Lonely, Sad, Depressed Most of the Time? It’s called Persistent Depressive Disorder

Perhaps you’ve struggled with depression in the past. You’ve thought of going to see someone about it. But you have stretches where life really isn’t that bad. Maybe it’s just that you’ve learned to function with the constant heaviness of relationships, school or work, and the daily grind. Did you know that there is a milder form of depression that endures over time? It’s called Persistent Depressive Disorder or Dysthymia. It comes with sadness, directly impacts your life, and might cause you to lose pleasure in normally enjoyable activities. Our therapists at Evanston Counseling are familiar with working with people trapped in this maze of weighty emotions. Read on to see if you can find yourself in our descriptions of the symptoms, causes, or risk factors.

Isn’t Persistent Depressive Disorder just a form of Major Depression?

No, not exactly. Though, if you’re dealing with dysthymia, you might find yourself slipping into a major depression from time to time. The biggest difference between major depression and dysthymia is the duration and severity. Johnshopkinsmedicne.org defines dysthymia like this:

Dysthymia is a milder, but long-lasting form of depression.

Persistent Depressive Disorder is a mood disorder that is more continuous and long-term than major depressive disorder. Just because you’ve spent a good portion of your life dealing with this form of depression doesn’t mean it has to continue. At Evanston Counseling, we are experts in using a form of therapy called Cognitive Behavioral Therapy (CBT) as a treatment for dysthymia. Research shows CBT to be very effective in treating depression.

What Causes Persistent Depressive Disorder and Who is at Risk?

Doctors and researchers have not pinpointed the exact causes of this depression. They have seen patterns among the people that have persistent depression, though.

They have noted that if you’re suffering from major depression, anxiety, substance misuse, personality disorders, you might be more likely to develop dysthymia.

Also, if someone in your family experiences persistent depression, you might be more likely than most to have it. This relationship doesn’t mean you definitely will deal with depression. It just means you have a greater chance. It tends to run in families.

Chronic pain sufferers are also among those with a higher occurrence of this form of depression.

Don’t forget that we all produce different amounts of the neurotransmitters that help to regulate our moods. If you’re dealing with persistent depressive disorder, your brain may not be producing enough of the biochemicals to help keep your mood boosted.

This article at mayoclinic.org, lists the following risk factors:

• Having a first-degree blood relative, such as a parent or sibling, with major depressive disorder or other depressive disorders.
• Traumatic or stressful life events, such as the loss of a loved one or major financial problems.
• Personality traits that include negativity, such as low self-esteem, being too dependent or self-critical, or always thinking the worst will happen.
• History of other mental health disorders, such as a personality disorder.

As you can see, many situations in your life, your emotions or your body could contribute to you having dysthymia.

What are the Symptoms of Persistent Depressive Disorder?

We said that dysthymia differs from major depressive disorder. We should also say that this disorder is not the “blues.” It’s more serious than just feeling down continually.

So, you might be wondering about the symptoms associated with persistent depressive disorder. Johnshopkinsmedicine.org lists the following symptoms:

• Lasting sad, anxious, or “empty” mood
• Less ability to concentrate, think, and/or make decisions
• Less energy
• Fatigue
• 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

Doctors at mayoclinic.org would add the following symptoms:.

• Loss of interest in daily activities.
• Self-criticism or feeling you’re not capable.
• Trouble focusing clearly
• Problems getting things done well and on time.
• Quickly becoming annoyed, impatient or angry.
• Avoidance of social activities.
• Feelings of guilt and worries over the past.

If you visit your healthcare provider to determine if persistent depressive disorder is an accurate diagnosis, they will want to know how long you’ve felt depressed. Generally, they’ll want to determine if you’ve felt depressed for two or more years and have at least two of the symptoms listed above.

Be sure to let them know the other health challenges you are dealing with that might impact your mental wellness. Cancer, heart disease, and chronic pain are high on the list of health challenges for people dealing with persistent depressive disorder.

If you have questions, seek medical care. Allow your healthcare provider to determine what you are dealing with.

Be aware that there are several myths that may be keeping you from getting help.

Myths about Persistent Depressive Disorder

At therecoveryvillage.com, they’ve identified some myths around dysthymia that we think are important to mention.

Myth #1 – I’m not depressed all the time.

You may be disqualifying yourself from persistent depressive disorder because you don’t feel lonely, down, or sad continually. Please know that people with dysthymia have good days and bad days. You may have become good at masking difficulties and problems. Pushing through the pain may just be what you do. These behaviors may have convinced you that you are not depressed all of the time, so what you are dealing with is not that serious.

Myth #2 – If Persistent Depressive Disorder is milder, it must not be too serious.

This thought is perhaps one of the most dangerous. Doctors and therapists have found that people with dysthymia tend to be at a greater risk of dealing with suicide. You would want to pay attention to dysthymia to get treatment for the suicidal thoughts.

If you think persistent depressive disorder isn’t serious, you may ignore the major medical issues that can be associated with it (i.e. like cancer or chronic pain).

Myth #3 – Persistent depressive disorder is difficult to treat.

You may think that since dysthymia can fly under your radar, it might be hard to treat. This study done by researchers in the UK found that Cognitive Behavioral Therapy for depression with taking antidepressants, had these results:

Over the course of 46 months, 43 per cent of those who had received CBT had improved, reporting at least a 50 per cent reduction in symptoms of depression, compared with 27 per cent who continued with their usual care alone. Importantly, the study also found that this type of ‘high intensity’ CBT was a cost effective treatment from the perspective of the health service. 

As we’ve mentioned before on the blog, medication can be another effective treatment for depression along with Cognitive Behavioral Therapy. Selective serotonin reuptake inhibitors are the class of drugs most commonly recommended for depression. This medication will block the amount of serotonin absorbed back into your body. This action leaves more serotonin available for your brain to use. These higher levels of serotonin help to increase your mood.

Takeaway – If you’re feeling continually depressed and want to investigate what treatment for dysthymia looks like with one of our Evanston therapists, call us at (773) 983-8444 for a free, 15-minute phone conversation. We will listen and direct you to the right person to help you with therapy for persistent depressive disorder. Or you can schedule a time to chat with us here to learn how Cognitive Behavioral Therapy can help you better manage your persistent depression.