Episodes Of Depression Can Last A Long Time
Apart from having episodes of depression frequently, some people also have episodes that last for years.
The DSM criteria requires patients to have symptoms of depression for at least two weeks before they can be diagnosed, but an episode of depression lasts around three months on average. 22 There is a lot of variation between people. When people have episodes that last over two years, their condition is labeled chronic depression.
Is there something different about these patients?
People who have chronic depression tend to be different from the average patient in several ways. They are more likely to also have other conditions, such as anxiety disorder, and more likely to have a family history of mental illness. They are also more likely to have had depression for the first time when they were young, typically under the age of 25.23
This is another way that depression is complex: it occurs at widely different times in peoples lives. The most likely age when people develop depression for the first time is around 19. 24 But most patients develop it much later than this. In this meta-analysis, the median age of onset was around 31, while a quarter of people developed depression for the first time when they were older than 46 years old. There are large differences in the age of onset, as you can see in the chart.
Why Its Hard To Open Up
Talking about our emotions can be difficult.
Humans are still social animals and advertising our problems, especially ones that have historically been misunderstood, runs counter to our biology and social conditioning, says Dr. Sinyor.
Were programmed to project strength to those around us. That said, weve come a long way. Decades ago we had the same issue with cancer. People were frightened or embarrassed to talk about it, but now its become easier to share that diagnosis.
Founder Heights Family Counseling
How are you doing, I commonly ask clients, and the response is Im okay The okays are sounding different these days. Heavier. There is a lot of hope as of late. Vaccines have been a game changer for many, as many are able to re-enter society after a lost year. However, there is still a heaviness. Ive been talking to lots of people lately and listening to what feels heavy right now and why feelings of depression might be lingering.
1. Going back to normal is scary. Many people talk about how they once yearned for normalcy, for life to be pre-pandemic normal again. Yet, now they feel scared. They note that as scary as it was to go into lockdown, they feel just as scared to enter into normalcy. Some say that maybe their pre-pandemic life wasnt as good as they previously thought. The grueling schedule no longer feels right. Others note that change is difficult, and they just became accustomed to this new life.
2. Your meaning and purpose might have shifted. Maybe pre-pandemic life, work goals, life goals, or something else gave you drive and purpose. However, you find yourself disoriented with these goals now and arent sure what you want your new goals or purpose to be. This can lead to a feeling of blah and/or depression. This is a time that I love meeting people in therapy to help align and center again.
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Take Care Of Yourself
You can also improve symptoms of depression by taking care of yourself. This includes getting plenty of sleep, eating a healthy diet, avoiding negative people, and participating in enjoyable activities.
Sometimes depression doesnt respond to medication. Your healthcare professional may recommend other treatment options if your symptoms dont improve.
These options include electroconvulsive therapy or repetitive transcranial magnetic stimulation to treat depression and improve your mood.
Changes To Your Role In Life
Even life changes that youve expected and planned for can be harder to adjust to than you expect. Changes in role, like becoming a parent or retiring, usually affect important areas of your life, such as:
- where you live
- peoples expectations of you
- your beliefs
- who you have around to support you.
The difficulty, challenges and conflict that come along with these life changes can contribute to depression and anxiety.
Keep in mind that a major change for one person can affect the whole whnau. For example, having a baby doesnt just involve new roles and responsibilities for the parents. It can also bring about changes for the whole whnau, including brothers and sisters, grandparents, cousins, aunts and uncles. These changes require some adjustment by everyone.
Find out more about some of the most challenging changes we go through below:
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What Are The Challenges Of Measuring Depression
Content validity: We might want to know whether the questionnaires were measuring depression at all. How would we be sure of this?
We could first think about which emotions and behaviors we associate with depression sadness, tiredness, guilt, a loss of energy, and so on and we could make sure that the questionnaires ask about all of these emotions.
Criterion validity: We could also find out if peoples responses to the questions are correlated with other things we associate with depression.
For example, if someone is severely depressed, we might expect that they are also less sociable and that they perform poorly at work or school. We could test whether this is the case for people who scored high on a questionnaire for depression.
Discriminant validity: We could also test whether their responses are uncorrelated with things we dont associate with depression, such as their height or intelligence.
Internal consistency: Another important thing wed want to know is whether the questions were actually tapping into the same phenomenon.
Do all the questions measure depression or are some measuring other concepts instead? To test for this, we could look at how closely peoples answers to different questions align with each other.
One consequence of this focus is that scores shouldnt also measure other concepts.
Fortunately, there are straightforward ways to test this: we could measure how consistent different doctors were at diagnosing the same patients.
