If you’re feeling lost, it can be hard to think about doing anything at all. You don’t know what direction you’re heading in and some of the most basic decisions can feel like climbing a mountain.
You feel as though your vitality and lifeforce are missing in action. Your drive, desire and will to show up in life feels like part of some far off reality, which deprives you of direction and purpose.
This, then, creates issues with mental capacity that affects your ability to communicate, meaning you can’t make yourself understood. And so, you can’t get your needs met, which leaves you feeling left out and abandoned.
You can’t do the things you really want because you’re so tired of life. The constant narrative in your head cycles between verses of, ‘I feel worthless, nothing makes me happy, why can’t I be happy?’
This is the lesser-told story of long-term depression (dysthymia). And the reason it falls within that category is that it’s still just not that widely spoken about.
And this leads to some very real concerns, such as:
- How long does depression actually last?
- Is long term depression curable?
- Can depression have permanent side effects?
If you’ve been suffering from long-term depression and have been asking yourself these questions, we’re going to answer them all for you, right here.
How Does Long-Term Depression (Dysthymia) Affect Your Lifestyle?
Long-term depression presents differently depending on your general baseline of mental health. And it doesn’t always mean you can’t live a functional life. In fact, it’s not uncommon for people to have no real idea about their condition until it’s diagnosed.
We live in such a fast-paced goal-oriented world, it’s entirely possible to justify some of the mental patterns, such as being bored of life and feeling overwhelmed as ‘normal.’ But in reality, they’re not. The human brain is not designed for suffering and feeling downtrodden.
Long-Term Depression (Dysthymia) and Social Activities
Social activities are one of the key areas of life that begin to suffer first. It’s all too easy to make excuses and not show up when you’re in the midst of depression. And part of the reasoning for that is feeling flat and hopeless. And so, the longer a period of depression lasts, the harder it becomes to meet your obligations.
This is typical of most cases of depression. There’s an apathy that sets in which can sometimes develop over a few weeks or months. Although, it can present much quicker. And once you start down the path of withdrawing, it becomes all too easy to fall into victimhood narratives, which leads to further depression and a deeper withdrawal from your regular activities.
Long-Term Depression (Dysthymia) and Interpersonal Relationships
Once you start turning down invitations to social activities, the obvious effect is less contact with your friends and peer group. This creates its own issues, especially if you’re unable to open up to your friends about why you can’t see them. It can lead to your friends perceiving that you’re blowing them off, which can sometimes lead to tension and animosity.
And so, this then causes you to retreat further into yourself, withdrawing and bottling everything up inside. And because those feelings are repressed – going unexpressed – it creates an emotional compound effect of further hurt and isolation, and the feeling of being abandoned by your friends if they’re unable to hold you in a vulnerable state.
Long-Term Depression (Dysthymia) and Family Dynamics
There are multiple ways your relationships can go with your family. If your depression is severe enough and there is an avoidant attachment style at play, it can see you withdraw and become further isolated. Again, leading to a heightening and intensifying of your condition.
On the opposite end of the spectrum, if you’ve been able to communicate your needs to your family and they’re able to provide support, depending on the intensity of depression and the capacity of your family, it can sometimes lead to guilt, strain and anxiety on those supporting family members. Although, please be aware that this in no way invalidates your needs and what you’re experiencing. Your depression and mental is not burden. You, are not a burden.
Long-Term Depression (Dysthymia) and Work and School
Perhaps the most challenging area of life to remain high-functioning is within both a school and work environment. And this is due to the fact these obligations are generally much harder to navigate. They require you to show up at pre-agreed times and work to targets and deadlines.
This is precisely not the environment you want to be in when you have a diagnosis of long-term depression. Having to manage the pressure of being in such highly structured institutional environments can lead you to feel like you’re a burden to everyone around you, which can affect your sense of worth and ability to make meaningful contributions when you’re not in a place to do so. It’s highly counter-intuitive.
Common Mental Thought Processes in Long-Term Depression (Dysthymia)
The themes that reoccur in most instances of depression are those relating to self-worth, self-esteem, your place in the world and an inability to access the full range of human emotions. This can lead to questions and mental processes such as:
- “Why do I feel like my life is over?”
- “I feel like everyone hates me.”
- “I want to cry but I can’t’”
- “Why am I sad?”
- “I feel broken.”
However, it’s important to remember that while these experiences are absolutely valid and no one will try to encourage you to feel that they’re not the present truth of how you feel, they still do represent a state of impermanence. You can move past these states of being with the right support.
What Does It Actually Mean to Suffer from Long-Term Depression? (Dysthymia)
As with all mental illnesses, long-term depression has a profound effect on your outlook and ability to function in your day-to-day life. It causes persistent sadness, hopelessness and distress on a physical, mental, emotional and spiritual level. And these symptoms can affect your ability to regulate your thoughts, behaviours and emotions.
Long-Term Depression, Dysthymia, Persistent Depressive Disorder, and Chronic Depression
Long-term depression goes by several names including dysthymia, persistent depressive disorder and chronic depression. Generally speaking, the symptoms within this spectrum of depression tend to last much longer – but can be relatively milder. However, it’s important to be aware that despite the ‘milder’ nature of dysthymia, it’s also possible that you may experience periods of major depression, which is sometimes called ‘double depression.’ You should also know, within the ever-changing landscape of the classification of mental illnesses, dysthymia and chronic depression are now commonly referred to as persistent depressive disorder.
