Chronic Depression

Chronic depression shares the same symptoms as the other types of depression. Including low self-esteem, plummeting energy, poor concentration, hopelessness, irritability, and insomnia. However, these symptoms are less severe and longer lasting.

What causes chronic depression?

No one knows for sure what causes chronic depression, it appears to be a combination of genetic, biochemical, environmental and psychological factors. In addition, chronic stress and trauma can provoke the disease.

You may be at higher risk of developing PDD if you are a woman. It also tends to run in families. If a family member has it or another type of depression, you could be more likely to get it.

Although its exact cause is unknown, persistent depressive disorder (PDD) appears to have its roots in a combination of genetic, biochemical, environmental and psychological factors. In addition, chronic stress and trauma can provoke PDD.

Changes in neurotransmitters (chemical messengers) in the brain may also precipitate dysthymia. Chronic stress or medical illness, social isolation, and thoughts and perceptions about the world can all influence the development of dysthymia. Other mental health conditions (e.g., borderline personality disorder) can also increase the risk of its development.

Research indicates that depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior appear to function abnormally. In addition, important neurotransmitters—chemicals that brain cells use to communicate—appear to be out of balance. But these images do not reveal why the depression has occurred.

Genetics can play a role, people with family members who have depression or dysthymia are more likely to experience dysthymia, especially when it starts early in life (teens the to early 20s).

What are the symptoms?

The symptoms of chronic depression occurs on most days for at least two years.

  • poor appetite or overeating
  • low self-esteem
  • poor appetite or overeating
  • difficulty sleeping or sleeping too much
  • low self-esteem
  • poor concentration
  • low energy
  • fatigue
  • Feelings of hopelessness.
  • Loss of interest in daily activities
  • Sadness, emptiness or feeling down
  • Low self-esteem, self-criticism or feeling incapable
  • Trouble concentrating and trouble to make decisions
  • Irritability or excessive anger
  • Decreased activity, effectiveness, and productivity
  • Avoidance of social activities
  • Feelings of guilt and worries over the past


The best treatment is a combination of psychotherapy and medication.

Antidepressants balance the chemicals in your brain. They raise levels of the hormone serotonin to lift your mood, help you sleep and make you feel less irritable.

Dysthymia can be treated with various types of antidepressants, including:

  • selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft)
  • tricyclic antidepressants (TCAs), such as amitriptyline (Elavil) and amoxapine (Asendin)
  • serotonin and norepinephrine reuptake inhibitors (SNRIs), such as desvenlafaxine (Pristiq) and duloxetine (Cymbalta)

You may need to try different medications and dosages to find an effective solution for you. This requires patience, as many medications take several weeks to take full effect.

Talk to your doctor if you continue to have concerns about your medication. Your doctor may suggest making a change in dosage or medication. Never stop taking your medication as directed without speaking to your doctor first. Stopping treatment suddenly or missing several doses may cause withdrawal-like symptoms and make depressive symptoms worse.

Psychotherapy will usually include emotional support and education about depression. Cognitive behavioral therapy is designed to examine and help correct faulty, self-critical thought patterns. Psychodynamic, insight-oriented or interpersonal psychotherapy can help a person sort out conflicts in important relationships or explore the history behind the symptoms.