Do I Have Chronic Depression?

Reviewed Sep 6, 2018

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Summary

  • Differs from acute depression in duration and also in the seriousness of its effects.
  • Social and work factors as well as medical conditions can look like chronic depression.

During the past two weeks, have you felt down, depressed or hopeless? During these same two weeks, have you felt little interest or pleasure in doing things you normally like to do? If your answer to either of these questions is yes, then you may be experiencing depression. 

Depression that is bad enough to interfere with your work or getting along with other people is a serious problem. It robs life of joy and hope. Getting through the day becomes a painful task. Depression is hard on you and on others who care about you. It can even set the stage for a serious medical health problem. Depression that makes work or your social life hard is called chronic depression when it lasts a long time. Chronic depression doesn’t usually get better without treatment. If you don’t know that help is needed, though, you won’t look for it. So how do you know if you have chronic depression?

What is chronic depression?

Chronic depression is the label for a few different conditions. Each of these lasts at least two years without a significant break. A major depressive episode that lasts this long is one pathway to chronic depression. It includes low mood or loss of pleasure for at least two weeks, and is present every day or most of each day, along with at least five other symptoms. These include changes in sleep, changes in appetite, loss of interest, low energy, poor concentration, reduced or restless activity, or suicidal thoughts or actions. Major depressive episodes last at least two years in one of every five people. If you have gotten partly better, you still may have chronic depression if you never got back to wellness.  

In some cases of depression, the symptoms were never bad enough to be called major depression. Yet they interfered with work or social life. They were not explained by other health conditions. Depressed mood was present most of the day, more days than not, for at least two years. At least two additional problems were also present during this time. These could be appetite that was too low or too high, too little or too much sleep, low energy, low self-esteem, poor concentration, or feelings of hopelessness. During the two years, depressive symptoms did not lift for longer than two months at a time. This form of depression is called persistent depressive disorder (or dysthymia). If it started first and a major depressive episode came later, this is called double depression.

What causes chronic depression?

Depressive symptoms aren’t always caused by the disease of depression. It is important to know when other causes are present because the treatment approach may be different. Some life situations, for example, can make a person feel depressed all the time. If you are in a difficult job or relationship, or worried all the time about your health or finances, you cannot enjoy your life as fully as possible.

If you were harmed or traumatized as a child, or if you get very anxious, your symptoms may look like chronic depression. Some medical problems such as low thyroid functioning, heart disease, anemia or lung disease can drain your energy and look like depression. Some sleep problems, such as breathing trouble during sleep called sleep apnea, can cause symptoms like depression. Drugs such as alcohol, antihypertensives and steroids can create symptoms that look like it too. 

Many people with chronic depression never get evaluated or treated. Some individuals consider signs and symptoms of depression to be a natural part of the aging process. Others associate these symptoms with their culture and/or other social beliefs. If you think you have chronic depression, please seek help from your doctor or a mental health specialist. That way, you have a good chance to feel better, enjoy life more, and function more successfully.

By James M. Ellison, M.D., M.P.H.
Source: Pignone MP, Gaynes BN, Rushton JL, et al. Clinical guidelines: Screening for depression in adults: A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2002;136:765-776; Torpey DC, Klein DN. Chronic depression: Update on classification and treatment. Current Psychiatry Reports 2008;10:458-464; Murphy JA, Byrne GJ. Prevalence and correlates of the proposed DSM-5 diagnosis of chronic depressive disorder. J Affective Disord 2012;doi:10.1016/j.jad.2012.01.033
Reviewed by Philip Merideth, M.D., J.D., Physician Advisor, Beacon Health Options

Summary

  • Differs from acute depression in duration and also in the seriousness of its effects.
  • Social and work factors as well as medical conditions can look like chronic depression.

During the past two weeks, have you felt down, depressed or hopeless? During these same two weeks, have you felt little interest or pleasure in doing things you normally like to do? If your answer to either of these questions is yes, then you may be experiencing depression. 

Depression that is bad enough to interfere with your work or getting along with other people is a serious problem. It robs life of joy and hope. Getting through the day becomes a painful task. Depression is hard on you and on others who care about you. It can even set the stage for a serious medical health problem. Depression that makes work or your social life hard is called chronic depression when it lasts a long time. Chronic depression doesn’t usually get better without treatment. If you don’t know that help is needed, though, you won’t look for it. So how do you know if you have chronic depression?

What is chronic depression?

Chronic depression is the label for a few different conditions. Each of these lasts at least two years without a significant break. A major depressive episode that lasts this long is one pathway to chronic depression. It includes low mood or loss of pleasure for at least two weeks, and is present every day or most of each day, along with at least five other symptoms. These include changes in sleep, changes in appetite, loss of interest, low energy, poor concentration, reduced or restless activity, or suicidal thoughts or actions. Major depressive episodes last at least two years in one of every five people. If you have gotten partly better, you still may have chronic depression if you never got back to wellness.  

In some cases of depression, the symptoms were never bad enough to be called major depression. Yet they interfered with work or social life. They were not explained by other health conditions. Depressed mood was present most of the day, more days than not, for at least two years. At least two additional problems were also present during this time. These could be appetite that was too low or too high, too little or too much sleep, low energy, low self-esteem, poor concentration, or feelings of hopelessness. During the two years, depressive symptoms did not lift for longer than two months at a time. This form of depression is called persistent depressive disorder (or dysthymia). If it started first and a major depressive episode came later, this is called double depression.

