It frequently presents in the form of physical complaints with normal medical workups. Although sadness and grief are normal responses to loss, depression is not. Grief is usually accompanied by an intact self esteem, whereas depression is characterized by a sense of guilt and worthlessness. In general, there are three major types of depression with similar symptoms in each group. Depression may occur in reaction to some identifiable stressor or adverse life situation, usually the loss of a person by death, divorce, financial crisis, loss of a role.
Anger is often a symptom which in turn leads to feelings of guilt.
Depression occurs within 3 months of the stressor and causes impairment in social, occupational, or school performance. Symptoms vary but can include loss of interest and pleasure, withdrawal from activities, feeling guilty, unable to concentrate, anxiety, fatigue, feeling worthless, insomnia, weight loss, agitation. Dysthymia is a chronic depressive disturbances with sadness, loss of interest, and withdrawal from activities over a period of 2 years or more. Generally, the symptoms are milder but longer lasting than major depressive episode. Seasonal Affective Disorder dysfunction in circadian rhythms occur more in winter and believed to be due to decreased exposure to light.