Is Major Depressive Disorder Chronic

Abnormal Fc In Fed And Rd

A significant disrupted component consisting of 48 connections was found in the FED and RD groups, compared with the HCs . Specifically, the component mainly included inter-network connectivity of SMN-SN, SMN-DAN, SMN-DMN, SMN-ECN, SN-ECN, DAN-ECN, and intra-network connectivity of SN and ECN .

A disrupted component with hypoconnectivity was found in the FED group, compared to HCs . The component mainly included inter-network connectivity of SMN-DMN. Besides, the average FC value of hypoconnectivity in the FED group was significantly lower than those with RD and the HCs, while no significant difference was found between the RD group and the HCs.

Fig. 1: Disrupted components in FED and RD.

What Is Chronic Depression

Put simply, chronic depression is an ongoing version of depression. The condition goes by several other names, including persistent depressive disorder, dysthymia or chronic major depression.

Chronic depression was mistaken for a personality disorder in the past, but the difference is that chronic depression is something that can be changed, rather than a permanent pervasive nature.

Its commonly agreed that chronic depression lasts for a minimum of two years. Thats in comparison to normal depression, where symptoms are generally present daily for about two weeks.

Chronic depression symptoms, by contrast, can range from more to less severe on a varying, daily basis, yet they cannot be absent for more than two months in order to be considered chronic.

Chronic depression symptoms typically also include at least two of the following:

According to the NIMH, the causes of depression can be biological, genetic, psychological or environmental.

Diabetes, poor exercise, a lack of social interactions and low sunlight are all potential contributors.

Depression symptoms are equally as varied and nebulous.

Its also perhaps unfair to say normal symptoms, since every persons depression is a little different. It can vary by genderfor example, men exhibit irritability, anger and exhaustion.

Sleep and motivation problems can also pop up during depression.

Its also not uncommon for a depressed person to experiences cramps, headaches or stomach issues.

Then What Do People Mean When They Say Chronic Depression

In 2013, the DSM-5 changed some of the terms for depressive disorders. They combined dysthymia and chronic major depressive disorder into one condition called persistent depressive disorder .

An estimated 1.3% of U.S. adults experience PDD at some time in their lives. However, recent research points to the possibility that some people who tick all the boxes for MDDwhich requires depression for just two weekshave been suffering from a persistent disorder rather than an episodic one all along.

A subset of people with depression have ongoing symptoms that never fully subside. Depression is so embedded in their everyday life and outlook that they may think its normal, or part of their personality. This is what weand the general populacemeans when they think of chronic depression.

This long-term, low-grade form of depression lasts two years at minimum. Doctors used to call this type of depression dysthymia, and people without medical degrees sometimes call it smiling, hidden, or high-functioning depression.

Recommended Reading: I Want To Come Out Of Depression

Modifications To Treatment Of Mdd

• Lifestyle changes: Exercise may be particularly beneficial.
• Pharmacotherapy: Older adults have an increased risk of adverse effects from medications .
• SSRIs: preferred first-line treatment in individuals aged ⥠60 years
• Consider using reduced frequencies and/or lower doses than in the general adult population.
• Minimize polypharmacy whenever possible.

Cognitive impairment should be considered as a possible underlying cause of depression in older adults.

In older patients, monitor for hyponatremia after starting or adjusting the dosages of SSRIs, SNRIs, TCAs, or mirtazapine.

How Can I Cope With Persistent Depressive Disorder

In addition to taking medication and going to therapy, consider doing things you enjoy, such as:

• Do something nice for someone else.
• Go to a movie, a show or a ballgame.
• Hang out with people who have positive attitudes.
• Paint, or try some arts and crafts.
• Spend time outside.
• Spend time with friends, in person or on the phone.
• Take a yoga class, learn to meditate, or walk with a friend.

A note from Cleveland Clinic

PDD can make you feel sad or down most of the day, most days, over a long period of time. Talk to your healthcare provider if you have depressive symptoms. Medication, counseling and healthy lifestyle choices can make you feel better. If you feel like you might hurt yourself or someone else, seek help immediately. Youre not alone.

Last reviewed by a Cleveland Clinic medical professional on 03/08/2021.

References

Don’t Miss: Can Hypnosis Help With Bipolar Depression

Sochronic Depression Isnt That Bad

Not true at alland this is one of a few problems with the current PDD and MDD categorizations, which emphasize the duration of your depression over the severity of symptoms. For example, some depressed people experience severe chronic symptoms every day for six or seven yearsthey dont get back to normal in between depressive episodes. Neither the PDD nor the MDD diagnoses take into account these people who have major depression 24/7/365.

Plus, just because you have one form of depression doesnt mean you cant also have another. An unlucky 75% of people with dysthymia will also experience an MDD episode. So after the major depressive episode ends, these people return to their usual chronically depressed baseline instead of feeling symptom-free. Doctors call this double depression.

