What Is Chronic Depression?

Reviewed Aug 17, 2017

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Summary

  • Depression that lasts at least two years is called chronic.
  • Chronic depression is serious but treatable.

Many of us wake each morning feeling happy and good. We look forward to being with other people, working, eating, exercising or having fun. We may be starting a busy and stressful day, but there will be moments that bring us joy. There may also be times when we are feeling sad or down. These periods may be brief lasting only a day or two.

However, for some of us, the day begins differently. Imagine waking up tired. You slept poorly and are in a bad mood. Your body aches. You don’t have much energy. Getting out of bed is almost too difficult. The day ahead looks hard. Nothing seems fun, but you have got to keep going. If this is how you feel most of the day, and if you have been feeling this way for several weeks, you may have depression. Chronic depression is repeated long-lasting bouts that come and go.

Understanding major depressive disorder

Depression is a complicated word. You might say you are depressed when you’re just feeling lousy for the moment. Major depressive disorder, though, is the disease of depression. That means having a low mood for more than two weeks, along with other problems such as changes in sleep, appetite, focus and interest. You might feel guilty, restless or have very low energy. You might even be thinking about ending your life. Major depressive disorder is diagnosed when a lot of these problems are present, but depression even with fewer symptoms can be very bad.

Understanding chronic depression

Most people with major depression feel better over time. With treatment such as medications or psychotherapy, many get better faster. But at least one in every five people with significant depression keeps on feeling that way for months. Once it has lasted at least two years, it is called a chronic depression.

Chronic depression comes in a few different forms. Some people have persistent depressive disorder (or dysthymia), a condition in which a person’s mood is depressed most of the day, more days than not, for at least two years. At least two of the following problems are also present during this time: appetite that is too low or too high, too much or too little sleep, low energy, low self-esteem, poor concentration or feelings of hopelessness. During this time, there is no break in the low mood and other problems that last longer than two months at a time. The mood problems can’t be blamed on drugs or medical conditions or other problems. The low mood gets in the way of working or getting along with other people. If someone with dysthymia gets depressed enough to fit the description for major depression, they are said to have double depression.

Chronic depression also can refer to an episode of major depression that has lasted at least two years or improved only partly.

Depression that begins earlier in life is more likely to become chronic. Chronic depression also can begin in later years. Having a family member with it can increase the risk of experiencing depression.

A depression that is chronic is more serious in some ways, because it is less likely to get better even with treatment. Chronic depression is often found in people with lower social support. It is linked, too, with a greater risk for having other issues such as alcohol or other drug problems. People with chronic depression are more likely to think about or complete suicide. They experience a sense of poorer health and a greater level of disability.

The good news

Chronic depression is serious and common, but it is a treatable condition. Treatment may be needed for a long time, since the risk for getting depressed again is high, but newer antidepressants and specially designed approaches to psychotherapy offer hope to many. With good treatment, there can be relief from depression and much greater happiness in life!

By James M. Ellison, MD, MPH
Source: Gelenberg AJ, Kocsis JH, McCullough JP et al. The state of knowledge of chronic depression. J Clin Psychiatry 2006;67(2):179-184; Hölzel L, Härter M, Reese C, et al. Risk factors for chronic depression—a systematic review. J Affect Disord 2011;129(1-3):1-13; Klein DN, Shankman SA, Rose S. Ten-year prospective follow-up study of the naturalistic course of dysthymic disorder and double depression. Am J Psychiatry. 2006;163(5):872-80.
Reviewed by Gary R. Proctor, MD Regional Chief Medical Officer, Southeast/Central Region, Beacon Health Options

Summary

  • Depression that lasts at least two years is called chronic.
  • Chronic depression is serious but treatable.

Many of us wake each morning feeling happy and good. We look forward to being with other people, working, eating, exercising or having fun. We may be starting a busy and stressful day, but there will be moments that bring us joy. There may also be times when we are feeling sad or down. These periods may be brief lasting only a day or two.

However, for some of us, the day begins differently. Imagine waking up tired. You slept poorly and are in a bad mood. Your body aches. You don’t have much energy. Getting out of bed is almost too difficult. The day ahead looks hard. Nothing seems fun, but you have got to keep going. If this is how you feel most of the day, and if you have been feeling this way for several weeks, you may have depression. Chronic depression is repeated long-lasting bouts that come and go.

Understanding major depressive disorder

Depression is a complicated word. You might say you are depressed when you’re just feeling lousy for the moment. Major depressive disorder, though, is the disease of depression. That means having a low mood for more than two weeks, along with other problems such as changes in sleep, appetite, focus and interest. You might feel guilty, restless or have very low energy. You might even be thinking about ending your life. Major depressive disorder is diagnosed when a lot of these problems are present, but depression even with fewer symptoms can be very bad.

Understanding chronic depression

Most people with major depression feel better over time. With treatment such as medications or psychotherapy, many get better faster. But at least one in every five people with significant depression keeps on feeling that way for months. Once it has lasted at least two years, it is called a chronic depression.

