Depression is not one single experience. Clinicians use several labels to describe patterns of symptoms, how long they last, and whether particular features are present. This guide explains the different types of depression, why the distinctions matter, and where established treatments, including TMS therapy, may fit.
General information only, not medical advice. If you feel unable to stay safe, call 000. For crisis support in Australia, Lifeline is available 24/7 on 13 11 14.
1. Major depressive disorder (MDD)
Major depression involves a sustained low mood and/or loss of interest, along with symptoms such as changes in sleep, appetite, energy and concentration.
Severity varies, so care can range from structured therapy through to urgent, specialist support.
2. Persistent depressive disorder (dysthymia)
Persistent depressive disorder (dysthymia) describes long-lasting depressive symptoms that may be less intense day-to-day but draining over time.
Because it can feel like “just how I am”, people often delay help.
3. Melancholic depression
Melancholia is commonly treated as a subtype of major depression, often with a marked loss of pleasure and physical changes such as disturbed sleep.
Clinicians may manage it more assertively because it can be severe.
4. Psychotic depression
Psychotic depression is depression with psychotic features, such as delusions or hallucinations.
This needs urgent assessment, as judgement and safety can be affected.
5. Bipolar depression
Depression can occur within bipolar disorder, alongside episodes of mania or hypomania. Bipolar disorder and cyclothymic disorder are related conditions.
If you have had periods of unusually high energy, reduced need for sleep, or risky behaviour, raise it with your GP or psychiatrist, as it can change treatment choices.
6. Seasonal affective disorder (seasonal pattern depression)
Seasonal affective disorder (SAD) describes depression that follows a seasonal pattern.
Support may include psychological therapy, practical changes to daily routines and, for some people, medication.
7. Antenatal and postnatal (perinatal) depression
Depression can occur during pregnancy or after birth. Symptoms can be missed amid sleep disruption and the pressures of caring for a baby, so early assessment matters.
Assessment and treatment options
There is no single test that confirms depression. Assessment usually covers symptoms, duration, functioning, safety, past episodes and medical contributors. Treatment in Sydney is often “stepped”, matching care to severity and prior response. A GP can help you navigate the right depression treatment and eventually bring about favourable outcomes.
Treating depression – TMS therapy in Sydney
Repetitive transcranial magnetic stimulation (rTMS) is a clinic-based, non-invasive treatment that uses magnetic pulses to influence brain circuits involved in mood. RANZCP states rTMS is generally safe, well tolerated and supported by evidence in major depressive disorder, including treatment-resistant depression.
The RACGP also notes that anaesthesia is not required and patients remain conscious during treatment. Here are a few pointers about TMS therapy:
- Non-invasive, clinic-based treatment with no surgery; anaesthesia isn’t required for sessions.
- TMS falls under outpatient care, which means most people can resume normal activities soon after each visit.
- Evidence supports it for major depressive disorder, including treatment-resistant cases, with meaningful response in many, and can complement therapy and medication.
- People stay awake and it does not usually affect memory or concentration
- Side effects are generally mild and brief, which commonly includes headache, fatigue, or scalp discomfort.
Frequently Asked Questions:
1) What are the main different types of depression?
Common categories include major depressive disorder and persistent depressive disorder (dysthymia). Clinicians also describe subtypes such as melancholic and psychotic depression, and patterns such as seasonal affective disorder and perinatal depression. Depressive episodes may also occur within bipolar disorder or cyclothymic disorder, which affects treatment planning.
2) What’s the difference between major depression and dysthymia?
Major depression is usually more intense and episodic, often causing a noticeable drop in functioning. Dysthymia tends to be less severe on a given day, but it lasts much longer and can quietly erode motivation and confidence. Because patterns can overlap, an assessment should look at the longer story, not only recent weeks.
3) Can depression include psychosis?
Yes. Psychotic depression involves depression plus psychotic features such as hallucinations or delusional beliefs. Because a person’s judgement may be impaired, this needs prompt clinical assessment. If you think someone may act on harmful thoughts, treat it as urgent and seek immediate support, including Lifeline for crisis help.
4) What is TMS (rTMS) and how does it work for depression?
rTMS uses a magnetic coil near the scalp to deliver pulses that can influence activity in areas linked to mood regulation. RANZCP describes rTMS as a therapeutic medical procedure with a good evidence base in major depressive disorder. Sessions are delivered in a clinic setting without anaesthesia.
5) Is TMS safe and what are the side effects?
Common side effects reported in clinical use include temporary scalp discomfort and headache. A treating clinician should discuss your personal risks, including rare complications, and consider your medical history and current medications before treatment begins.
