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Chronic Depression Counseling in Broken Arrow

By Alina Morrow, LPC

Disclaimer: The article below is for informational purposes only and should not be considered as direct advice, a personal diagnosis, or as an individual treatment plan. Always consult with a mental health professional or medical doctor if you have concerns.

Introduction and Overview

Chronic depression, also known as dysthymia, dysthymic disorder or minor depression, is a form of depression characterized by a long-lasting, but mild (depression) symptoms that last for at least 2 years for adults and 1 year for children or adolescents. This form of depression is less disabling than major depressive disorder, and the person is capable of managing their life for the most part, and do not require hospitalization.

Chronic Depression

This form of depression causes changes in the person’s well-being and

  • the way he or she thinks (concentration and decision making difficulties,
  • short term memory problems,
  • negative thoughts and thinking such as pessimism,
  • excessive guilt,
  • self-criticism,
  • feels (sad feelings without reason),
  • lack of enjoyment in activities,
  • low motivation,
  • irritability and temper problems,
  • feelings of helplessness and hopelessness, and
  • behaves (the person isolates themselves from society, apathy, may cry excessively, constantly complains, act out his or her anger through temper outbursts, experiences decreased sexual activity, decreased productivity and household responsibilities).

Even if the symptoms are not as severe as major depressive disorder, those who suffer from dysthymia experience a depressed mood and at least two of the following additional symptoms:

  • appetite change (poor appetite or overeating),
  • sleep disturbance (insomnia or hypersomnia),
  • decreased energy or fatigue,
  • low self-esteem,
  • poor concentration and inability to make decisions,
  • feeling of hopelessness.

Dysthymia has an equal chance of happening in both sexes during the preteen years which can lead to a negative impact on the child's social interaction and school performance. Children and adolescents that suffer from dysthymia have low self-esteem, poor social skills, are pessimistic, irritable, and cranky. When early onset occurs (before the age of 21), chronic depression increases the risk of developing psychological abnormalities or personality disorders, and subsequent major depressive episodes.

During early adulthood, dysthymia occurs in approximately 6 percent of the US population and strikes women 2 to 3x more than men.

Dysthymia is more common among first-degree biological relatives of people that suffer from major depressive disorder or dysthymia than among the general population.

Those that suffer from chronic depression can develop major depressive disorder. Statistics showing that up to 70 percent of those with chronic mild depression (dysthymia) have both dysthymic disorder and major depressive disorder (a condition known as double depression).

Dysthymic disorder has a high prevalence among those that suffer from:

  • panic disorders, (conditions characterized by repeated, unpredictable attacks of intense fear followed by severe anxiety symptoms),
  • personality disorders, (a group of psychiatric disorders characterized by dysfunctional, chronic behavior patterns that negatively affects the social, personal and work-related relationships)
  • social phobias,
  • substance abuse,
  • multiple sclerosis, (a chronic progressive nervous disorder involving loss of myelin sheath around certain nerve fibers)
  • AIDS,
  • hypothyroidism, (a glandular disorder resulting from insufficient production of thyroid hormones)
  • chronic fatigue syndrome, (a medical condition characterized by a prolonged and severe tiredness and/or weakness that cannot be relived by rest and is not caused by other conditions)
  • diabetes, and
  • post-cardiac transplantation.

Treatment of Chronic Depression (Dysthymia)

There are several treatment options available for people that suffer from dysthymia.

I. Pharmacotherapy
The number of studies that focused on the efficiency of antidepressants on people that suffer from dysthymia is quite limited, but it is widely accepted that a significant portion of the dysthymic population benefits from antidepressant medication. Antidepressant medications have proven to reduce most of the symptoms, but residual symptoms and behavioral patterns associated with relapse (such as social withdrawal, low self-esteem, poor communication skills, hopelessness, negative cognitive style, lack of motivation) often persist during or after treatment.

