Although independent of one another, these four categories show an escalating intensity of depression. In general, we could divide depression into two categories: situational and chemical. Situational Depression exists when a painful situation presses the heart down for a period of time. Chemical Depression can occur when your body chemistry does not function properly.
A person can have both types of depression at the same time. During these heavy-hearted times when hope seems elusive, emotions feel flat and the heart feels sick. Solomon, the wise author of the Book of Proverbs, explains that …“Hope deferred makes the heart sick, but a longing fulfilled is a tree of life.”(Proverbs 13:12)
The four types of depression described below, are not listed in this order in a diagnostic manual. They are intended to show the increasing negative impact of depression:
- Normal Depression …Is sometimes called Situational Depression or Reactive Depression. Is an involuntary sadness based on a reaction to painful life situations – Normal problems of life press down the heart for a short period of time (for example, rejection, failure, illness) – Transitional stages of life often press down the heart (for example, adolescence, empty nest, midlife crises, major moves, menopause, retirement). When severe troubles fell upon God’s servant Job (the death of all his children, the destruction of all his possessions), one of his friends observed Job’s understandable depression. “Now trouble comes to you, and you are discouraged; it strikes you, and you are dismayed.” (Job 4:5)
- Masked Depression …Is hidden depression (for example, repressed memories of physical, sexual, verbal, or emotional abuse); Is a state of enduring sadness based on unresolved, buried conflict – Painful feelings are denied or covered up; therefore, recovery takes longer because of failure to work through the pain – Relief from emotional pain is unconsciously found in excessive busyness, activities, addictions, or other alternatives. The Bible describes how hidden hurts still result in heartache.…“Even in laughter the heart may ache, and joy may end in grief.” (Proverbs 14:13)
- Neurotic Depression …Is a minor mental and emotional Depressive Disorder classified as Adjustment Disorder with Depressed Mood, meaning that the depression results from failure to adjust to a distressing situation – A person with neurosis has a disorder, meaning that normal activities of daily living are impaired – A person with any Depressive Disorder has “clinical depression” the need for diagnosis and treatment based on direct, ongoing observation. Is a prolonged state of sadness lasting longer than the normal time frame expected for emotional recovery – based on “stressors” (for example, loss of an endeared relationship, a financial or work crisis, retirement). Symptoms interfere with normal work and social functioning. The cause can usually be traced to an identifiable, precipitating event. The Psalms reflect the pain of prolonged sorrow.…“How long must I wrestle with my thoughts and every day have sorrow in my heart? How long will my enemy triumph over me?” (Psalm 13:2)
- Psychotic Depression …Is the most severe type of depression under the classification Major Depressive Disorder (MDD). Is based on dissociation or a loss of contact with reality. A psychosis is an extreme state of depression. A psychosis is usually accompanied by hallucinations and/or delusions, making those who are psychotic a potential danger to themselves and/or others. Those afflicted with a psychotic depression can identify with the terror, despair, and skewed perspective described in this Psalm. …“My days vanish like smoke.… My heart is blighted and withered like grass; I forget to eat my food.… I lie awake; I have become like a bird alone on a roof.… I eat ashes as my food and mingle my drink with tears.… I wither away like grass.”(Psalm 102:3–4, 7, 9, 11)