Unipolar Depression – Major Depression – Signs, Symptoms & Treatment

Unipolar Depression

This is a major depression type named as a major depressive episode, which usually occurs after the manic phase in the form of classic unipolar depression. It is a psychiatric state of mind having all classic symptoms of lethargy, anhedonia, despondency, morbid, sleep disturbance, suicide attempts and feelings of worthlessness, but have no organic dysfunction.


Diagnostic Criteria for Unipolar Depression

The diagnostic criteria define the analyses and identification of unipolar depression. Here is the list of diagnostic criteria with different abnormal moods which significantly interfere with the life of the affected individual:

  • Abnormal loss of all pleasure and interest
  • Abnormally depressed mood swings
  • If 18 or greater than 18, abnormal irritable mood swings, nearly on regular basis, for at least 2 weeks.
  • Abnormal loss of all pleasure and interest mostly daytime, nearly on regular basis, 2 weeks at least.

Five of the following signs have been shown during the depressed period.

  • Abnormal unhappy mood (particularly at adolescent age).
  • Weight disturbance.
  • Weight loss or weight gain.
  • Decreased appetite.
  • Abnormal insomnia, abnormal hypersomnia or sleep disturbance.
  • Abnormal activity such as abnormal slowing or abnormal agitation.
  • Loss of energy or abnormal fatigue.
  • Indecisiveness or poor concentration.
  • Inappropriate guilt or abnormal self-reproach.
  • Abnormal morbid feelings of death or suicide attempts.

Sign and Symptoms

There are different factors contributing related to the development of unipolar depression. Typically, these factors manifest in coping reactions and behaviors to how the person feels. Depends on the condition, you may feel the various signs and symptoms.

  • Inability to focus
  • Restlessness
  • Negative thinking with the inability to access positive solutions
  • Agitation
  • Irritability
  • Lashing out at loved ones
  • Suicidal thoughts, morbid
  • Lethargy and exhaustion
  • Weight gain or loss
  • Increase in sleep
  • Withdrawing from regular activities or from loved ones.

These signs and indications are not due to the mood-contrasting psychosis. There is a combination of hypomanic episodes, diverse episode or manic episode. The signs are not due to the use of prescription, alcohol, street drugs or physical illness. Moreover, it is not due to the normal bereavement. According to the definition of the unipolar depressive disorder, the conditions do not include the following factors:

  1. Normal bereavement
  2. Street drug use, medication, alcohol, physical illness
  3. Bipolar Depressive diseases
  4. Mood-contrasting psychosis such as Delusional Syndrome, Schizoaffective Disorder, Schizophreniform Disorder, Schizophrenia disorder or Psychotic Disorder Not Specified).

Unipolar Depression Causes

Despondency is being generally a normal feedback to loss of interest. However, in unipolar depressive disorder, despondency is due to:

  • Loss of pleasure
  • Persists for more than 2 weeks
  • Functional impairment

Unipolar depression causes disabled physical symptoms such as weight, sleep, appetite and psychomotor activity. The sadness disorder is described as discouraging, hopeless or depressive attitude. This sadness is denied at the first time. Body pains or aches is the primary sign of the unipolar depression and considered as the true feeling of sadness. The loss of pleasure or interest in this disorder is the reduced capacity of the extreme sad feeling known as anhedonia. The outcome is the lack of motivation that can be quite crippled.

Abnormal Irritable Mood

Primarily this disorder showing irritable condition, rather than apathetic mood or depressed condition. Officially, this is not recognized by adults and not recognized easily in adolescents and children.  Unluckily, the irritable depressive disorder alienate their close relationship due to their cranky mood and criticisms.

Physical Symptoms

Slowing or Agitation:

Mental obstruction (an actual physical slowing of movement, speech, and movement) or psychomotor anxiety (physical restlessness or observable pacing) mostly present in the severe form of the unipolar depressive disorder.

Abnormal Appetite:

Many depressive individuals face weight loss or loss of appetite. Sometimes, excessive eating or weight gain also seen in some patient. Alterations in weight have been seen significantly.

Loss of Vitality or Fatigue:

Reflective fatigue and lack of potential typically are very disabling and prominent.

Abnormal Sleep:

Most depressed patients will be facing frequent awakening, difficulty sleeping during night time or early morning sleeping or awakening. The excessive sleeping occurs in some depressive patients.