Some of the antidepressants used to treat dysthymia include: tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), specific serotonin reuptake inhibitors (SSRIs) (which have shown to be as effective as tricyclics and better tolerated), and more recently, newer serotonergic agents.

II. Psychotherapy
Psychotherapy is another treatment option that is proven to be effective in treating dysthymia. Psychotherapy focuses on the psychological impairment associated with chronic depression. During therapy, the therapist reassures the client of a depth understanding on the issues and difficulties caused by depression, assess the clients needs, self-destructive potential, and suicide ideation, and guides the patient to adopt functional cognitive, emotional and behavioral patterns.

There are several types of therapy used with people that suffer from dysthymia:

A. Individual Psychotherapy: Experience and new research have showed that short-term focused psychotherapies, that target a specific problem, work better with depressed people than long-term analytic approaches that target personality changes. Some of the individual psychotherapies effective in treating chronic depression are:

Cognitive Behavioral Therapy (CT): This is a form of therapy based on the idea that the thoughts, and not the external events or people, trigger the feelings and behaviors. It is considered one of the most rapid forms of therapy in terms of its results, and is one of the most studied forms of therapy for chronically depressed people. Research shows that those suffering from chronic depression respond very well to cognitive behavioral therapy, and the depressed symptoms register a significant reduction similar with those achieved in controlled antidepressant trials.

Cognitive behavioral therapy focuses on several key topics such as:

(1) the relationship established between thinking and mood,
(2) identifying dysfunctional thoughts, automatic thoughts and rational responses, and core beliefs,
(3) identifying and understanding the cognitive distortions, and the level of assertiveness displayed by the person.

Interpersonal Psychotherapy (IPT): This is a short-term, contractual, "here and now" focused psychotherapy that has proven to be effective in treating depressed people. Recent studies have showed that individual interpersonal psychotherapy may be effective in treating dysthymic patients that did not respond to antidepressants.

Interpersonal psychotherapy focuses on three main goals:

(1) symptom relief,
(2) the person’s level of adaptation to the social and interpersonal circumstances associated with the depression onset and evolution, and
(3) restoring the person’s level of functioning.

Cognitive-Behavioral Analysis System of Psychotherapy: This is new form of therapy elaborated to treat chronic depression. It combines the cognitive-behavioral and interpersonal interventions. Its main goal is to teach the person to take responsibility for their depression and regain control over their moods using adaptive strategies.

The therapy sessions are planned around several key topics such as:

(1) challenging the depressed person to identify pessimistic assumptions,
(2) establishing causal connections between a mature thinking and better outcomes, and
(3) changing the patient’s negative patterns of interaction with family, friends and other members of the society.

B. Group Therapy: Group therapy offers the comfort of shared experiences among people with the same affliction while reducing a person's sense of isolation. Each group is lead by one or two therapists. This form of therapy encourages feedback among its participants by expressing the feelings triggered by the discussion’s subject or situation, or becoming aware of the way each person interacts with others. It also offers the possibility to interact with others that share same problem and provides the opportunity to safely exhibit new behaviors. Group therapy offers a save environment which helps participants build a comfortable level of trust in each other that allows them to talk honestly about personal and intimate issues.

C. Family Therapy: Family therapy is another form of psychotherapy that can be effective in treating chronic depression. Depression affects not only one person, but the entire family by intefering with its normal functioning. This form of therapy is focusing on the problem as a system of interaction between family members by identifying the role of a sick person in the family structure and level of functioning. Family therapy emphasizes family relationships as an important factor in its members psychological health.

The therapy sessions centers around several key topics such as:

(1) a comprehensive family assessment,
(2) a systematic progression following defined treatment stages,
(3) establishing the family’s responsibility toward changes, and
(4) improving the family ability to cope better with depression.

Related Information:

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Are you suffering from chronic depression? Contact Tulsa Therapist Alina Morrow, LPC, today to make an appointment and get the help and relief you deserve. You can reach me by texting or calling 918-403-8873 or by Email.

Page Last Updated: October 30, 2016

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