What Can I Do About Chronic Depression?

Reviewed Aug 17, 2017

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Summary

  • If you have chronic depression, you need to recognize it before you can get it treated.
  • Positive lifestyle changes can help you conquer it.

Chronic depression is clinically significant depression that has lasted at least two years. It is more serious than short-lived depression. It takes the fun out of life. Relationships and work tend to suffer and you may care less and less about how you look. You may even neglect your health and medical issues. It is important to seek help if some of these symptoms sound familiar.

How do I know if I have chronic depression?

Before you can get help, you need to be seen by your doctor or someone with mental health training. Learning about depression will help you to avoid blaming yourself and feeling like a failure. A doctor will help you take stock of the problem and think about the next steps toward recovery. Don’t put this off, because your chances for wellness and recovery are better if you seek help earlier. Try not to let hopeless, negative thoughts keep you from getting help.

Other conditions can look like chronic depression. Your doctor will help you think about what is causing your symptoms. Identify the stressful events in your life. Follow up on health issues if they are present. Pay attention to psychiatric conditions other than depression and to the harmful effects of medicine, alcohol and recreational drugs. Any of these might need special attention if present.

How is it treated?

If chronic depression is present, you can help yourself by making changes in your lifestyle and by starting treatment. These approaches work together to help you get better faster and to stay healthier.

Think about your lifestyle. Do you stick to a healthy diet? You can get depressed when your diet is missing things that your body needs. Abusing alcohol or using recreational drugs can worsen symptoms of depression and make it harder to find relief.

What about your activity? Physical exercise is good not only for your body but also for your mind and your mood. Aerobic exercise and weight training both help you stay healthy, happy and fit.

Are you making enough time for fun? You will enjoy life more if you make time to do things that bring you joy. Go dancing, or to a movie or sports event. It may be more fun than you expect.

Are you keeping involved with people? Social interactions are a very important part of a healthy lifestyle. When you’re depressed, you probably don’t want to see anyone or do more than you need to do. But pushing yourself to do these things will help you recover better and more quickly. You may find it helpful to go to a support group. Check out the Depression and Bipolar Support Alliance, listed below, for a list of groups in your area.

Although making these kinds of lifestyle changes can be hard, there are many supports available to help you. Weight-loss groups and exercising with a buddy are some examples to consider.

If you have chronic depression, you should also get professional help, though fewer than half of people with it actually do. The help consists of talk therapy or psychotherapy, antidepressant medications, or the combination of both of these.

Studies have shown that antidepressants help many people with chronic depression. The newer pills, those that increase brain serotonin levels, are often successful in reducing the symptoms. They have mild side effects for most people. They may take time to work, or you may need to try more than one type to find the best one for you.

A few psychotherapies have been shown very effective in treating chronic depression. Cognitive-behavioral therapy (CBT) focuses on identifying and changing the self-defeating, negative thoughts that increase depression. A special form of CBT, the cognitive-behavioral analysis system of psychotherapy (CBASP), focuses on understanding the effects that behavior has on other people and teaches skills for changing those effects. Interpersonal therapy (IPT) targets problems related to interpersonal conflict, social role transitions, social skills deficits, and grief.

The combination of psychotherapy and medicine is fastest and most effective for many individuals. Psychotherapy is especially important for those chronically depressed people whose history included traumatic events. Try to find a therapist with specific experience treating chronic depression.

With lifestyle changes and treatment, chronic depression is likely to get better. It takes time, though, for improvement to occur. Hopelessness and thoughts of failure can get in the way of recovery. With the right kind of help and enough time, improvement is likely. Know that there is help and life can be much more rewarding and enjoyable after depression improves.

Resources

Depression and Bipolar Support Alliance
(800) 826-3632
www.dbsalliance.org

National Alliance on Mental Illness
www.nami.org

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;Torpey DC, Klein DN. Chronic depression: Update on classification and treatment. Current Psychiatry Reports 2008;10:458-464.
Reviewed by Gary R. Proctor, MD Regional Chief Medical Officer, Southeast/Central Region, Beacon Health Options

Summary

  • If you have chronic depression, you need to recognize it before you can get it treated.
  • Positive lifestyle changes can help you conquer it.

