Anergic depression refers to a specific set of symptoms that are more prominent than others in the individual experiencing them. People who have an anergic type of depression might not have some of the other classic symptoms of depression. Someone with these symptoms might be mistaken for lazy or having some other type of depressive disorder.
Definition and Criteria of Depression
The Diagnostic and Statistical Manual of Mental Disorders, Revised (DSM-IV-TR, 2000) has specific criteria that must be met in order for a person to be diagnosed with Major Depressive Disorder. There is a difference between a Major Depressive Episode (MDE) and Having Major Depressive Disorder (MDD). Two be diagnosed with depression, you must have at least one episode and the absence of symptoms indicating another type of mood disorder. For instance, a manic episode would point to bipolar disorder. A MDE has two categories of symptoms. The first category contains: 1. Persistent feeling of sadness, being "blue or down." 2. Persistent lack of enjoyment in things you once did enjoy (anhedonia). The second category includes: 1. Insomnia or hypersomnia (inability to sleep or sleeping too much). 2. Change in appetite (eating too much or too little). 3. Fatigue/ loss of energy. 4. Psychomotor retardation or agitation (movements are agitated, jerking or take a great deal of effort). 5. Difficulty concentrating, inability to make decisions. 6. Excessive, inexplicable guilt or low self-esteem. 7. Recurrent thoughts of death or suicide. In total, you must experience five of the nine symptoms (at least one from category one, and four or more from category two for a period of two weeks or more to be diagnosed with MDD.
Definition of Anergic Depression
Dictionary.com defines anergy as a deficiency or lack of energy. Referring to the DSM criteria for MDD, anergy is essentially played out in the symptoms (e.g., loss of interest, lack of energy, psychomotor retardation). However, there is recognition that anergic depression looks a little different than people who do not experience those symptoms. A blog called "Psycho Babble with Dr. Bob" featured a post by a man reporting he suffers from anergic depression. This man described himself as consistently lacking energy or motivation to the point where it is debilitating in his everyday life. As a result, this man has to force himself to perform minimal tasks that the typical person would have little to no trouble completing.
Anergy as an Atypical Depression
Since depression can take several different forms (as there are nine unique symptoms), anergic depression is known as an atypical depression. Atypical depression is the most difficult to treat because people who have it are able to experience slightly elevated moods relative to positive events. While a person with anergic depression might lack the energy and motivation throughout their typical day, most likely they are able to experience happiness when something positive occurs, such as a friend visiting or receiving a favorable review at work. Because of this, recognizing any atypical depression, and especially the anergic type, is more difficult. Suffers might simply be seen as lazy or apathetic.
Other Types of Anergic Mood Disorders
Anergic depression has been found to accompany medical illness, especially in older patients. A few studies in the 1990s found that stimulant medication helped treat these symptoms. Another mood disorder, called dysthymia, is a low-level depression (meaning the symptoms are not as severe or pronounced), that lasts for at least two years. Anergy is a typical symptom of dysthymia. Anergy can also be experienced in bipolar disorder when a person is experiencing a depressive cycle.
The treatment for anergic depression will not vary much from treating other forms of depression. Monoamine oxidase inhibitors or selective serotonin reuptake inhibitors, which help reorganize neurotransmitters (chemicals) in the brain, are viable options for treating depression. Specific types of therapy can also prove helpful and help instill long-term changes, Cognitive behavioral therapy (CBT) will address specific thoughts and connect them to behaviors. A person with anergic depression might lack the motivation to wash the dishes to the point there is mold growing on them. CBT will help locate the thought behind the avoidance of performing the task and help the client change the way they think. Motivational Interviewing helps clients examine their ambivalence to promote positive changes. A lack of motivation and the inability to make positive choices are major features of anergic depression. Group therapy can be helpful as it exposes a person to others with similar problems or situations. Group therapy allows a person to benefit from clinical interventions as well as the insight of others with similar experiences.