July 13, 2024

Chronic Depression

Depression is often bandied about casually to explain a person’s moodiness and odd behavior changes. The term itself has become a catch-all label and excuse for a host of conditions associated with despondency. The casual usage of the term depression belies the seriousness of this health disorder.

In the United States alone, close to 10 percent of the population suffer from some form of depression. In the world’s developed nations, about 15 percent of the population suffer from depression so much so that by the year 2020, depression is expected to be second in the list of top fatal illnesses. Presently, health experts conjecture that everyone in the world has been touched by depression through their own illness or that of loved ones.

What is Chronic Depression?

Medical experts have identified different types of depression for the purpose of diagnoses and treatment. In general, depression is characterized by an overwhelming sense of sadness and helplessness, low self-esteem and aversion to anything pleasurable including socialization. When symptoms persist for at least two years without any indication of remission, it is called chronic depression.

Types of Chronic Depression

Different sub-categories of chronic depression have been identified.

Dysthymic Disorder

From the Greek word thumos meaning temper, dysthymia essentially refers to a mild yet persistent state of low mood, feelings of hopelessness and low self-esteem. With dysthymia, patients lack the ability to focus on anything even activities that were previously of interest to the person. Patients with dysthymic disorder may continue to be functional. Some health professionals may consider it more severe than major episodic depression because of the prolonged manifestation of symptoms. Left untreated, chronic depression can lead to other chronic illnesses, exacerbate existing ones or turn into major depression.

Chronic Major Depression

When patients diagnosed with major depression have unremitting symptoms for at least two years without a hiatus, the diagnosis changes to chronic major depression. Obviously, this is more severe and more devastating than dysthymic disorder. One out of every five patients diagnosed with depressive disorders have chronic major depression, a condition that could be difficult to treat but is fairly manageable with the right therapies.

Double Depression

When dysthymic disorder that manifests for about two years is followed by an episode of major depression, it is referred to as double depression. This is a serious but fairly common condition that affects three out of four patients with depressive disorders.

What are the Symptoms of Chronic Depression

Chronically depressed persons will experience all or some of the following symptoms in no particular order.


• Inability to manage sleeping patterns – chronically depressed patients have difficulty getting up and staying out of bed or they may be completely unable to sleep
• Social isolation, withdrawal and aversion to social activities including those that were previously pleasurable to them.
• Inability to focus and slow reflexes
• Persistent despondency with no apparent reason
• Chronic pain or physical illnesses that may not have any obvious medical cause
• Irrational behavior
• Prolonged melancholia with no obvious cause
• Constant crying jags
• Unintended weight gain or weight loss that happens quickly
• Explosive display of anger and irritability
• Feelings of hopelessness and poor self-esteem
• Chronic fatigue and absence of motivation
• Poor memory and disorganization, lack of concentration
• Constant negativity
• Constant anxiety and worry
• Persistent thoughts of death and dying
• Thoughts of suicide and attempts at suicide
• Depression interferes with a person’s ability to manage school or their work life.

The defining characteristic of the chronically depressed has to do with duration of illness. The diagnosis is used on persons who, for at least two years, have been experiencing extreme and unrelenting feelings of excessive sadness coupled with at least two other symptoms listed above.

Causes of Chronic Depression

Genetic Pre-Disposition

Unlike other types of depression, chronic depression can be rooted in genetics. Persons who have had a family member affected with depressive disorder are more likely than others to develop the condition themselves.

Chemical Imbalance

Another known cause of chronic depression is chemical imbalance. When the neurotransmitters serotonin, norepinephrine and dopamine are out of whack, mood changes that lead to depression can occur.

Hormonal Changes

Hormonal changes can lead to depression. Estrogen and testosterone levels in the body can change with age or life events. These changes can alter biochemical processes and lead to depression that lasts for longer periods. In women, menopause is considered a precursor to chronic depression.

Physical Changes in the Brain

Physical changes in the brain due to the aging process or physical trauma.

Social and Environmental Factors

Social and environmental factors including death of loves ones, divorce, financial setbacks and traumatic events can lead to chronic depression.

Diagnosing Chronic Depression

Studies indicate that 80 percent of persons suffering from depression are not receiving any kind of treatment while 41 percent who recognize the symptoms on their own are too embarrassed to seek treatment.

Recognizing the symptoms of chronic depression is the first step. Self-reporting the symptoms to a doctor or qualified medical health professional will pave the way for a suitable care plan.

Medical professionals use established methodologies to diagnose chronic depression. Medical and family histories are examined. A complete physical including blood work will be done to rule out other conditions that could mimic depressive disorders. Some doctors will use behavioral tests to establish baseline information that will be useful in treatment and management of the symptoms.

depression treatmentTreatments and Management of Chronic Depression

For ailments that persist over a period of time, treatment and management go hand in hand. With chronic depression, a combination of antidepressant therapy and psychotherapy appear to offer the best chances for recovery.

Medications that have been useful in the treatment of depressive symptoms include tricyclic antidepressants, selective serotonin reuptake inhibitors and monoamide oxidase inhibitors. Moreover, therapies like the Cognitive Behavioral Analysis System of Psychotherapy allows chronically depressed patients to understand their problems and become more engaged in finding solutions for their issues.

Other treatment options are also used to help treat chronic depression including:


  • Talk therapy. Talk therapy can be between patient and psychological therapist or between patient and a trusted friend or family members. Often, the ability to elucidate one’s thoughts can lead to powerful solutions. At best, it makes the patient feel less alone.
  • Holistic treatments
  • Natural therapies such as acupuncture, yoga and meditation.
  • Hypnotherapy
  • Lifestyle changes including changes in diet and exercise regimen.
  • Group therapy

It Takes Courage

Chronic depression is as real an illness as diabetes or heart disease. The physical manifestations may not be as obvious but they will be if chronic depression is left untreated.

Contrary to misguided belief, a chronically depressed person is not able to just snap out of it. Depression is an ailment that took time to develop will take time, patience and a lot of resources to cure.

As soon as one recognizes the symptoms in themselves or in a loved one, seek help from a professional or a trusted person. There is no excuse not to seek treatment because chronic depression IS curable, albeit not quickly.

With access to appropriate therapies and a support network of health professionals, family and friends, chronic depression can be managed and most importantly those with the condition can reclaim their lives. The prognosis for someone suffering from chronic depression is excellent if that individual gets help and follows the treatment prescribed. Given time, complete recovery is a distinct possibility.


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