Risk Factors For Suicide
Not all people with risk factors will be suicidal. In addition to depression or other mental illness, risk factors for suicide include:
- Current or past history of substance abuse
- Past history of suicide attempt
- Family history of suicide
- Family history of mental illness or substance abuse
- Firearms in the home
- Feelings of hopelessness
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There’s No One Reason For Depression
Lots of things influence whether a person gets depressed. Some of it is biology things like our genes, brain chemistry, and hormones. Some is environment, including daylight and seasons, or social and family situations we face. And some is personality, like how we react to life events or the support systems we create for ourselves. All these things can help shape whether or not a person becomes depressed.
Genes
Research shows that depression runs in families. Some people inherit genes that contribute to depression. But not everyone who has a family member with depression will develop it too. And many people with no family history of depression still get depressed. So genes are one factor, but they aren’t the only reason for depression.
Brain Chemistry
Chemicals called neurotransmitters help send messages between nerve cells in the brain. Some neurotransmitters regulate mood. When a person is depressed, these neurotransmitters might be in low supply or not effective enough.
Genes and brain chemistry can be connected: Having the genes for depression may make a person more likely to have the neurotransmitter problem that is part of depression.
Stress, Health, and Hormones
Things like stress, using alcohol or drugs, and hormone changes also affect the brain’s delicate chemistry and mood.
Getting enough sleep and regular exercise often has a positive effect on neurotransmitter activity and mood.
Daylight and Seasons
Life Events
Family and Social Environment
A Critical Inner Voice
If youve ever been bullied or seen anyone be bullied on a daily basis, then you know how much this can take a toll on you and destroy your mood.
Now imagine this voice isnt coming from the outside but is actually coming from yourself every day
No one intentionally tries to pick on themselves, but a lot of us do it unconsciously. Maybe it started after a few mistakes or failures, or maybe youre putting too much pressure on yourself.
It probably feels nothing at the very beginning, but if you slowly develop a critical inner voice and verbally attack yourself from the inside every single day, youll certainly end up feeling depressed.
It can be hard to recognize and diagnose this kind of depression because you cant see how hard you are on yourself, and in this particular case neither can the people around you.
Start noticing your thoughts and how you view yourself closely. Are you putting a lot of pressure on yourself and feel really bad if you dont live up to the expectations? Are you being over-critical all the time but have gotten so used to it that you dont see it?
A critical inner voice can easily lead to depression. If youre feeling depressed but cant figure out why then this might be the reason.
If youre struggling with this, you can start out by writing down everything that runs in your head for one day, and then take a look at what youve written. Would you speak like that to someone else?
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Rising Depression Due To Coronavirus Pandemic
Talking about the past few months in particular, or the year 2020 in general, there has been a steep rise in mental health problems since quarantine has come into place, and as horrible things have happened around us, including the pandemic and the deaths it has caused, the riots that the US has seen, the many tragedies that have happened around the world and so on.
In fact, the U.S. Census Bureau recently reported that as many as a thirds of Americans are showing signs of clinical depression and anxiety.
If you are currently struggling with your mental health during this unprecedented time, reach out to BetterHelp today and get the support you deserve.
Depression, anxiety, and other mental health issues are becoming amplified during the recent pandemic, in addition to which coronavirus patients and their families are also at high risk to develop depression and anxiety.
Maurizio Fava, MD is the psychiatrist-in-chief of the Department of Psychiatry at Massachusetts General Hospital, and he says about the relation between the rise in mental health issues like depression during the pandemic: Its quite understandable the coronavirus pandemic is likely to cause significant stress and psychological distress for a large proportion of the population, and we know the rates are progressively increasing.
According to Dr. Fava, various factors related to coronavirus may be contributing to the increase in depression rates, like
· Grief over losses of life around the world
I Was One Of The Walking Depressed Some Of My Clients Are Too
We have many of the symptoms of clinical depression, but we are still functioning.
On the surface, people might not know anything is wrong. We keep working, keep going to school, keep looking after our families.
But were doing it all while profoundly unhappy. Depression is negatively impacting our lives and relationships and impairing our abilities.
Our depression may not be completely disabling, but its real.
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Do Cultural Values Of Happiness Cause Depression
Next, we selected around 100 participants who met the clinical cut-off score for depression to take part in a month-long daily-diary study. They were asked to complete a survey at the end of each day about their depressive symptoms that day, as well as whether they had felt socially pressured not to experience such feelings.
We found perceived social pressure not to feel depressed reliably predicted increased depressive symptoms the next day. However, this perceived social pressure was not predicted by prior feelings of depression. This provided evidence it was not that depressed people thought others expected them not to feel that way, but that this felt social pressure itself was contributing to symptoms of depression.
