Long term depression, also called dyshtymia or chronic depression, is characterized as depression that lasts for at least two years. Symptoms of long term depression are similar to regular depression, and include chronic sadness, anxiety, loss of interest, changes in sleep and eating habits, fatigue or lack of energy, trouble concentrating and overwhelming feelings of guilt and hopelessness.
Like other forms of depression, long term depression can cause serious interference in an individual’s daily life; especially concerning their relationships with other people. People with long term depression are typically described as having unhappy or gloomy personalities, which often makes it difficult to form and maintain healthy relationships with others.
Causes of Long-Term Depression
Although the exact cause of long term depression is unknown, several factors may be involved. Causes may include the following:
Genetics
Like depression and other psychological conditions, some individuals may be genetically predisposed to dyshtymia.
Substance Abuse
Studies show that long term depression can often correlate with substance abuse; however, it is debated as to which is the cause and which is the effect. For example, dyshtymia may stem from long term substance abuse, or an individual with long term depression may self medicate in order to relieve symptoms of depression. No matter the cause or effect, studies show that each disease can intensify the symptoms of the other.
Social Factors
Social factors often play a role in depression and other psychological illnesses. Stressful lifestyles, socioeconomic status and lack of social support can often cause or intensify symptoms of dyshtymia.
Emotional or Psychological Trauma
If not dealt with properly, traumatic events can often lead to long term depression. Events such as the death of a loved one, a divorce or the loss of a job can often lead to chronic depression.
Other Psychological Conditions
Long term depression can often coexist with or stem from other psychological conditions, such as anxiety, phobias, bipolar disorder and/or schizophrenia.
Risk Factors
Since the exact cause of long term depression is not known, it can be hard to pinpoint risk factors for the disease. However, certain factors seem to increase the risk of long term depression, including having close relatives who suffer from dyshtymia, depression or other psychological conditions and stressful or traumatic life events.
In addition, studies show that adult females are much more likely to suffer from dysthymia than their male counterparts. This could be due to higher levels of stress hormones in women, or could stem from the fact that men are less likely to admit and seek treatment for symptoms of depression.
Complications of Long Term Depression
If left untreated, symptoms of long term depression can intensify and lead to complications such as reduced quality of life, suicidal thoughts or actions, social isolation, difficulties at school or work and conflicts with friends and family members.
Diagnosis
In addition to a physical examination, a complete psychological evaluation is necessary when diagnosing long term depression. Psychological evaluations often include filling out questionnaires and discussing symptoms with a mental health professional.
Since symptoms of dysthymia can often mimic those of other psychological conditions, a doctor will have to rule out other causes for symptoms, including manic depression or bipolar disorder, personality disorders, drug or alcohol abuse and seasonal affective disorder, also known as seasonal depression.
In order to be diagnosed as dysthymic, an individual must meet the main criterion as having symptoms of depression that have lasted for at least two years. In addition, symptoms must interfere with the ability to function in daily life and must include at least two symptoms of regular depression such as loss of interest and disturbances in sleep and eating patterns.
Treatment for Long Term Depression
Primary treatment options for long term depression include medication and talk therapy. Sometimes one or the other is used, but treatment is typically more effective when a combination of the two methods is used.
Talk therapy can include several different types of therapy, including the following:
Psychoanalysis
Psychoanalysis is performed with a mental health professional in a one-on-one environment. The point of this time of therapy is to explore an individuals subconscious in order to find causes of depression or other psychological conditions. Patients usually undergo psychoanalysis several times a week, and are encouraged to speak freely about their thoughts, fears, experiences and emotions.
Behavior Therapy
Also performed in a one-on-one setting, his type of talk therapy focuses on how a person’s behavior can relate to their depressive symptoms. Aspects of behavior therapy include role playing, self-monitoring, logging activities and behaviors and behavior modification. Behavior therapy often utilizes the concept of rewarding positive behaviors, which can serve as motivation for positive behaviors.
Cognitive Therapy
Used primarily for depression, this type of psychotherapy encourages the patient to change the way he sees the world and himself. Aspects of cognitive therapy include self-imagery and self-instruction
Group Therapy
Group therapy is when a group of individuals with similar symptoms are treated by one or more therapists in a group setting. Members of a group are encouraged to share their thoughts, feelings, coping methods, etc. Support group therapy is usually successful in alleviating some of the guilt and shame associated with depression, as well as offering support and motivation from like-minded individuals.
Medications
Medications used to treat dyshtymia are the same as those used to treat
depression. These medications include antidepressants such as the following:
Monoamine Oxidase Inhibitors, or MAOIs
Serotonin and Norepinephrine Reuptake Inhibitors, or SNRIs
Selective Serotonin Reuptake Inhibitors, or SSRIs
Norepinephrine and Dopamine Reuptake Inhibitors, or NDRIs
Tricyclic antidepressants
Tetracyclic Antidepressants
Although these medications work in different ways, all antidepressants treat depression by affecting certain chemicals in the brain that are responsible for mood. Antidepressants are typically prescribed on a “trial and error” basis, meaning that several medications may be administered until the desired effect is achieved.
Antidepressants are often associated with undesirable side effects or adverse reactions. Side effects can include weight gain, sexual dysfunction, worsening
of symptoms, headache, problems with digestion, drowsiness and dizziness. In children, adolescents and young adults, antidepressants have been linked with dangerous effects such as suicide.
Prevention of Long Term Depression
Although causes of long term depression may include psychological or genetic factors, there are ways to reduce the risk of developing this condition. Prevention methods include a healthy diet, regular exercise, avoiding stressful situations whenever possible, making an effort to remain social and maintain
relationships, learning relaxation techniques and setting reasonable life goals. In addition, since depression can lead to dyshtymia, seeking help for symptoms as soon as they present themselves is crucial in prevention.
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