Symptoms of Long-Term Depression (Dysthymia)
The symptoms of long-term depression (dysthymia) are similar to those that make up a diagnosis of major depressive disorders, although they’re fewer in number and present much less intensely. They include:
- Feeling sad and in a depressed mood most of the day
- Feeling apathetic towards things that used to you bring joy
- Experiencing changes in weight (either losing or gaining within a 5% margin)
- Experiencing insomnia or feeling the need to sleep during the day
- Feeling physically restless and unable to concentrate on tasks
- Experiencing chronic fatigue or a severe loss of energy throughout the day
- Feeling hopeless, lost, worthless and generally tired of life
- Inability to concentrate and make decisions throughout the day
- Persistent thoughts of death, departing and suicide ideation
Variables That Influence How Long Depression Lasts
The way depression presents itself and how long it lasts is a difficult question to answer, as each individual has their own unique set of circumstances. But to give you an idea of what factors might influence the length and intensity of your depression, here are some of the most common areas:
- Comorbidity (where you have an additional mental health condition)
- A history of depression in your family
- Your predominant thinking style, outlook and cognitive patterns
- If you’ve experienced past trauma, which can affect you on a sliding scale of severity
- Coping with the loss of a loved one (associated patterns of unresolved grief)
- A lack of proper social support that can lead to feelings of abandonment
- Leading a constantly demanding and stressful life
The presence of any one of these factors can increase the intensity of your depression and also the length of time required to fully regulate and return to a place of ease within yourself.
Long-Term Depression: Neuroscience Explained
In neurophysiology, long-term depression is rooted in the reduction of the neuronal synapses’ ability to function in their regular function and capacity. This means that over time, these synaptic connections in the neurons become weaker. This is the opposite effect of long-term potentiation, which is the strengthening of synapses that leads to a long-lasting increase in signal strength allowing neurons to transmit – speak – to one another. Although, there are multiple different mechanisms by which long-term depression can occur with regards to neurophysiology. The most widely studied of these at the time of writing are NMDA and AMPA receptors. These play a significant role in cognition, particularly relating to certain forms of learning, memory and also where free-thinking and problem-solving is required. Long-term depression has also been found to have links to pathological states such as drug addiction, mental retardation and neurodegenerative diseases such as Alzheimer’s.
Long-Term Depression: Commonly Asked Questions
One of the biggest problems in living with a long-term mental illness that might not yet be diagnosed or only recently diagnosed is finding the answers to your questions. So we’ve compiled some of the most commonly asked questions you might have about long-term depression to help make that process of discovery easier for you.
How long is long-term depression?
Long-term and persistent depressive disorder can come and go over a period of years with the intensity of these episodes changing as your life circumstances evolve. In this sense, the depression can appear episodic with the minimum occurrence lasting around two months before symptoms begin to ease. But this is just one example and may not fit your particular circumstances. It might be that your depression is more persistent and rarely if ever lessens. So, unfortunately, there really is no absolute or definitive answer to this question.
Does depression cause memory loss?
The short answer is yes depression can cause memory loss. But again, it isn’t as simple as just leaving it there, as that information might cause as much fear as it would validate that your memory problems are the result of your depression. Fortunately, depression only affects short-term memory and not the formation of long-term memory. In a 2013 study, researchers found people with depression couldn’t identify objects on a screen that were either similar or identical to objects that they’d just seen. A 2015 study also concluded that depression might cause short-term memory loss.
Can depression have permanent side effects?
Yes, it has been found that depression can have some permanent side effects on the brain, which can become more of a risk factor if left untreated. This is the conclusion of Professor Poul Videbech who specialises in psychiatry at the Centre for Psychiatric Research at Aarhus University Hospital. In his study, he found that around 20% of depression patients don’t make a full recovery and still experience difficulty remembering and concentrating once they’re over the main symptoms of the condition. He remarked, ”My review shows that depression leaves its mark on the brain as it results in a ten per cent reduction of the hippocampus,” he says. ”In some cases, this reduction continues when the depression itself is over.”
Is long-term depression curable?
‘Cure’ is too much of an absolute that’s steered away from within mental health. The obvious implication is if it’s ‘cured,’ then a disease or condition should never return, which is wholly realistic and an unfair expectation to offer to people. Depression, like many other mental illnesses, isn’t cured, but can absolutely be treated on an individual case-by-case basis. And this can lead to a huge lessening of symptoms and dramatic improvement in your quality. Depression is most definitely treatable by a whole array of therapies, most notably cognitive behaviour therapy (CBT).
What can long-term depression lead to?
If left untreated, depression can lead to a host of persistent symptoms that include those that have been listed above and includes sleep dysregulation (insomnia), heart disease, weight gain or loss, a weakened immune system as well as physical pain and discomfort. Untreated depression can also lead people to substance abuse as a coping mechanism, which, if it reaches the stage of addiction, can have a significant impact on the ability to remain functioning and present within your interpersonal relationships.