Everyone experiences periods of gloom, sadness, guilt or hopelessness from time to time. Losing a loved one, a layoff, an accident or a relationship break-up can lead to a heavy emotional period. These temporary emotions will subside over time, but when the gloom turns into a chronic feeling of despair, chronic depression may be present.
What is a chronic depression
Chronic depression is a mild, long-term form of depression. Mild should not be underestimated here, because although symptoms of chronic depression are often less intense, the symptoms are always present for more than two years.
Chronic depression is not always easy to recognise. Not for outsiders, but not for the person with the depression either. Some people suffering from chronic depression cannot remember ever feeling any different. Functioning in daily life is often still just possible, but the world actually always feels grey and drab. Energy for social contact is little or nonexistent, only the most urgent things happen. Chronic depression often has a major impact, as the condition persists and quality of life is very much impaired by the symptoms. Chronic depression can persist for years to a lifetime.
Causes of chronic depression
It is not always clear where chronic depression comes from. There are a number of factors that may play a role in the development of chronic depression:
- (Family) circumstances such as low income
- Traumatic experiences in childhood such as abuse
- A chronic physical illness such as cancer
- A personality disorder such as borderline
How can you recognise it?
The first signs occur in half the cases before the age of 25, and are then sometimes difficult to recognise because they are considered a natural part of life.
The depressive mood is present for at least 2 years and can be recognised by the following symptoms: dejected mood, markedly diminished interest or pleasure, sleep disturbances, change in appetite, loss of energy, agitation or just lethargy, impaired concentration, feelings of guilt and worthlessness and suicidal thoughts.
The more of these symptoms you exhibit, the more severe the depression. Suffering and the impact on functioning in daily life also help determine severity. A characteristic feature of chronic depressive mood disorder or dysthymic disorder is that gloomy periods alternate with periods when one feels somewhat better. However, periods without symptoms never last longer than two months.
Symptoms of chronic depression
A variety of symptoms may occur in chronic depression. Symptoms of chronic depression may include:
- Feelings of inferiority
- Feelings of hopelessness
- Feelings of helplessness
- Lack of joy in life
- Frequent and frequent brooding, feelings of anxiety
- Problems concentrating and difficulty making decisions
- Poor appetite or excessive eating
- Lack of energy or fatigue
- Sleep problems such as insomnia or just sleeping too much
- Not wanting to live anymore, suicidal thoughts
What can you do yourself?
The goal is to get your life back on track, and regain control of it. Therefore, try to restore or maintain your activities and social contacts yourself. A weekly plan can help. Write down what you want to do each day, and at what time, and carry it out. Also plan activities with other people, at a hobby or sports club.
If you feel support is needed, talk to your GP about it. He may be able to refer you specifically for psychological help. Experience shows that putting depression behind you is not easy. Many (most) patients do not come out of it on their own. That is why a support network is very valuable. Your partner, family and friends can help you.
The input of a psychologist is definitely recommended. He can help bring out the underlying causes of your depression, and chart a path to recovery.
What can your doctor do?
Your doctor will obviously treat any underlying illnesses first. If there are none, or if they are resolved, then all attention can go to the depression. Most people benefit from supportive conversations with their doctor and/or psychologist. Treatment with medication is especially useful in periods when your depression worsens significantly or if you are walking around with suicidal thoughts. Then, even admission to a specialised service may be necessary.