Depression can take on many forms. It behaves differently for different individuals, but there are also different types of depression diagnoses. Although most people think of major depressive disorder — characterized by major depressive episodes that may last for a period of a few weeks, persistent depression is equally valid and impacts 2.5% of Americans today.
What does persistent depression look like and how does it vary from major depression? Let’s break it all down in today’s blog.
What Is Persistent Depression?
Persistent depressive disorder, also called dysthymia or dysthymic disorder, is a form of mild but chronic depression. Those with persistent depression may experience mild depressive episodes for a period of months or even years. During a depressive episode, those with dysthymia may simply feel low or fatigued. Because these symptoms last for such a long time, it may be difficult for them to notice that they are depressed before a diagnosis.
Some symptoms of persistent depression include:
- Low self-esteem and frequent self-critical thoughts
- A persistent or frequent feeling of hopelessness
- Vague, general loss of interest in the things that once brought joy
- Fatigue or a sense of feeling mildly “burned out”
- Low activity
- Spotty memory and concentration
- Irritability and social withdrawal
While mild, these depressive symptoms can still have a significant impact on your life. They may impact your ability to concentrate during work or participate in your relationships. They can also impact your sense of self.
How Is Dysthymia Different From Major Depressive Disorder?
With major depressive disorder, patients may experience severe episodes of depression, low mood, fatigue, and hopelessness for days or weeks at a time. This can be consuming at times. Many patients with major depressive disorder describe feeling as though they can’t get out of bed in the morning. It can impact their ability to work or be present in their family lives.
When not experiencing these depressive episodes, those with major depressive disorder will typically feel a baseline of emotional stability. The distinction between depressive episodes and not tends to be very recognizable.
On the other hand, dysthymic episodes tend to be milder and subtler. Patients may not always struggle to get out of bed, and they may be able to go about their tasks for the day with just a mild feeling of irritation or fatigue. They may simply feel that they’re tired or “in a funk.” These symptoms can last for months or even years. Persistent depression is “persistent,” meaning that more often than not, the patient feels these symptoms of mild depression.
Double Depression
Although dysthymic episodes tend to have milder symptoms than major depressive episodes, patients with dysthymia can also sometimes experience a complication called “double depression.” Double depression occurs when someone with dysthymia experiences major depressive episodes. In fact, over half of patients diagnosed with dysthymia will gradually begin to develop worsening symptoms which can eventually lead to double depression. This is why it’s important to recognize dysthymia and treat it so that you can better manage your symptoms.
Treatment For Dysthymia
There is treatment for dysthymia to help you manage your low moods and depressive symptoms. It’s important to take dysthymia seriously rather than trying to simply “tough out” your depressive episodes. Speaking to a mental health provider and getting an assessment for depression — especially persistent depression disorder — is the first step.
A few common treatments for dysthymia include:
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are the most common medications prescribed to patients with dysthymia. These are also used to treat anxiety, which many patients with dysthymia have in addition to their persistent depression. SSRIs increase your serotonin levels in order to stabilize your mood. Where dysthymic episodes can leave you feeling a little low, SSRIs give your mood a little lift, helping you to have a more balanced mood overall.
Some common examples of SSRIs include: sertraline (Zoloft), escitalopram (Lexapro), or fluoxetine (Prozac).
Tricyclic Antidepressants (TCAs)
Tricyclic antidepressants block serotonin reuptake as well as norepinephrine reuptake in the presynaptic tunnels, thus allowing for an increase of both chemicals with a concentrated effect. TCAs are frequently used to treat depression — both major depression and persistent depression. Some common examples of TCAs include: desipramine (Norpramin), amoxapine (Asendin), or clomipramine (Anafranil).
Serotonin and Norepinephrine Reuptake Inhibitors (SSNIs)
SSNIs work in a similar way to SSRIs, but they also increase levels of norepinephrine. This neurotransmitter is responsible for things like arousal, attention, and cognitive function, as well as stress responses. SSNIs are often prescribed to patients with depression who struggle to motivate themselves or have vegetative symptoms. They are stronger drugs than SSRIs, but may be effective for some with worsening symptoms of dysthymia.
Talk Therapy
Therapy may be used to treat dysthymia in addition to or instead of antidepressant medication. It’s important to speak with a mental health provider about the right choice or combination of treatments for you.
Through talk therapy, patients can learn coping strategies and problem solving skills to help them manage their symptoms. They can also identify elements of their life or their thinking that may be worsening their symptoms of depression. Therapy can help patients to realize their life worth living goals, and put plans into action to reach them.
There are a few different types of talk therapy that can help patients with dysthymia, including:
- Cognitive behavioral therapy (CBT)
- Cognitive behavioral analysis system of psychotherapy (CBASP)
- Dialectical behavioral therapy (DBT)
- Interpersonal therapy (IPT)
Your Mental Health Is Valid. Take Persistent Depression Seriously.
It’s easy for those suffering from mental illness to invalidate their own experiences. Many people with depression find themselves wondering if they’ve made it all up while outside of a depressive episode. For those with persistent depression, there is sometimes the urge to dismiss those milder symptoms because “it’s not as bad as it could be.” But persistent depression is real, and you still deserve treatment for your persistent depression.
Rivia Mind has a number of experienced clinicians who work with dysthymic patients, and we’re here to help you. Contact us today to learn more or schedule a free 15 minute consultation.
