Risk Factors For Depression
Depression can affect anyoneeven a person who appears to live in relatively ideal circumstances.
Several factors can play a role in depression:
- Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
- Genetics: Depression can run in families. For example, if one identical twin has depression, the other has a 70 percent chance of having the illness sometime in life.
- Personality: People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be more likely to experience depression.
- Environmental factors: Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression.
Lifestyle Changes For Chronic Depression
This is probably a great time to remind you that, in any situation where you feel less than yourself, its a good idea to contact a general healthcare provider.
They may give you therapeutic or medicinal referrals, but they will also help you narrow down possible causes of depression and sources of continued struggles.
Several lifestyle factors can contribute to depression and mood disorders, including your health, weight, diet, habits, and blood pressure.
Cutting some bad habits like smoking or drinking might help raise your mood, and the added benefit of exercise might do wondersits been shown in some cases to be as effective as medication.
If Youre Considering Self
You can access free support right away with these resources:
- The National Suicide Prevention Lifeline. Call the Lifeline at 800-273-8255 for English or 888-628-9454 for Spanish, 24 hours a day, 7 days a week.
- The Crisis Text Line. Text HOME to the Crisis Text Line at 741741.
- The Trevor Project. LGBTQIA+ and under 25 years old? Call 866-488-7386, text START to 678678, or chat online 24/7.
- Veterans Crisis Line. Call 800-273-8255, text 838255, or chat online 24/7.
- Deaf Crisis Line. Call 321-800-3323, text HAND to 839863, or visit their website.
- Befrienders Worldwide. This international crisis helpline network can help you find a local helpline.
The cause of chronic depression isnt clear just yet, and more research is needed. Experts believe a number of factors can contribute to the development of chronic depression, including:
Chronic depression often goes untreated for many. Because the symptoms can be mild but persistent, a person with chronic depression may think its simply a part of their personality and not something that can be managed.
But there are many treatments for chronic depression that might help you feel better.
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How Is Dysthymia Diagnosed
A mental health specialist generally makes the diagnosis based on the person’s symptoms. In the case of dysthymia, these symptoms will have lasted for a longer period of time and be less severe than in patients with major depression.
With dysthymia, your doctor will want to make sure that the symptoms are not a result of a physical condition, such as hypothyroidism.
If you are depressed and have had depressive symptoms for more than two weeks, see your doctor or a psychiatrist. Your provider will perform a thorough medical evaluation, paying particular attention to your personal and family psychiatric history.
There is no blood, X-ray or other laboratory test that can be used to diagnose dysthymia.
How Is Persistent Depressive Disorder Treated
The most effective treatment for PDD combines medications and talk therapy, or counseling.
Antidepressants are prescription drugs that can relieve depression. There are many different kinds of medications for the treatment of depression. The most commonly used fall into two broad categories:
- Selective serotonin reuptake inhibitors .
- Serotonin-norepinephrine reuptake inhibitors .
You may need to take medication for a month or longer before you feel a difference. Make sure to continue taking the medication exactly as your healthcare provider prescribed. Even if you have side effects or feel much better, dont stop without talking to your healthcare provider first.
Counseling can also help manage PDD. One type of therapy, cognitive behavioral therapy , is often helpful for depression. A therapist or psychologist will help you examine your thoughts and emotions and how they affect your actions. CBT can help you unlearn negative thoughts and develop more positive thinking.
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What Are The Best Treatments For Chronic Depression
Every person is affected differently by chronic depression, and theres no single therapy that works for everyone. Whoever finally discovers it is going to be a bazillionaire.
Experts believe that the most effective treatment is a one-two punch of psychotherapy plus , or psychotherapy plus another FDA-approved treatment, such as electroconvulsive therapy , electrical stimulation of the brain while patients are under anesthesia, or repetitive transcranial magnetic stimulation , a type of brain stimulation using magnetic fields.
The most important part of treatment is to never give up. Never surrender! Persistent depression requires persistent treatment. Its unlikely that youll stumble across the perfect remedy right off the bat. Trial and error is a big part of treating chronic depression, so be patient and remain open and willing to try new solutions.
Psychotherapy can help you stay actively engaged and focused on getting better through structured weekly appointments. In therapy, youll learn to identify and change your distorted view of the world and negative self-talk, plus how to manage your stress better.