Even if you do have typical PDDwhich, per the official criteria is less intense depression than MDDdont just say phew and be complacent about it. Many people think that if youre able to get up in the morning and make it through work or school without curling into the fetal position, you cant be that depressed.

Well, guess what? You only think youre not depressed enough to need help because youre so used to feeling like crap! Thats what happens when your depression is chronic .

How Do Doctors Diagnose Chronic Depression

Well, they probably wont since, as we mentioned, chronic depression isnt an actual diagnosis per the DSM-5its a colloquial term.

Your doctor will probably consult the DSM-5 and ask questions to see if your experience matches with the symptoms of PDD. Answering the questions to the best of your ability will lead to a more accurate diagnosis.

Since theres no blood test or cheek swab that can determine if you have chronic depression, your doctor will need to rely on conversations with you to get a full history, including any depression symptoms in childhood, adolescence, and adulthood what stressors youre dealing with now any physical symptoms youre currently experiencing your medical history, plus a family history of mental illness and major medical issues.

Your doctor may also want to rule out underlying medical causes, such as thyroid disease and vitamin deficiency, which can mimic symptoms of depression.

They may ask about any medications youre taking, such as beta-blockers for hypertension, acid reflux drugs, anti-inflammatory corticosteroids, cholesterol-lowering statins, and more, or they might ask about your use of alcohol and street drugs. Theyre not just being nosytheyre trying to get to the root of the problem, and some of these substances are linked to depressive symptoms.

Before we move on to treatments, remember thisits important!

Also Check: Is Ritalin Used For Depression

Deterrence And Patient Education

Patient education has a profound impact on the overall outcome of major depressive disorder. Since MDD is one of the most common psychiatric disorders causing disability worldwide and people in different parts of the world are hesitant to discuss and seek treatment for depression due to the stigma associated with mental illness, educating patients is very crucial for their better understanding of the mental illness and better compliance with the mental health treatment. Family education also plays an important role in the successful treatment of MDD.

Can We Predict A Chronic Course In Major Depressive Disorder

Major depressive disorder often follows a chronic trajectory that involves comorbid affective and anxiety conditions. Studies are ongoing to try and elucidate the factors that drive chronicity, reported Professor Brenda Penninx at EPA Virtual 2021.

Major depressive disorder is often perceived as an episodic condition, and many patients do recover from their relatively short index episode. For the majority of patients, however, this is not the case and their MDD follows a chronic and disabling trajectory, reported Professor Brenda Penninx, University of Amsterdam, the Netherlands.

MDD develops into a chronic disorder

A long-term follow-up of more than 900 patients with MDD showed that, over time, the proportion of patients in remission steadily declines. At 2-, 4-, and 6-year follow-up, the proportion of patients in remission was 58%, 41%, and 32%, respectively.1

The concept of chronic MDD should include affective and anxiety disorders

Patients with MDD often suffer from comorbid affective and anxiety conditions , Professor Penninx highlighted. Although conceptualised as distinct disorders, these conditions have similar physiological dysregulations to MDD, and should be included when examining the clinical course of patients.1

Chronicity of MDD is the rule, not the exception

Can we predict chronicity in patients with MDD?

To achieve the best therapeutic response, we need to be able to predict which patients will have a chronic disease course.

Read Also: Depression Support Groups Savannah Ga

What Are The Symptoms Of Dysthymia

Dysthymia is milder, yet more long lasting than major depression. Each person may experience symptoms differently. Symptoms may include:

• Lasting sad, anxious, or empty mood
• Less ability to concentrate, think, and/or make decisions
• Feeling hopeless
• Weight and/or appetite changes due to over- or under-eating
• Changes in sleep patterns, such as fitful sleep, inability to sleep, early morning awakening, or sleeping too much
• Low self-esteem

To diagnose this condition, an adult must have a depressed mood for at least 2 years , along with at least 2 of the above symptoms. The symptoms of this illness may look like other mental health conditions. Always talk with a healthcare provider for a diagnosis.

Major Depressive Disorder Recurrent Unspecified

2016201720182019202020212022Billable/Specific Code

• F33.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
• The 2022 edition of ICD-10-CM F33.9 became effective on October 1, 2021.
• This is the American ICD-10-CM version of F33.9 – other international versions of ICD-10 F33.9 may differ.

• Applicable To annotations, or

Recommended Reading: I Feel Stressed And Depressed

What You Can Do: Daily Habits Make A Difference

These healthy lifestyle habits, along with professional treatment, can help you manage the symptoms of major depression:

Treatment Works. SAMHSA Can Help You Find It.

Effective treatments for major depressive disorder are available in your area. The earlier that you begin treatment, the greater likelihood of a better outcome. For confidential and anonymous help finding a specialty program near you, visit SAMHSAs Early Serious Mental Illness Treatment Locator.