Cognitive Symptoms and Major Depressive Disorder

  • Inappropriate guilt or abnormal self-reproach
  • Indecisiveness or Abnormal poor concentration
  • Reduced concentration is an initial sign of the unipolar depressive disorder. The disheartened person rapidly becomes intellectually exhausted when asked to study, read, or solve complex issues.
  • Negative thinking about specific character
  • Marked amnesia often accompanies the unipolar depression. As it degrades, this memorial loss can be easily erroneous for early senility known as dementia.
  • Atypical moody thoughts of death (not just fear of vanishing) or suicide

Unipolar depression causes marked dropping of self-confidence and self-esteem with increased negativity, hopelessness, and worthlessness. At risky stages, the person feels unreasonably and excessively mortified. Unipolar depression can be extremely dangerous and it eventually leads toward extremely suicidal or self-defeating actions. The sign and symptoms of the suicidal behavior are correlated with the signs of hopelessness or feeling of worthlessness.

History of Depressive Patients

Every depressive patient has a series of different life events. The history may include:

  • Severity and time course
  • History related to level of recovery and prior episodes
  • History of hypomanic or manic episodes
  • Suicidal plan, intents or ideation.

Examination of Unipolar Depressive Disorder

Analyses of possible medical outcomes are very necessary, such as chronic infection, hypothyroidism, anemia, substance abuse, drug side effects, antihypertensive and oral contraceptives etc. different screening tests are recommended for medical causes of the unipolar depression after a physical examination. Different lab tests include CBC (complete blood count), liver and renal function test, electrolyte or thyroid tests, etc. The suicidal ideation is present in serious condition, there are other complicating conditions and there is lack of supportive behavior at home.


Some scientists believed that antidepressants found to be equally effective in therapeutic doses. Almost 2-6 weeks latent period is effective for effective therapeutic doses. Medications continue to prevent the relapse for 4 to 9 months. For persistent depression, doctors recommend chronic prophylactic therapy.

Second-generation Antidepressants:

Second generation antidepressants include the selective serotonin reuptake inhibitors such as:

  • Venlafaxine used to monitor blood pressure
  • Bupropion recommended for the patients having the cardiac arrest. Also used as monotherapy with certain antidepressants for rest at bedtime.
  • Trazodone (Desyrel), the best treatment for those persons facing poor response or side effects from the antidepressants. Contraindicated with terfenadine and astemizole
  • Mirtazapine (Remeron)
  • Nefazodone (Serzone)


Supportive psychotherapy therapy is a part of unipolar depression treatment. Other categories of psychotherapy proved to be helpful in moderate to unipolar depression, with medication.

Substance Abuse:

The substance abuse is very common in depressed persons (especially cocaine and alcohol). Street drugs or alcohol is often used as a home remedy for unipolar depression. Though, the use of street drugs worsens the signs of the depressive disorder. Unipolar depression may be an outcome of alcohol or drug withdrawal and normally seen after the use of amphetamine and cocaine.

Risk Factors for Unipolar Depression

  • Neurological syndromes: Parkinson’s disease, multiple sclerosis, migraine, different kinds of epilepsy, brain tumors, encephalitis
  • .Endocrine disorders: hyperparathyroidism, diabetes mellitus Cushing’s disease and hypothyroidism.
  • Medications: Few medicines can cause unipolar depression, particularly antihypertensive mediators such as beta blockers, analgesics, calcium channel blockers and few anti-migraine medications.


Chronicity or disadvantages in unipolar depressive disorder are linked with the following factor:

  • Early age of onset
  • Inadequate treatment
  • Only partial recovery after one year
  • The greater number of previous episodes
  • Severe initial symptoms
  • Severe chronic medical illness
  • Family dysfunction
  • Experiencing another mental disorder (e.g. Cocaine Dependency and Alcohol Dependency)

Unipolar Depression VS Bipolar Depression

This article focuses on the unipolar depression and evidence concerning with the bipolar depression appear to be parallel or unique in their course, symptoms, and etiology. Over the past few years, conceptions of the unipolar depression with bipolar depressive disorder varied widely. The change in the conceptualization has been shown fundamental changes in the analyses and diagnosis nomenclature. Depression and mania are different terms, yet associated with the phenomena since Greece. According to the recent history, mood disorders have been divided into different syndromes of depression and mania. According to the father of psychiatric nosology, Kraepelin is the first individual who differentiates the depression and mania.