There are several types of medications prescribed for chronic depression, including:
Similarly, ECT and rTMS arent a surefire fix. Some people notice their depressive symptoms fading away after a series of brain stimulation treatments, while others see no result whatsoever.
Treatment For Psychotic Depression
If you experience both depression and psychosis, youll want to get support from a mental health professional right away. This condition typically doesnt improve without professional treatment.
Your care team may recommend a short stay in a psychiatric hospital to treat severe psychosis and persistent thoughts of self-harm or suicide.
Treatment for psychotic depression generally involves psychotropic medications, though you have other options, too.
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What Else Can I Do To Feel Better
Getting an accurate diagnosis and effective treatment is a major step in feeling better with chronic depression. In addition, ask your doctor about the benefits of healthy lifestyle habits such as eating a well-balanced diet, getting regular exercise, avoiding alcohol and smoking, and being with close friends and family members for strong social support. These positive habits are also important in improving mood and well-being.
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.
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Risk Factors And Causes Of Dysthymia
The causes of dysthymia have not been clearly established but dysthymia appears to share the same biological markers of major depression. In electroencephalogram and polysomnogram testing, 25% of people with dysthymia disorder have sleep changes similar to those seen in major depression. Chronic stress and illness are associated with chronic depression and it seems to run in families, occurring more often in women than in men. Many people with dysthymia have a long-term medical problem or another mental health disorder, such as anxiety, alcohol abuse, or drug addiction.
Antidepressants For Chronic Depression
Antidepressants are medications that modify the serotonin levels in your brain and how your neurons interact to regulate depression.
And while all antidepressants are generally considered effective, there are a few that stand out.
TCAs keep more serotonin in your brain for extra supply, and SSRIS, which are the most commonly prescribed antidepressant, block serotonin from being reabsorbed by neurons, leaving more available for transmission.
Talk with your healthcare professional about other medications youre taking to avoid negative interactions, and ask about side effects, which vary among drugs.
You may find that you have to try more than one antidepressant to find the right fit for you. Your healthcare professional can help with this, too.
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Some Common Causes Of Depression
Researchers have particularly been interested in investigating whether depression is an inherited condition. A major theory is that certain genetic changes make neurotransmitters ineffective or scarce.
The other major component is environmental triggers which may make a person who is genetically predisposed to depression more likely to develop it. Certain factors that make it more likely a person will experience clinical depression include:
- A family history of depression
- Experiencing a traumatic event or major life change
- Financial troubles
- Being very ill or injured , needing to have surgery or undergo medical treatment, or having to manage a chronic and/or progressive health condition
- Caring for a loved one who has a major illness, injury, or disability
- Taking certain medications that can cause symptoms associated with depression
- Using illegal drugs and/or misusing alcohol
If you have experienced a form of depression before, you may be more likely to experience it again or develop another form in response to certain stressors or life changes .
Tips For Living Well With Major Depressive Disorder
Living with major depression can feel lonely. People may be fearful or ashamed of being labeled with a serious mental illness, causing them to suffer in silence, rather than get help. In fact, most people with major depression never seek the right treatment. But those struggling with this illness are not alone. Its one of the most common and most treatable mental health disorders. With early, continuous treatment, people can gain control of their symptoms, feel better, and get back to enjoying their lives.
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Seek Support For Symptoms Of Depression
Depression is often not recognised and can go on for months or even years if left untreated. Its important to seek support as early as possible, as the sooner a person gets treatment, the sooner they can recover.
Untreated depression can have many negative effects on a persons life, including serious relationship and family problems, difficulty finding and holding down a job, and drug and alcohol problems.
There is no one proven way that people recover from depression. However, there is a range of effective treatments and health professionals who can help people on the road to recovery.
There are also many things that people with depression can do for themselves to help them recover and stay well. The important thing is to find the right treatment and the right health professional for a persons needs.
Psychological Differences Between Chronic And Acute Recurrent Depression
Dr. Gelenberg: How do people with chronic depression differ psychologically from those with acute recurrent depression? Dr. McCullough, I know, has studied the influence of the type of depression on response to psychotherapy. Perhaps you could give us a succinct summary of what essentially has been a lifetime of work.
