percent of people who start an SSRI treatment notice improvement in their symptoms within six to eight weeks. Some common examples of SSRIs include citalopram and fluoxetine, which are believed to be highly effective with a low possibility of side effects. Other medications for unipolar depression include tricyclic antidepressants of TCAs, which are often prescribed if treatment with SSRIs fails. TCAs are not the primary drug for depression, and their side effect profile is worse.
People in particular situations, such as pregnancy or lactation, must always seek professional advice before commencing any medication to protect themselves and their babies.
Psychotherapy
Also known as talk therapy, psychotherapy involves meeting with a psychiatrist regularly to discuss mental health and talk about any issues related to an underlying condition. While psychotherapy alone may not be enough to manage unipolar symptoms on its own, many studies have found it effective, especially when combined with antidepressant use. A large-scale study that took place in 2013 with more than 400 participants found that treatment-resistant depression responded well to talk therapy in addition to taking regular medication. [4]
Psychotherapy can particularly help with unipolar depression management by assisting patients to:
- Increase the feelings of esteem and self-worth
- Regain life control
- Improve communication skills
- Identify new ways to solve challenging life situations or cope with them
- Change the overall belief system to be more positive
- Increase the sense of life satisfaction
- Replace bad habits with positive ones
- Adjust to stressful events
- Get out of a crisis phase
Can Lifestyle Changes Make Unipolar Depression Better?
In addition to medication and therapy, making positive changes in life can also improve the symptoms of unipolar depression. Some simple adjustments in daily habits may go a long way in helping people become better at handling various life situations and improving overall mental health.
Mentioned below are some lifestyle changes to make unipolar depression symptoms more manageable:
- Eating right: Studies found that foods rich in vitamin B, such as legumes, meat, whole grains, and dark leafy vegetables, can positively affect people with unipolar depression. Protein-rich foods like peas, lean meat, yogurt, and beans can also help combat these symptoms by boosting energy and alertness.
- Getting enough sleep: Most people should aim for 8 hours to regain energy and acquire and maintain a stable and positive mood. Those struggling to sleep must get in touch with a doctor to learn what more they can do to improve their sleep cycles.
- Regular exercise: Research indicates that exercising regularly can provide equal benefits to using antidepressants to manage the symptoms of unipolar depression. This is because exercises, especially the ones high in intensity, release chemicals in the brain known as endorphins that carry positive psychological effects.
- Avoiding alcohol: Alcohol is a depressant of the central nervous system, which means that it can worsen the symptoms of depression. Heavy alcohol use also decreases the efficacy of antidepressants. Unfortunately, people with unipolar depression may frequently rely on alcohol to manage their symptoms, which puts them at risk of developing an addiction. For these reasons, people with all sorts of mood disorders must avoid alcohol use and take precautions if drinking.
FAQs
What is the difference between bipolar vs unipolar depression?
Unipolar depression is used to separate major depressive disorder from bipolar disorder, in which a person may experience alternating periods of depression and mania. Sometimes, bipolar disorder may be misdiagnosed as depression in people going through the depressive phase. Due to this misdiagnosis, they may receive treatment that cannot help them with their symptoms. Remember that unipolar depression only causes the typical symptoms of depression, such as low mood, guilt, sorrow, and loss of joy in activities, in contrast to bipolar, where manic and hyperactive symptoms may replace these depressive symptoms.
Can unipolar depression cause any secondary symptoms?
The typical symptoms of unipolar depression used to make a diagnosis can sometimes lead to secondary symptoms, such as the following:
- Relationship conflicts
- Trouble getting a job or keeping it
- Difficulties with self-care
- Trouble with academics
References
1 Major Depression – National Institute of Mental Health (NIMH) [Internet]. www.nimh.nih.gov. [cited 2023 Dec 22]. Available from: https://www.nimh.nih.gov/health/statistics/major-depression?ref=guides.clarahealth.com
2 Abuse S, Administration MH. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet].
3 Rnic K, Dozois DJ, Martin RA. Cognitive distortions, humor styles, and depression. Europe’s journal of psychology. 2016 Aug;12(3):348.
4 Martin S. Your Precious Life: How to Live it Well. Orpen Press; 2016 Aug 12.