Chronic depression is clinically significant depression that has lasted at least two years. It is more serious than short-lived depression. It takes the fun out of life. Relationships and work tend to suffer and you may care less and less about how you look. You may even neglect your health and medical issues. It is important to seek help if some of these symptoms sound familiar.

How do I know if I have chronic depression?

Before you can get help, you need to be seen by your doctor or someone with mental health training. Learning about depression will help you to avoid blaming yourself and feeling like a failure. A doctor will help you take stock of the problem and think about the next steps toward recovery. Don’t put this off, because your chances for wellness and recovery are better if you seek help earlier. Try not to let hopeless, negative thoughts keep you from getting help.

Other conditions can look like chronic depression. Your doctor will help you think about what is causing your symptoms. Identify the stressful events in your life. Follow up on health issues if they are present. Pay attention to psychiatric conditions other than depression and to the harmful effects of medicine, alcohol and recreational drugs. Any of these might need special attention if present.

How is it treated?

If chronic depression is present, you can help yourself by making changes in your lifestyle and by starting treatment. These approaches work together to help you get better faster and to stay healthier.

Think about your lifestyle. Do you stick to a healthy diet? You can get depressed when your diet is missing things that your body needs. Abusing alcohol or using recreational drugs can worsen symptoms of depression and make it harder to find relief.

What about your activity? Physical exercise is good not only for your body but also for your mind and your mood. Aerobic exercise and weight training both help you stay healthy, happy and fit.

Are you making enough time for fun? You will enjoy life more if you make time to do things that bring you joy. Go dancing, or to a movie or sports event. It may be more fun than you expect.

Are you keeping involved with people? Social interactions are a very important part of a healthy lifestyle. When you’re depressed, you probably don’t want to see anyone or do more than you need to do. But pushing yourself to do these things will help you recover better and more quickly. You may find it helpful to go to a support group. Check out the Depression and Bipolar Support Alliance, listed below, for a list of groups in your area.

Although making these kinds of lifestyle changes can be hard, there are many supports available to help you. Weight-loss groups and exercising with a buddy are some examples to consider.

If you have chronic depression, you should also get professional help, though fewer than half of people with it actually do. The help consists of talk therapy or psychotherapy, antidepressant medications, or the combination of both of these.

Studies have shown that antidepressants help many people with chronic depression. The newer pills, those that increase brain serotonin levels, are often successful in reducing the symptoms. They have mild side effects for most people. They may take time to work, or you may need to try more than one type to find the best one for you.

A few psychotherapies have been shown very effective in treating chronic depression. Cognitive-behavioral therapy (CBT) focuses on identifying and changing the self-defeating, negative thoughts that increase depression. A special form of CBT, the cognitive-behavioral analysis system of psychotherapy (CBASP), focuses on understanding the effects that behavior has on other people and teaches skills for changing those effects. Interpersonal therapy (IPT) targets problems related to interpersonal conflict, social role transitions, social skills deficits, and grief.

The combination of psychotherapy and medicine is fastest and most effective for many individuals. Psychotherapy is especially important for those chronically depressed people whose history included traumatic events. Try to find a therapist with specific experience treating chronic depression.

With lifestyle changes and treatment, chronic depression is likely to get better. It takes time, though, for improvement to occur. Hopelessness and thoughts of failure can get in the way of recovery. With the right kind of help and enough time, improvement is likely. Know that there is help and life can be much more rewarding and enjoyable after depression improves.

Resources

Depression and Bipolar Support Alliance
(800) 826-3632
www.dbsalliance.org

National Alliance on Mental Illness
www.nami.org

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;Torpey DC, Klein DN. Chronic depression: Update on classification and treatment. Current Psychiatry Reports 2008;10:458-464.
Reviewed by Gary R. Proctor, MD Regional Chief Medical Officer, Southeast/Central Region, Beacon Health Options

Summary

  • If you have chronic depression, you need to recognize it before you can get it treated.
  • Positive lifestyle changes can help you conquer it.