Dr. McCullough: At this point, I cannot make a distinction between these patients. I am seeing someone now who can recall 15 to 20 recurrent episodes of major depressive disorder. To me, she has chronic depression. Perhaps Dr. Thase or Dr. Kocsis can help fine-tune a distinction between a person who has many recurrent episodes and one who meets clear criteria for chronic depression.
Dr. Thase: I have noticed that people with chronic depression are disproportionately negative in the way they view themselves, their world, and their future. They are very pessimistic and unlikely to believe they have the capacity to take action to solve their problems. My colleagues and I have found that the Cognitive Behavioral Analysis System of Psychotherapy ,6 developed by Dr. McCullough, helps patients with chronic depression make sense of their problems and learn new techniques for taking action to solve their problems.
Do you think chronic depression tends to respond less well to traditional cognitive-behavioral therapy than to CBASP? If so, why?
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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.
Signs And Symptoms: How To Identify Depression
Diagnostic and Statistical Manual of Mental Disordersdiagnosed with major depressive disorder
- Constantly feel tearful, empty, or worthless?
- Have little interest or pleasure in your work, hobbies, friends, family, and other things you once enjoyed?
- Notice dramatic changes up or down in your appetite or your weight not related to dieting?
- Often feel listless or fatigued for no obvious reason?
- Have trouble concentrating or making decisions?
- Find yourself wringing your hands, pacing, or showing other signs of anxious restlessness or the opposite, moving or speaking more slowly than usual?
- Struggle with insomnia or sleep too much?
- Have recurrent thoughts of suicide or death?
To be diagnosed with MDD, one of your symptoms must be a persistent low mood or a loss of interest or pleasure, the DSM-5 states. Your symptoms must also not be due to substance abuse or a medical condition, such as thyroid problems, a brain tumor, or a nutritional deficiency.
Of course, its normal to have any or all of these symptoms temporarily from time to time. The difference with depression is that the symptoms persist and make it difficult to function normally.
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Signs And Symptoms Of Dysthymia
Dysthymia was once considered less severe than major depression, and due to its elongated nature, its diagnosis was often missed. More and more though, clinicians are realizing dysthymia can have major consequences on a person’s life and functioning.
Similar to major depression, dysthymia impairs everyday functioning, increases the risk of death from physical disease and increases the risks of suicide. As dysthymia is a depressive disorder, depressed and negative moods are common as well as restlessness, anxiety and irritability. Other dysthymia, or chronic depression, symptoms are:
- Unexplained periods of unhappiness in childhood
- Being overweight / underweight
- Loss of pleasure from activities previously found enjoyable
- Little time spent on hobbies and activities
- A family history of dysthymia
- Effort spent primarily on work and little left for social and personal relationships
- Increased negative reaction to criticism
- Slowed speech and minimal visible emotion
How Are Chronic Diseases Related To Poor Health
Chronic disease is disease that persists over a long period of time. Chronic disease can hinder independence and the health of people with disabilities, as it may create additional activity limitations. People with chronic disease often think that they are free from the disease when they have no symptoms.
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Psychotic Depression Vs Major Depression
MDD, or clinical depression, can affect your mood, behavior, everyday life, and physical health.
An episode of major depression typically involves:
- a persistent low mood or a loss of interest in everyday life for at least 2 weeks
- four or more other symptoms of depression
Psychosis isnt included in the nine main symptoms of depression, and many people living with MDD never experience psychosis.
The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition classifies the two separately, listing depression with features of psychosis as Other Specified Depressive Disorder.
Depression is always serious. Still, experts tend to consider MDD with psychosis more serious than depression without psychosis because its more likely to involve:
- difficulty concentrating or making decisions
- frequent feelings of worthlessness, helplessness, self-hatred, or guilt
- frequent thoughts of death, dying, or suicide
Psychosis involves a break or disconnect from reality, so people experiencing it arent necessarily aware of their symptoms, which can include:
- hallucinations, or seeing, hearing, and feeling things that arent real
- delusions, or believing things that arent true
- psychomotor impairment, or slowed thoughts, movements, and feelings
- a state of stupor, where youre unable to move, speak, or respond to your environment
Psychotic hallucinations and delusions might involve:
Experts separate MDD with features of psychosis into two categories:
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!
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