Chronic depression comes in a few different forms. Some people have persistent depressive disorder (or dysthymia), a condition in which a person’s mood is depressed most of the day, more days than not, for at least two years. At least two of the following problems are also present during this time: appetite that is too low or too high, too much or too little sleep, low energy, low self-esteem, poor concentration or feelings of hopelessness. During this time, there is no break in the low mood and other problems that last longer than two months at a time. The mood problems can’t be blamed on drugs or medical conditions or other problems. The low mood gets in the way of working or getting along with other people. If someone with dysthymia gets depressed enough to fit the description for major depression, they are said to have double depression.

Chronic depression also can refer to an episode of major depression that has lasted at least two years or improved only partly.

Depression that begins earlier in life is more likely to become chronic. Chronic depression also can begin in later years. Having a family member with it can increase the risk of experiencing depression.

A depression that is chronic is more serious in some ways, because it is less likely to get better even with treatment. Chronic depression is often found in people with lower social support. It is linked, too, with a greater risk for having other issues such as alcohol or other drug problems. People with chronic depression are more likely to think about or complete suicide. They experience a sense of poorer health and a greater level of disability.

The good news

Chronic depression is serious and common, but it is a treatable condition. Treatment may be needed for a long time, since the risk for getting depressed again is high, but newer antidepressants and specially designed approaches to psychotherapy offer hope to many. With good treatment, there can be relief from depression and much greater happiness in life!

By James M. Ellison, MD, MPH
Source: Gelenberg AJ, Kocsis JH, McCullough JP et al. The state of knowledge of chronic depression. J Clin Psychiatry 2006;67(2):179-184; Hölzel L, Härter M, Reese C, et al. Risk factors for chronic depression—a systematic review. J Affect Disord 2011;129(1-3):1-13; Klein DN, Shankman SA, Rose S. Ten-year prospective follow-up study of the naturalistic course of dysthymic disorder and double depression. Am J Psychiatry. 2006;163(5):872-80.
Reviewed by Gary R. Proctor, MD Regional Chief Medical Officer, Southeast/Central Region, Beacon Health Options

Summary

  • Depression that lasts at least two years is called chronic.
  • Chronic depression is serious but treatable.

Many of us wake each morning feeling happy and good. We look forward to being with other people, working, eating, exercising or having fun. We may be starting a busy and stressful day, but there will be moments that bring us joy. There may also be times when we are feeling sad or down. These periods may be brief lasting only a day or two.

However, for some of us, the day begins differently. Imagine waking up tired. You slept poorly and are in a bad mood. Your body aches. You don’t have much energy. Getting out of bed is almost too difficult. The day ahead looks hard. Nothing seems fun, but you have got to keep going. If this is how you feel most of the day, and if you have been feeling this way for several weeks, you may have depression. Chronic depression is repeated long-lasting bouts that come and go.

Understanding major depressive disorder

Depression is a complicated word. You might say you are depressed when you’re just feeling lousy for the moment. Major depressive disorder, though, is the disease of depression. That means having a low mood for more than two weeks, along with other problems such as changes in sleep, appetite, focus and interest. You might feel guilty, restless or have very low energy. You might even be thinking about ending your life. Major depressive disorder is diagnosed when a lot of these problems are present, but depression even with fewer symptoms can be very bad.

Understanding chronic depression

Most people with major depression feel better over time. With treatment such as medications or psychotherapy, many get better faster. But at least one in every five people with significant depression keeps on feeling that way for months. Once it has lasted at least two years, it is called a chronic depression.

Chronic depression comes in a few different forms. Some people have persistent depressive disorder (or dysthymia), a condition in which a person’s mood is depressed most of the day, more days than not, for at least two years. At least two of the following problems are also present during this time: appetite that is too low or too high, too much or too little sleep, low energy, low self-esteem, poor concentration or feelings of hopelessness. During this time, there is no break in the low mood and other problems that last longer than two months at a time. The mood problems can’t be blamed on drugs or medical conditions or other problems. The low mood gets in the way of working or getting along with other people. If someone with dysthymia gets depressed enough to fit the description for major depression, they are said to have double depression.

Chronic depression also can refer to an episode of major depression that has lasted at least two years or improved only partly.

Depression that begins earlier in life is more likely to become chronic. Chronic depression also can begin in later years. Having a family member with it can increase the risk of experiencing depression.

A depression that is chronic is more serious in some ways, because it is less likely to get better even with treatment. Chronic depression is often found in people with lower social support. It is linked, too, with a greater risk for having other issues such as alcohol or other drug problems. People with chronic depression are more likely to think about or complete suicide. They experience a sense of poorer health and a greater level of disability.

The good news

Chronic depression is serious and common, but it is a treatable condition. Treatment may be needed for a long time, since the risk for getting depressed again is high, but newer antidepressants and specially designed approaches to psychotherapy offer hope to many. With good treatment, there can be relief from depression and much greater happiness in life!

By James M. Ellison, MD, MPH
Source: Gelenberg AJ, Kocsis JH, McCullough JP et al. The state of knowledge of chronic depression. J Clin Psychiatry 2006;67(2):179-184; Hölzel L, Härter M, Reese C, et al. Risk factors for chronic depression—a systematic review. J Affect Disord 2011;129(1-3):1-13; Klein DN, Shankman SA, Rose S. Ten-year prospective follow-up study of the naturalistic course of dysthymic disorder and double depression. Am J Psychiatry. 2006;163(5):872-80.
Reviewed by Gary R. Proctor, MD Regional Chief Medical Officer, Southeast/Central Region, Beacon Health Options

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