Chronic Depression: Definition, Symptoms, Causes, Diagnosis, Treatment and Perspectives

It is a relatively new diagnosis that combines the diagnoses of dysthymia and chronic major depressive disorder.

Persistent depressive disorder is a form of chronic depression.

Like other types of depression, chronic depression causes persistent feelings of deep sadness and hopelessness.

These feelings can affect mood and behavior, and physical functions, including the patient’s appetite and sleep.

As a result, people with the disorder often lose interest in doing activities they once enjoyed and have difficulty completing daily tasks.

These symptoms are observed in all forms of depression.

In chronic depression, however, the symptoms are less severe and more lasting.


They can persist for years and can interfere with the activities of daily life and personal relationships.

Chronic depression can also make it harder to deal with symptoms.

However, a combination of medications and talk therapy may effectively treat chronic depression.

Symptoms of chronic depression

Among the most frequent symptoms presented by the patient suffering from chronic depression are:

  • Sadness or depressed mood most of the day or almost every day.
  • Loss of enjoyment in things that were once pleasurable.
  • An essential change in weight (gain or loss of more than 5% of weight in a month).
  • Insomnia or excessive sleep almost every day.
  • Being physically restless or exhausted in a way that is noticeable by others.
  • Fatigue or loss of energy nearly every day.
  • Feelings of hopelessness, worthlessness, or excessive guilt almost every day.
  • Problems with concentration or decision-making nearly every day.
  • Recurrent thoughts of death or suicide.

The symptoms of chronic depression are similar to those of depression.

However, the critical difference is that chronic depression has symptoms that occur on most days for at least two years. These symptoms include:

  • Persistent feelings of sadness and hopelessness.
  • Sleeping problems.
  • Low level of energy
  • A change in appetite.
  • Difficult to focus.
  • Indecision.
  • A lack of interest in daily activities.
  • Decrease in productivity
  • Low self-esteem.
  • A negative attitude
  • Avoid social activities.

Symptoms of chronic depression often begin to appear during childhood or adolescence.

Children and adolescents with chronic depression may seem irritable, moody, or pessimistic for a prolonged period.

They may also show behavior problems, poor performance at school, and difficulty interacting with other children in social situations.

Your symptoms may appear and disappear for several years, and their severity may vary over time.


Specialists are not sure what causes dysthymia or depression.

Genes may play an important role, but many affected people do not have a family history of depression, and others with a family history do not have depression problems.

It is also believed that abnormal functioning participates in the brain circuits or in the pathways of nerve cells that connect different brain regions, which regulate mood.

The main stressors of life, chronic diseases, medications, and relationship or work problems can also increase the chances of dysthymia in people biologically predisposed to develop depression.

The cause of chronic depression is not known. Certain factors can contribute to the development of the condition. These include:

  • A chemical imbalance in the brain.
  • A family history of the state.
  • There is a history of other mental health conditions, such as anxiety or bipolar disorder.
  • Stressful or traumatic life events, such as losing a loved one or financial problems.
  • Chronic physical illness, such as heart disease or diabetes.
  • Physical brain trauma, like a concussion.


The specialist will first perform a physical examination to make an accurate diagnosis.

He will also perform blood tests and other laboratory tests to rule out possible medical conditions that may be causing his symptoms.

If there is no physical explanation for the symptoms, then you can begin to suspect that there is a mental health condition.

The current mental and emotional state of the patient and symptoms include:

  • A depressed mood almost every day, for most of the day.
  • Having little appetite or overeating
  • Difficulty falling asleep or falling asleep
  • Low energy or fatigue.
  • Low self-esteem.
  • Little concentration or difficulty in making decisions.
  • Feelings of hopelessness

For adults to be diagnosed with the disorder, they must experience a depressed mood most of the day, almost every day, for two or more years.

For children or adolescents to be diagnosed with the disorder, they must experience a depressed mood or irritability most of the day, almost every day, for at least a year.

Obtaining an accurate diagnosis and effective treatment is an essential step to feeling better in cases of chronic depression.

Treatment of chronic depression

The treatment for chronic depression consists of medications and talk therapy.

It is believed that medication administration is a more effective form of treatment than conversation therapy when used alone.

However, a combination of medications and talk therapy is usually the best treatment.


Chronic depression can be treated with several types of antidepressants, including:

  1. Selective serotonin reuptake inhibitors include fluoxetine (Prozac) and sertraline (Zoloft).
  2. Tricyclic antidepressants include amitriptyline (Elavil) and Amoxapine (Asendin).
  3. Inhibitors serotonin and norepinephrine reuptake, such as desvenlafaxine (Pristiq) and duloxetine (Cymbalta).

Different drugs and doses may be tried to find an effective solution for the patient.

This requires time and patience since many medications take several weeks to full effect.

There are different classes of antidepressants available to treat chronic depression.

The specialist will evaluate the physical and mental health, including any other medical condition of the patient, and then find the antidepressant that will provide the patient with greater efficacy and benefit with the minimum appearance of side effects.

Antidepressants can take several weeks to function fully.

They should be taken for at least six to nine months after an episode of chronic depression.

In addition, it can sometimes take several weeks to stop an antidepressant safely.

Only the doctor can suggest a change in dosage or medication.

It would help if you never stopped taking the medication as directed without the specialist ordering it.

Stopping treatment suddenly or losing several doses can cause withdrawal symptoms and worsen depressive symptoms.


Conversation therapy is a beneficial treatment option for many people with chronic depression. Help the patient in the following aspects:

  • Learn to express thoughts and feelings healthily.
  • Deal with emotions.
  • Adapt to a life challenge or a crisis.
  • Identify the thoughts, behaviors, and emotions that trigger or aggravate the symptoms.
  • Replace negative beliefs with positive ones.
  • Recover the feeling of satisfaction and control in life.
  • Set more realistic goals.
  • Conversation therapy can be done individually or in groups.

Support groups are ideal for those who want to share feelings with other people experiencing similar problems.

Psychotherapy or conversation therapy is used in chronic depression and other mood disorders to help the person develop the right skills to cope with everyday life and challenge the patient’s negative misstatements about himself.

Psychotherapy can also help increase adherence to medications and the adoption of healthy lifestyle habits and help the patient and his family understand mood disorders.

All family members or members of the support group can benefit from the therapy.

Lifestyle changes:

Chronic depression is a long-term condition, so it is essential to actively participate in your treatment plan.

Making certain adjustments in lifestyle can complement medical treatments and help relieve symptoms. These changes include:

  • Habituarse to do exercises at least three times a week.
  • Adopt a diet that consists mainly of natural foods, such as fruits and vegetables.
  • Avoid the consumption of drugs and alcohol.
  • Visit an acupuncturist.
  • Take supplements, including St. John’s wort and fish oil.
  • Practice yoga, tai chi, or meditation.
  • Write in a journal the experiences.

The benefits of healthy lifestyle habits are following a balanced diet, exercising regularly, avoiding alcohol and smoking, and sharing with close friends and family to gain solid social support.

They are optimistic and critical habits to improve the patient’s mood and well-being.

For the treatment of chronic depression, specialists may recommend psychotherapy or talk therapy, medications such as antidepressants, or a combination of these therapies.

While chronic depression is a severe illness, it is also treatable.

As with any chronic disease, early diagnosis and medical treatment can reduce symptoms’ intensity and duration and reduce the likelihood of developing an episode of major depression.

Long-term perspectives for people suffering from chronic depression

  • Because it is a chronic disease, some patients never recover completely.
  • Treatment can help control symptoms, but it is not successful for everyone.
  • Some people may continue to experience severe symptoms that interfere with their personal or professional life.