If you, or someone you know, need help to stop using substances whether the problem is methamphetamine, alcohol or another drug call SAMHSAs National Helpline at or TTY: , or text your zip code to 435748 , or use the SAMHSAs Behavioral Health Treatment Services Locator to get help.

What Are The Types Of Major Depression

There are several types of depressive disorders:

Also Check: What To Do If Your Suffering From Depression

Lifetime Course And Mental Health Treatment

There were no significant differences in the age of onset of CMDD and DD, average number of lifetime major depression episodes, or the duration of the longest episode . Over half of individuals with DD, and a significantly greater percentage with CMDD , received some type of mental health treatment in their lifetime, but age at first treatment did not differ across disorders for those who sought treatment. Rates of outpatient, inpatient, and pharmacological treatment were significantly greater for CMDD. After adjusting for sociodemographic variables, all treatment modalities except for pharmacological treatment remained significantly higher for individuals with CMDD.

How Is Dysthymia Treated

Treatment may include one or a combination of the following:

• Medicine. Many different medicines are available to treat depression. It often takes 4 to 6 weeks for anti-depressants to have a full effect. Its important to keep taking the medicine, even if it doesnt seem to be working at first. Its also important to talk to your healthcare provider before stopping. Some people have to switch medicines or add medicines to get results.
• Therapy. This is most often cognitive behavioral or interpersonal therapy. It focuses on changing distorted views of yourself and your environment. It also works to improve relationship skills, and identify and manage stressors.

Because this condition usually last for longer than 5 years, long-term treatment may be needed.

If you have depression, there are things you can do to help yourself. Depression can make you feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings may make you feel like giving up. It is important to realize that these negative views are part of the depression and may not reflect reality. Negative thinking fades as treatment begins to take effect. Meanwhile, consider the following:

Recommended Reading: Apps That Help You With Depression

What Are The Signs And Symptoms

Major depression symptoms vary from person to person. To receive a diagnosis of major depressive disorder, some of these signs and symptoms must be present for at least two weeks. Anyone who has questions should consult their doctor.

• Continued feelings of sadness, hopelessness, pessimism, emptiness
• Fatigue, lack of energy
• Insomnia or other sleep issues such as waking up very early or sleeping too much
• Anxiety, irritability, restlessness
• Lack of interest or joy in hobbies and activities
• Changes in appetite, leading to weight loss or weight gain
• Moving, talking, or thinking more slowly
• Trouble concentrating, thinking clearly, or making decisions
• Vague aches and pains, such as headaches, joint pain, back pain, or digestive problems
• Thoughts of death or suicide, or suicide attempts

What Is The Outlook For Someone With Major Depressive Disorder

While someone with MDD can feel hopeless at times, its important to remember that the disorder can be treated successfully. There is hope.

To improve your outlook, its critical to stick with your treatment plan. Dont miss therapy sessions or follow-up appointments with your healthcare professional.

Never stop taking your medications unless your therapist or healthcare professional advises you to.

On days when you feel particularly depressed despite treatment, it can be helpful to call a local crisis or mental health service or the National Suicide Prevention Lifeline. Resources are available.

A friendly, supportive voice could be just what you need to get you through a difficult time.

Read Also: Lack Of Sleep Causes Depression

Strengths And Limitations Of This Study

• Strict and specific inclusion-criteria, matching-procedure and recruitment-procedure, leading to maximal contrast for major depressive disorder -vulnerability, without distortion due to important confounders: MDD-residual symptoms and medication.

• Unique integration of a wide range of measures in a prospective repeated measures design will allow disentangling of recurrent MDD state-factors and trait-factors.

• The extensive assessment procedure needed to measure all variables of interest and confounders will potentially lead to inclusion of participants that are intrinsically aware of the necessity to perform clinical research and readily willing to cooperate.

• Only including participants who currently do not use psychotropic drugs may lead to selection of particular patient subgroups that for example, previously experienced little benefit or adverse effects from medication.

Do I Have The Symptoms Of Chronic Depression

Is your depression chronic ? Then, yep, it meets the definition. Like we said, chronic depression isnt a clinical diagnosis, so theres no checklist of symptoms to tick off. If youre wondering whether you qualify for a clinical diagnosis of persistent depressive disorder , here are the symptoms.

People with PDD experience depressed mood for a period of two years or longer, and two or more of the additional symptoms below. Your symptoms would be distressing and affect daily functioning, and youd never be without them for more than two months at a time.

You May Like: Natural Therapy For Depression And Anxiety

Treatment For Chronic Depression Symptoms

Because chronic depression is so similar to regular depression, the treatments are nearly identical.

The exceptions are fewyet as you might suspect, youll likely be treating chronic depression for longer than other forms of the condition.

Chronic depression symptoms can be managed by both medications and therapy.

In fact, medication and therapy are considered equal in terms of effectiveness, and doing both is likely a necessity for effective chronic depression treatment.