Chronic depression: symptoms, prognosis and treatment

A Quick Guide

Chronic depression, also known as dysthymia, is a persistent and distressing form of depression lasting at least two years with few symptom-free periods. It differs from other types of depression in its long duration, higher likelihood of comorbid psychological disorders, impaired functioning, and early age of onset. Treatment options include medication, cognitive behavioral therapy, interpersonal psychotherapy, and combination therapy, although challenges in treatment adherence and coping strategies may affect the prognosis.

What is chronic depression?

Ever wondered what severe depression looks like? Not many people are aware but chronic depression or dysthymia is one of the most long-lasting and distressing forms of depression. It is different from a major depressive disorder which is non-chronic with respect to its clinical, social, and psychological ramifications. To put it simply, one can define it as a state of low mood persisting with two years of continuous symptoms and few symptom-free periods.

Other names for chronic depression

DSM-V specifies different forms of severe depression such as dysthymic disorder, chronic major depressive disorder, major depressive episode, double depression, and major depressive episode recurrent or partial remission without full recovery. Among all of these, the continuity or persistence of symptoms is common.

Symptoms

A few signs of it include the following:

• Low self-esteem
• Hopelessness
• Low mood
• Social withdrawal
• Disturbed sleep
• Disturbed appetite
• Low energy or fatigue
• Difficulty concentrating or making decisions

How is chronic depression different from other types of depression?

Unlike other forms of depression, chronic or severe depression comes with a higher probability of the following:

• Presence of comorbid psychological disorders e,g, anxiety, panic disorder, etc
• Higher disturbance in daily functioning including impaired social and occupational life
• History of childhood maltreatment or adversity
• Family history of mood disorders
• Early age of onset of depression
• According to some researchers, hypothalamic pituitary adrenal activity is also increased in it.

Prognosis and Depression Treatment

Individuals with severe depression who also have a comorbid personality or anxiety disorder, poor relationship with one’s mother, history of childhood sexual abuse, and family history of depressive disorders, have a poor prognosis. Nonetheless, recovery is always possible if treatment options are utilized persistently.

The following treatment options may be useful:

• Medication such as antidepressants is helpful in reducing symptoms and the risk of relapse.
• The following two psychotherapies have been found to be effective in treating chronic depression. Cognitive behavioral therapy focuses on cognitive distortions and behavioral techniques. Similarly, Interpersonal psychotherapy focuses on interpersonal conflict social skill deficits, social roles, and grief-related problems, and is also effective
• However, many researchers and practitioners find Combination therapy including pharmacotherapy and psychotherapy the most effective approach to treating chronic depression.

Whereas, some factors that may act as obstacles in treatment include:

• Problems with adhering to treatment
• Premature termination or dropping out
• Individuals with emotion-focused, avoidant, and illuminative coping strategies have trouble recovering from dysthymia. Accordingly, it may predict a poor response to medication.

We hope the above article was useful for you in understanding chronic depression more clearly and its treatment options.