Living With Chronic Depression?

Chronic depression is when you experience the symptoms of depression frequently or continuously over a long time, often for years, says Aimee Daramus, PsyD, a licensed clinical psychologist and author of “Understanding Bipolar Disorder.”

Depression is a serious mental health condition that can cause you to feel sad and low, to the extent that it can affect your ability to eat, sleep, work, think, and function.

Chronic depression is a form of depression that persists for a long time. If you think you may have chronic depression, you’re not alone. According to the Centers for Disease Control and Prevention (CDC), close to 5% of adults regularly experience feelings of depression.

This article explores the symptoms, causes, and diagnosis of chronic depression, as well as some treatment options and coping strategies that may be helpful.

Symptoms of Chronic Depression

These are some of the symptoms of chronic depression, according to Dr. Daramus:

• Sadness
• Emotional numbness
• Anger, anxiousness, or irritability
• Feelings of guilt or worthlessness
• Feelings of pessimism or hopelessness
• Rumination over personal losses or failures
• Lack of pleasure in anything
• Lethargy or restlessness
• Lowered concentration
• Difficulty making decisions
• Low motivation levels
• Hallucinations or delusions
• Changes in sleep or appetite
• Unintended weight loss or gain
• Fatigue and lack of energy
• Headaches, cramps, or other aches and pains
• Thoughts of death, self-harm, or suicide

Causes of Chronic Depression

These are some of the potential causes of chronic depression, according to Dr. Daramus:

• Chemical imbalances: Imbalances of certain brain chemicals, known as neurotransmitters, can cause chronic depression.
• Genetics: Depression can be genetic, and you may be more likely to develop it if a biological relative has it. According to the American Psychiatric Association, a person has a 40% chance of developing depression if a first degree relative such as a parent, sibling, or child has it.
• Trauma, stressors, or life events: Sometimes, depression is the way that someone responds to a traumatic event. It can also happen because of a life event or stressor, such as a bad breakup or a toxic workplace. Some people are more sensitive to these stressors than others.
• Health conditions: Depression can co-occur along with certain medical conditions such as cancer, heart disease, diabetes, Alzheimer’s disease, and Parkinson’s disease. These are chronic health conditions that may be worsened by chronic depression.
• Medications: Certain prescription medications can affect the balance of chemicals in the brain and cause depression as a side effect. For instance, some people find that birth control pills or statins bring on depression.
• Substances: Substances like alcohol, nicotine, and drugs can trigger or worsen depression.

Diagnosing Chronic Depression

It’s important to note that chronic depression isn’t an official diagnosis, rather, it can occur when you have any form of depression that lasts for a long time.

According to Dr. Daramus, these are some of the forms of depression that may persist for months or years, to the extent that they become chronic conditions:

• Major depressive disorder (MDD): Major depression, also known as clinical depression, is a form of depression where you experience intense and overwhelming symptoms that interfere with your ability to function. To be diagnosed with major depression, you have to have it for at least two weeks, but you may in fact have had it off and on for years.
• Persistent depressive disorder (PDD): Also known as dysthymia, persistent depression is a constant, mild form of depression that lasts for over two years. It can look a lot like being constantly grouchy or pessimistic.
• Seasonal affective disorder (SAD): This is a form of seasonal depression that generally develops in winter and recedes in summer, when there is more natural sunlight.
• Long-term perinatal depression: Some people develop depression during or after pregnancy. This depression can sometimes persist for years, becoming chronic. It's most common in new mothers, but new fathers occasionally have it too.
• Psychotic depression: People who have depression sometimes also have symptoms of psychosis, such as delusions and hallucinations, which can make it difficult to differentiate between what’s real and what isn’t.
• Bipolar depression: People who have bipolar disorder may experience periods of high energy, known as mania, and periods of low mood and lack of energy, known as bipolar depression.

The diagnostic process may involve a clinical interview that covers your medical history and your symptoms, says Dr. Daramus. She explains that in addition to asking about symptoms of depression, your healthcare provider may also ask about symptoms of trauma or bipolar disorder.

Your healthcare provider may also prescribe blood work or other tests, to rule out other potential causes of depression, such as low thyroid levels or irregular hormone levels, explains Dr. Daramus.

Treating Chronic Depression

Listed below are some of the forms of treatment that can help with chronic depression. Therapy and medication are the most common forms of treatment—they may be used either independently of each other or at the same time, says Dr. Daramus.

• Therapy: Therapy can help you address some of the mental and emotional causes of the depression you’re experiencing and develop coping skills to deal with them. Cognitive behavioral therapy (CBT), problem-solving therapy, and interpersonal therapy (IPT) are some of the evidence-based forms of therapy that can help.
• Medication: Antidepressant medications can help optimize the balance of neurotransmitters in your brain. As there are several kinds of antidepressants that work in different ways, you may have to try a few types before you find the best fit for you. 
• Sunlight lamps: Also known as light therapy boxes or SAD lamps, these lamps can be helpful to people who experience seasonal affective disorder, says Dr. Daramus.
• Brain stimulation therapy: These procedures involve stimulating the brain with electric currents or magnetic waves, and may be helpful to people who don’t respond as well to other forms of treatment.

Coping With Chronic Depression

Dr. Daramus shares some strategies that can help you cope with chronic depression:

• Challenge negative thoughts: Question and challenge your depressive thoughts. You'll often find that they're false. Dysfunctional beliefs are often formed earlier in life and connected to coping skills that are no longer working out for you.
• Join a support group: Find a support group or other community of people who also have depression, so you can share your experiences with them and feel less alone. Make sure it's a community that supports your recovery rather than enabling dysfunctional ways of coping.
• Find a healthcare provider you trust: You need to be able to trust your treatment provider. If you have more than one option, it's all right to talk to two or three healthcare providers before you decide who to work with.
• Find helpful outlets: Creative arts or sports that you genuinely like are good ways to personalize the way you manage depression. There are also a few video games that have been specially designed to help you learn coping skills for depression.

A Word From Verywell

Chronic depression can persist for many years. It may be mild, moderate, or severe, or it may even cycle between periods of higher and lower intensity. It’s important to seek treatment for it and work on developing coping skills to help you deal with it, so you can start to feel better.