Depression Articles

What is reactive depression? This article helps define reactive depression and offers information on the causes, risk factors, symptoms, and treatment options for reactive depression. Being depressed can be caused by a number of factors, reacting is just one.

Reactive Depression is a lay term associated with the diagnostic classification “adjustment disorder with depressed mood,” found in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition), while others use it synonymously with situational depression, and still others use it to refer to non-pathological depressions. This article will explain the disorder, the current thoughts about what causes and risk factors may be, symptoms, and an overview of treatments. Finally, some recent criticism of the category of adjustment disorders will be reviewed.

What Is Reactive Depression?

Reactive depression refers to one of the adjustment disorders listed in the DSM-IV, the one that is associated with depressed mood. The other types are:

• adjustment disorder with anxiety
• adjustment disorder with mixed anxiety and depressed mood
• adjustment disorder with disturbance of conduct
• adjustment disorder with mixed disturbance of emotions and conduct
• adjustment disorder unspecified

 Adjustment disorder (AD) is a short-term disturbance related to stress. Although it is normal to find the recovery from stressful events difficult, people with this disorder are judged to have a disproportionate reaction to a stressful event. A seasonal or continuous stress can also precipitate AD, but it is distinguished from bereavement, or mourning for someone who has died.

People with this disorder manifest their distress through their emotional reactions, their behavior, and/or their performance in their day-to-day activities, whether at work or at school. A person with reactive depression may be moody and tearful, feel hopeless, and/or show limited affect.

Causes and Risk Factors for Reactive Depression

The types of events that can lead to reactive depression include the end of a relationship, having problems at work or in school, imprisonment, dealing with a serious illness oneself or an illness suffered by a loved one, losing one’s job, a disturbance in family life, and financial problems, among others. People who don’t cope well with change in general may be more at risk for having reactive depression.

Symptoms of Reactive Depression

Unlike the other types of AD, which have the distinguishing features noted by the subtype name, reactive depression simply has the features of minor depression. It begins within three months of the identified stress, and leaves the sufferer either with more distress than is expected from the stress incurred or with a notable impairment of function in the social, occupational, or academic sphere (depending on age). It is limited to six months duration, unless it is chronic, in which case it may last longer.

Treatment of Reactive Depression

Because by definition AD is in response to a stressor, it is important to identify it and treatment may be aimed at its elimination, reduction, or accommodation, depending on what it is. Treatment is therefore likely to include improving coping strategies for stressors that cannot be ameliorated, as well working to gain perspective on the situation and identify supportive strategies. This is likely to be accomplished through psychotherapy, but antidepressants may also be used.

Sometimes a person with reactive depression is treated through group therapy or family therapy. Sometimes cognitive behavioral therapy is used.

Criticism of the Adjustment Disorders Including Reactive Depression

Some criticism has suggested that the subtypes of AD are not clearly defined and that the definitions should be reviewed. The lack of diagnostic specificity has been criticized by Baumeister and Kufner as leading to patients receiving treatments that are not based on scientific evidence of appropriateness, and a disinclination for researchers to invest their time and resources in finding out more about the area. In addition, they say that there need to be clearer criteria to distinguish adjustment disorders from both other diagnoses that are more specific, as well as from the range of normal human response when adapting to stressors.

Sources

emedicine.medscape.com
mayoclinic.com
journals.lww.com