Chronic depression is clinically significant depression that has lasted at least two years. It is more serious than short-lived depression. It takes the fun out of life. Relationships and work tend to suffer and you may care less and less about how you look. You may even neglect your health and medical issues. It is important to seek help if some of these symptoms sound familiar.

How do I know if I have chronic depression?

Before you can get help, you need to be seen by your doctor or someone with mental health training. Learning about depression will help you to avoid blaming yourself and feeling like a failure. A doctor will help you take stock of the problem and think about the next steps toward recovery. Don’t put this off, because your chances for wellness and recovery are better if you seek help earlier. Try not to let hopeless, negative thoughts keep you from getting help.

Other conditions can look like chronic depression. Your doctor will help you think about what is causing your symptoms. Identify the stressful events in your life. Follow up on health issues if they are present. Pay attention to psychiatric conditions other than depression and to the harmful effects of medicine, alcohol and recreational drugs. Any of these might need special attention if present.

How is it treated?

If chronic depression is present, you can help yourself by making changes in your lifestyle and by starting treatment. These approaches work together to help you get better faster and to stay healthier.

Think about your lifestyle. Do you stick to a healthy diet? You can get depressed when your diet is missing things that your body needs. Abusing alcohol or using recreational drugs can worsen symptoms of depression and make it harder to find relief.

What about your activity? Physical exercise is good not only for your body but also for your mind and your mood. Aerobic exercise and weight training both help you stay healthy, happy and fit.

Are you making enough time for fun? You will enjoy life more if you make time to do things that bring you joy. Go dancing, or to a movie or sports event. It may be more fun than you expect.

Are you keeping involved with people? Social interactions are a very important part of a healthy lifestyle. When you’re depressed, you probably don’t want to see anyone or do more than you need to do. But pushing yourself to do these things will help you recover better and more quickly. You may find it helpful to go to a support group. Check out the Depression and Bipolar Support Alliance, listed below, for a list of groups in your area.

Although making these kinds of lifestyle changes can be hard, there are many supports available to help you. Weight-loss groups and exercising with a buddy are some examples to consider.

If you have chronic depression, you should also get professional help, though fewer than half of people with it actually do. The help consists of talk therapy or psychotherapy, antidepressant medications, or the combination of both of these.

Studies have shown that antidepressants help many people with chronic depression. The newer pills, those that increase brain serotonin levels, are often successful in reducing the symptoms. They have mild side effects for most people. They may take time to work, or you may need to try more than one type to find the best one for you.

A few psychotherapies have been shown very effective in treating chronic depression. Cognitive-behavioral therapy (CBT) focuses on identifying and changing the self-defeating, negative thoughts that increase depression. A special form of CBT, the cognitive-behavioral analysis system of psychotherapy (CBASP), focuses on understanding the effects that behavior has on other people and teaches skills for changing those effects. Interpersonal therapy (IPT) targets problems related to interpersonal conflict, social role transitions, social skills deficits, and grief.

The combination of psychotherapy and medicine is fastest and most effective for many individuals. Psychotherapy is especially important for those chronically depressed people whose history included traumatic events. Try to find a therapist with specific experience treating chronic depression.

With lifestyle changes and treatment, chronic depression is likely to get better. It takes time, though, for improvement to occur. Hopelessness and thoughts of failure can get in the way of recovery. With the right kind of help and enough time, improvement is likely. Know that there is help and life can be much more rewarding and enjoyable after depression improves.

Resources

Depression and Bipolar Support Alliance
(800) 826-3632
www.dbsalliance.org

National Alliance on Mental Illness
www.nami.org

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;Torpey DC, Klein DN. Chronic depression: Update on classification and treatment. Current Psychiatry Reports 2008;10:458-464.
Reviewed by Gary R. Proctor, MD Regional Chief Medical Officer, Southeast/Central Region, Beacon Health Options

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