We then tried to recreate the kind of social environment that might be responsible for the pressure we observed as a central feature of depression. We decked out one of our testing rooms with some happiness books and motivational posters. We placed some study materials in there, along with sticky notes with personal reminders such as stay happy and a photo of the researcher with some friends enjoying themselves on holiday. We called this the happy room.
As study participants arrived, they were either directed to the happy room and told the usual testing room was busy so they would have to use the room the researcher had been studying in or to a similar room that had no happiness paraphernalia.
When To Seek Professional Help
If support from family and friends and positive lifestyle changes arent enough, it may be time to seek help from a mental health professional. There are many effective treatments for depression, including:
Therapy. Consulting a therapist can provide you tools to treat depression from a variety of angles and motivate you to take the action necessary. Therapy can also offer you the skills and insight to prevent the problem from coming back.
Atypical Depression: Whats in a Name? Article on the symptoms, diagnosis, and treatment of atypical depression.
Depression and Other Illnesses An overview of the mental and physical illnesses that often co-exist with depression, and how this impacts treatment.
Depression support & suicide prevention help
Depression support
In the U.S.: Find DBSA Chapters/Support Groups or call the NAMI Helpline for support and referrals at 1-800-950-6264
UK: Find Depression support groups in-person and online or call the Mind Infoline at 0300 123 3393
Australia: Find Support Groups and regional resources or call the SANE Help Centre at 1800 18 7263
India: Call the Vandrevala Foundation Helpline at 1860 2662 345 or 1800 2333 330
Suicide prevention help
In the U.S.: Call National Suicide Prevention Lifeline at 1-800-273-8255
UK and Ireland: Call Samaritans UK at 116 123
Australia: Call Lifeline Australia at 13 11 14
Other countries: Visit IASP or International Suicide Hotlines to find a helpline near you
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Signs Of Walking Depression
I once read that succumbing to depression doesnt mean you are weak, but that you have been trying to be strong for too long, which is maybe a form of denial. So much of life happens somewhere in between being okay and complete breakdownthats where many of us live, and doing so requires strength. ~ novelist Matthew Quick
Walking depression can be hard to recognize because it doesnt fit the more common picture of severe depression. But it can be just as dangerous to our well-being when left unacknowledged.
This list isnt meant to be exhaustive or to diagnose anyone. But these are some of the signs Ive observed in myself and those Ive coached:
Nothing is fun. You root around for something to look forward to and come up empty.
You cant find flow. Working on your creative projects feels like a grind, but you keep plodding away. There is research that shows that neuroticism is associated with lower rates of flow.
Your energy is low. Maybe youre not getting enough rest because youre too anxious to sleep, or youre trying to cram too many tasks into a day, or youre punishing yourself by staying up. Whatever the reason, you are effin tired.
You feel worse in the morning and better at night. I remember explaining this to a friend, who found it mystifying. In the morning I felt the crushing weight of all the things I had to do that day. In the evening I was temporarily free from expectations and could enjoy a moments respite.
Depression Is An Umbrella Condition Which Contains Subtypes
We can find out how peoples responses to questionnaires are related to each other through a method called factor analysis.
Using this method, researchers have usually found that some symptoms are more likely to occur together. In other words, the symptoms are part of groups they reflect underlying traits called latent factors. The latent factors that researchers have usually found are sadness, guilt, changes in sleep and appetite, and despair about the future.16
These latent factors also correlate with each other to a moderate degree, and researchers often find an underlying general dimension of depression.
If you knew where someone placed on this general dimension, you would be able to roughly predict which symptoms they had and how many symptoms they had. But their specific symptoms would still be informative and important to understand.
To investigate this more, some researchers use a method called latent class analysis. What this does is it tries to identify whether people can be classified into subtypes based on how they respond to questionnaires.
Plenty of studies have used latent class analysis to understand whether there are subtypes of depression. But different studies have identified very different numbers of subtypes, which might be because they analyzed different sets of questions.
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Getting Help For Depression
If you think you might be depressed, take a depression screening. Print out the results or e-mail them to yourself and then show them to a counselor or doctor.
To get help, start with your student health center or counseling service on campus. Most community colleges provide limited free mental health services and can refer you to local providers for longer-term treatment. You can also talk to your family doctor. Your local Mental Health America affiliate can refer or in some cases provide services as well. To find the nearest MHA affiliate, call 800-969-6642 or go to Find An Affiliate.
Remember, depression and other mental health conditions are nothing to be ashamed of. Depression is not a sign of weakness, and seeking help is a sign of strength. Telling someone you are struggling is the first step toward feeling better. You will need the help of a mental health professional to beat depression. Talk therapy, antidepressant medication or a combination can be very effective.
In crisis? If you or someone you know is in crisis now, seek help immediately. Call 1-800-273-TALK to reach a 24-hour crisis center or dial 911 for immediate assistance.