Depressive disorders are the most prevalent mental disorders in our current society. Depression is also one of the main causes of disability, due to the high functional impact it represents and the high frequency of suicidal behaviors. This set of factors causes depressive disorders to be a very important health problem for the World Health Organization (WHO).
The person who suffers from a depressive disorder experiences a depressed mood or sadness, which incapacitates the person’s normal functioning in one or various areas of their life.
Compared to the different depressive disorders, there is persistent depressive disorder, also recognized as dysthymia, which this Psychology-Online article will discuss: What is chronic depression? Symptoms, causes and treatment.
Definition of chronic depression
Persistent depressive disorder, or dysthymic disorder, is a depressive mood disorder that is socially known as chronic depression. The person who suffers from this chronicity is in a depressed mood for most of the day and although their symptoms are less severe than in major depression, it is very important to receive attention as soon as possible, due to the persistent duration of the symptoms. symptoms. People with chronic depression tend to usually be in a depressed mood, tired, with a negative view of themselves, the world and the future and with feelings of hopelessness, seeing everything around them in a negative way.
In order to determine a diagnosis of persistent depressive disorder or dysthymia, a series of symptoms must be present that we will describe below.
Symptoms of chronic depression
The person who suffers from chronic depression or dysthymia, during the two-year period (one year in children and adolescents), cannot have been without any of the following symptoms for two months in a row. The symptoms of chronic depression, according to the DSM-5, are:
- Little appetite or overeating. It can produce a considerable reduction in hunger or, on the contrary, an overeating of food.
- Insomnia or hypersomnia. People who suffer from it may have sleep disturbances, which can cause the person to not be able to sleep or, on the contrary, to sleep too much.
- Low energy or fatigue. Dysthymia causes people to feel low on energy most of the time, making it difficult for them to go about their daily lives as they used to.
- Low self-esteem. This state of mind causes the person to have a low concept of themselves, their abilities and their future projection.
- Lack of concentration or difficulty making decisions. The lack of concentration that this state of mind produces generates significant frustration for the person who suffers from it, thus damaging their self-esteem and making it more difficult for them to make their own decisions, due to a lack of self-confidence.
- Feelings of hopelessness. One of the most characteristic symptoms of chronic depression is the feeling of not finding alternative solutions to various situations or of not having expectations for the future, believing that you will not be able to get out of it and that you will never feel good again.
In addition, for its diagnosis the person must present this depressed mood for most of the day and on most days. On the other hand, a Bipolar episode type I or II must not have occurred, is not better explained by a psychotic disorder, and must not be caused by any substance or medical condition. The onset of dysthymia or chronic depression can appear early (before age 21) or late onset (after age 21) and its severity is classified as mild, moderate or severe.
If you feel identified with these symptoms you can do the to know if you may have chronic depression.
Causes of chronic depression
The cause of chronic depression is multifactorial: it involves biological, psychological and social mechanisms. However, an exact cause of persistent depressive disorder is unknown.
At a biological level, it is known that one of the causes of depressive disorders is a low level of serotonin, norepinephrine and/or dopamine in the brain. On the other hand, it is worth noting that the stressful psychological and social experiences such as stress, more demanding, negative personalities, recent losses, financial problems, breakups, etc. They increase the vulnerability of depressive illness, since they produce neurochemical changes that alter the interaction of neurotransmitters with the neurocircuits that maintain the mood, and which play an important role in depression.
Treatment of chronic depression or dysthymia
For the treatment of this disorder, it is of utmost importance that the person receives psychological treatment. Generally, in the face of chronic depression, a combined therapy and pharmacological treatment (with the use of antidepressants) tends to be used. However, each patient is unique and treatment must be adjusted to the needs of each person.
1. Evaluation
An evaluation must be carried out to be able to make the diagnosis, where a set of interview sessions are carried out with the person who is suffering and different tests tend to be used to help specify the information. The test most used in the assessment of depression is the Beck Depression Inventory (BDI-II), better known as .
2. Intervention
(CBT) has been shown to be the most effective therapy for the treatment of depression. This therapy aims to produce a behavioral, cognitive and emotional change that helps the person increase their quality of life.
As noted above, people with chronic depression have a set of automatic thoughts associated with a negative view of themselves, the world, and the future. These negative automatic thoughts cause this depressed mood to persist. So, if these negative thoughts change, there will be a change in the behaviors and emotions associated with these thoughts.
Thus, cognitive-behavioral therapy seeks to make the person aware of their negative irrational beliefs, in order to change them for more positive and healthy ones. This technique is known as cognitive restructuring, where the therapist’s job is to help the person detect these thoughts, reflect on them and reconstruct them again.
This state of mind can lead to anxiety and work is done to address this. techniques to reduce stress and anxiety, as they can be. In addition, problem-solving skills are worked on and management tools are presented. behavioral activation (help with sleeping habits, eating, carrying out activities that they previously enjoyed…) so that the person can continue with their daily lives in a healthier way. Finally, it is of utmost importance to provide the person with strategies for preventing relapses.
As previously indicated, its treatment tends to be combined with the administration of psychotropic drugs. Faced with this, it must be pointed out that antidepressants do not help the person with chronic depression to change their thoughts, but the reduction of symptoms helps the person to begin to see other possibilities regarding their situation.
CBT can be done with individual, family or group therapy. The individual model tends to last between 5 to 20 sessions, or more, lasting between 45 to 60 minutes.
If a loved one has depression, you may be interested to know.
This article is merely informative, at Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
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Bibliography
- American Psychiatric Association. (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Editorial Médica Panamericana, SA
- Baringoltz, S. (2007). Cognitive therapy and depression. Integration of cognitive contributions to psychotherapy and Cognitive Therapy.
- Jiménez-Maldonado, M., Gallardo-Moreno, G., Villaseñor-Cabrera, T & González-Garrido, A. (2013). Dysthymia in the clinical context. REV COLOMB PSIQUIAT, 42(2), 212-218.
- Royal College of Psychiatrists. (2009). Cognitive-Behavioral Therapy (CBT). 10/18/2017, from the Spanish Society of Psychiatry (SEP).
- Ruiz, M., Díaz, M & Villalobos, A. (2012). Manual of Cognitive-Behavioral Intervention Techniques. Bilbao: Editorial Desclée De Brouwer, SA