Long term depression, also often referred to as chronic depression, can occur for a wide variety of reasons. For some, the depressed mood remains almost constant for many years, a condition known as dysthymia, while others experience recurrent periods of major depression which are intense but temporary.
Major depressive disorder is a mental health condition which causes acute low mood, lack of motivation, intense fatigue, feelings of worthlessness, hopelessness or guilt, and thoughts of self harm or suicide. During major depression an individual is likely to struggle to continue with their daily routine and work, and is unlikely to find pleasure in activities that they would usually enjoy.
Symptoms of major depression are very acute and debilitating, and with long term depression, episodes tend to recur despite being successfully treated with each occurrence. Individuals with recurring major depression may be genetically predisposed to the condition, or they may have significant past or ongoing trauma or stress which contributes to episodes.
Some people with long term depression will actually have a condition called dysthymia, which shares some symptoms with major depression but presents itself in a different way. Dysthymic disorder generally has fewer, less intense symptoms than acute episodes of major depression. It tends to be diagnosed in individuals who have had depressive symptoms on most days for a period of two years or more.
Dysthymia can often occur for very long periods of time - sometimes as long as two years or more. However, since symptoms tend to be less severe than major depression, sufferers may find it is possible to continue with their normal daily routine and continue to work, despite feeling incredibly unhappy.
In some cases, episodes of major depression can occur whilst an individual is suffering from dysthymia, something known as "double depression". During these episodes, symptoms of depression will become significantly more severe and sufferers may struggle to continue with day to day life.
Around 3% of Americans currently have dysthymia, but it is possible that many simply don't seek help, treatment or even diagnosis because they attribute their constant low mood to their personality. Since people with dysthymia have less intense symptoms than those with major depression, they can remain mostly functional in their daily lives and therefore don't feel compelled to seek treatment. For this reason, dysthymia may be more common than the statistics would lead us to believe.
It is estimated that major depression affects one in six men and one in four women at some point in their lives. At least 50% of major depression sufferers go on to experience a second episode, and 80% of those have further recurrences. Individuals who have a medical history of depression are likely to have between five and nine episodes throughout their life.
Anybody who has been suffering from persistent low moods for several weeks or more should seek treatment from a doctor. Although the symptoms of dysthymia may seem manageable, if the mental illness is left untreated it could become worse and develop into episodes of major depression.
Individuals who are experiencing severe thoughts of self-harm or suicide should seek help as soon as possible. If it is not possible to visit your normal family doctor urgently and you are concerned that you might harm yourself or others, it may be necessary to visit the ER for urgent care and to get yourself out of immediate danger.
Episodes of major depression are typically treated with antidepressant medications (SSRIs, TCAs or SNRIs) and psychotherapies such as CBT, or a combination of both. These methods may be used each time an individual experiences an episode of depression, or they may be used as preventative treatments to reduce the risk of further major depressive episodes.
Treatments for dysthymia tend to be very similar to those for major depression, but there may be more focus on psychotherapy to help sufferers find methods to cope with their long term depression symptoms, change negative behaviors for positive ones, and identify things that contribute to low mood.