Functional DomainUnipolar DepressionBipolar Depression
Peer RelationshipsMore time on the computer, Decreased extracurricular activities or socializing.Excessive computer time, isolated activities, or isolated extracurricular activities.
School &  Academics / WorkModerate academic or work stress, work/Grades performance, deteriorating, cutting/missing class or work, decreased effort.high-stress work or academic stress, argumentative,  oppositional, doesn’t care about work, or school, failing performance.
Family  RelationshipsOppositional, negative and quiet.Aggressive, won’t talk, withdrawn, angry, brusque.
Suicidal IdeationOccasional, vague. Prior attempt, has a plan, frequently considered.
Other Self HarmNo attempts, but Occasional thoughts.Other self-injuries, cutting or damage.

Depressive Episode Criteria

Ideas of self-harm
Decreased activity
Diminished appetite

Reduced energy

Disturbed sleep

Loss of enjoyment or loss of interest in regular activities

Pessimistic thoughts

Depressive Mood

Ideas of unworthiness or guilt

Reduced confidence and self-esteem

With the move to differentiate unipolar depression from bipolar depression, few changes were made in the classification of depressive disorder which accompanied by mania. Mania and depression within unipolar depression viewed as a basic part of unitary sickness, dysregulation with a single dimension. Actually, the absence or presence of family history of unipolar depression with bipolar symptoms was no more included in the diagnostic criteria. The Unitarian view of unipolar depression justified with the difference between bipolar and unipolar depressive disorder, thought the episodes of unipolar depression are very common to other signs of the depressive disorder. These assumptions about unipolar and bipolar depressions are different and have been continued with the guided research for 30 years.

What’s “Manic Depression”?

At this stage of differentiation, it is very easy to forget the surrounding creations of the unipolar depression classification. Kraepelin and Hoche’s viewed:

“Manic-depressive disorder is a theoretical expression of the opposite pole of affectivity and close internal relationship, but there is no basic objective to raise against its relationship”

Different research has been identified from a biological correlation of manic-depression. It includes the increased level of dopamine activity, increased level of transmembrane potentials and alterations in dopamine receptor mechanism. Although, this article focus on the basic knowledge of unipolar depression and correlation with the bipolar depression, the comparison between these two terms, medicines, treatment and suitable home remedies to prevent the situation. While, there is no more research about the positive outcomes for neurotransmitter regulation, amphetamine-challenge mechanism, genetic transporter mechanisms, spectroscopy, neuro-transmitters actions. These suitable approaches are not better for the comparison terms and condition of the unipolar and bipolar depression. Three basic hormones are involved in both condition named as:

  • Dopamine
  • Norepinephrine
  • Serotonin (5-HT)

Psychosocial Antecedents to Depression

The psychosocial antecedents that are involved in the increased level of unipolar depression are:

  • Cognitive styles
  • Cognition during remission
  • Personality traits
  • Socio-environmental variables
  • Cognition during depressive episodes
  • Cognitive styles as predictors of depression

Psychosocial Treatment

Due to personality and cognitive similarities between bipolar and unipolar depression, it seems that psychosocial unipolar depressive treatments should equally effective for other types of the depressive disorder. Explaining the basic reason for equal efficacy is more important in the fact that depression stabilizers are used as mania treatment but not effective for other types.

Treatment and Physical Therapy

There are many depressive treatment approaches for unipolar depressive disorder. These methods include the following treatments:

  • antidepressant medications
  • somatic therapies
  • psychotherapy
  • electroconvulsive treatment

Electromotive Treatment

is avoided in many cases, only recommended in severe cases, if antidepressants and psychotherapy are not helpful. A specialist can provide both services prescribed antidepressants and psychotherapy, which is different for every person and depends on the condition. If you are facing any sign and symptoms of the major depressive disorder, you should talk to your doctor or specialist. Luckily, unipolar depressive disorder becomes the less activated form in recent years. There is plenty of information that is available for depression disorder, your specialist is likely to choose best strategies to recover your condition. The person should feel better by choosing the best method treatment. Talk to your doctor and specialist, is the first step of happy life. This is the best option to recover soon.



Reactive Depression