What causes chronic depression?

Depressive symptoms aren’t always caused by the disease of depression. It is important to know when other causes are present because the treatment approach may be different. Some life situations, for example, can make a person feel depressed all the time. If you are in a difficult job or relationship, or worried all the time about your health or finances, you cannot enjoy your life as fully as possible.

If you were harmed or traumatized as a child, or if you get very anxious, your symptoms may look like chronic depression. Some medical problems such as low thyroid functioning, heart disease, anemia or lung disease can drain your energy and look like depression. Some sleep problems, such as breathing trouble during sleep called sleep apnea, can cause symptoms like depression. Drugs such as alcohol, antihypertensives and steroids can create symptoms that look like it too. 

Many people with chronic depression never get evaluated or treated. Some individuals consider signs and symptoms of depression to be a natural part of the aging process. Others associate these symptoms with their culture and/or other social beliefs. If you think you have chronic depression, please seek help from your doctor or a mental health specialist. That way, you have a good chance to feel better, enjoy life more, and function more successfully.

By James M. Ellison, M.D., M.P.H.
Source: Pignone MP, Gaynes BN, Rushton JL, et al. Clinical guidelines: Screening for depression in adults: A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2002;136:765-776; Torpey DC, Klein DN. Chronic depression: Update on classification and treatment. Current Psychiatry Reports 2008;10:458-464; Murphy JA, Byrne GJ. Prevalence and correlates of the proposed DSM-5 diagnosis of chronic depressive disorder. J Affective Disord 2012;doi:10.1016/j.jad.2012.01.033
Reviewed by Philip Merideth, M.D., J.D., Physician Advisor, Beacon Health Options

Summary

  • Differs from acute depression in duration and also in the seriousness of its effects.
  • Social and work factors as well as medical conditions can look like chronic depression.

During the past two weeks, have you felt down, depressed or hopeless? During these same two weeks, have you felt little interest or pleasure in doing things you normally like to do? If your answer to either of these questions is yes, then you may be experiencing depression. 

Depression that is bad enough to interfere with your work or getting along with other people is a serious problem. It robs life of joy and hope. Getting through the day becomes a painful task. Depression is hard on you and on others who care about you. It can even set the stage for a serious medical health problem. Depression that makes work or your social life hard is called chronic depression when it lasts a long time. Chronic depression doesn’t usually get better without treatment. If you don’t know that help is needed, though, you won’t look for it. So how do you know if you have chronic depression?

What is chronic depression?

Chronic depression is the label for a few different conditions. Each of these lasts at least two years without a significant break. A major depressive episode that lasts this long is one pathway to chronic depression. It includes low mood or loss of pleasure for at least two weeks, and is present every day or most of each day, along with at least five other symptoms. These include changes in sleep, changes in appetite, loss of interest, low energy, poor concentration, reduced or restless activity, or suicidal thoughts or actions. Major depressive episodes last at least two years in one of every five people. If you have gotten partly better, you still may have chronic depression if you never got back to wellness.  

In some cases of depression, the symptoms were never bad enough to be called major depression. Yet they interfered with work or social life. They were not explained by other health conditions. Depressed mood was present most of the day, more days than not, for at least two years. At least two additional problems were also present during this time. These could be appetite that was too low or too high, too little or too much sleep, low energy, low self-esteem, poor concentration, or feelings of hopelessness. During the two years, depressive symptoms did not lift for longer than two months at a time. This form of depression is called persistent depressive disorder (or dysthymia). If it started first and a major depressive episode came later, this is called double depression.

What causes chronic depression?

Depressive symptoms aren’t always caused by the disease of depression. It is important to know when other causes are present because the treatment approach may be different. Some life situations, for example, can make a person feel depressed all the time. If you are in a difficult job or relationship, or worried all the time about your health or finances, you cannot enjoy your life as fully as possible.

If you were harmed or traumatized as a child, or if you get very anxious, your symptoms may look like chronic depression. Some medical problems such as low thyroid functioning, heart disease, anemia or lung disease can drain your energy and look like depression. Some sleep problems, such as breathing trouble during sleep called sleep apnea, can cause symptoms like depression. Drugs such as alcohol, antihypertensives and steroids can create symptoms that look like it too. 

Many people with chronic depression never get evaluated or treated. Some individuals consider signs and symptoms of depression to be a natural part of the aging process. Others associate these symptoms with their culture and/or other social beliefs. If you think you have chronic depression, please seek help from your doctor or a mental health specialist. That way, you have a good chance to feel better, enjoy life more, and function more successfully.

By James M. Ellison, M.D., M.P.H.
Source: Pignone MP, Gaynes BN, Rushton JL, et al. Clinical guidelines: Screening for depression in adults: A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2002;136:765-776; Torpey DC, Klein DN. Chronic depression: Update on classification and treatment. Current Psychiatry Reports 2008;10:458-464; Murphy JA, Byrne GJ. Prevalence and correlates of the proposed DSM-5 diagnosis of chronic depressive disorder. J Affective Disord 2012;doi:10.1016/j.jad.2012.01.033
Reviewed by Philip Merideth, M.D., J.D., Physician Advisor, Beacon Health Options

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