Depression is something nearly everyone has to deal with at some point, it’s a normal part of life’s up and downs. It’s often also experienced by people in winter periods as a seasonal mood disorder.
Chronic depression is a different situation entirely. Whilst chronic depression has in the past couple of decades received more understanding, research and awareness, it’s still a vastly neglected condition when considering how people aren’t getting the support they need to overcome chronic depression.
Chronic depression can have various causes, and finding that cause is the first step to dealing with this illness. Sometimes the cause is glaringly obvious and sometimes it requires introspection to really understand the reason for it.
The causes are extremely personal and varied, but generally form around certain situations such as ;
- Traumatic or stressful life events, such as childhood abuse, neglect, loss of a loved one, financial problems, or relationship difficulties
- Dealing with a chronic medical condition or persistent physical pain
- Certain personality traits, such as low self-esteem, pessimism, perfectionism, or being highly self-critical
- Factors in the environment, such as a dysfunctional family dynamic, social isolation, lack of social support, or exposure to violence or abuse
- Hormonal changes, such as those occurring during puberty, pregnancy, or menopause, as well as imbalances in the endocrine system
- Imbalances in neurotransmitters, such as serotonin, dopamine, and norepinephrine, which regulate mood
Whatever the cause, chronic depression can be a very difficult condition to treat. The common treatment doctors initially try is a combination of medication and therapy, whilst also giving advice on self-care.
Anti-depressants are generally the medication of choice and there are a wide selection of them available to prescribe all with slightly differing mechanisms, which are put into different groups such as SSRIs, SNRIs, TCAs, MAOIs and some which don’t fit into any one group.
The general purpose of most mainstream anti-depressants is to raise serotonin and/or norephedrine in order to assist with whatever the person is doing to improve their depression. Controversially there have been recent studies that have shown anti-depressants are no better than placebo, and it is logical that a pill can’t on it’s own solve such a complex problem as chronic depression, even if many people hope for a miracle pill to simply solve their problems easily. Anti-depressants are also connected with a wide range of debilitating side effects which can often make depression even worse to deal with, such as weight gain, anxiety, nausea, fatigue and even things like suicidal thoughts.
Many doctors correctly advise patients to make sure they are doing enough high intensity exercise in order to treat depression. High-intensity exercise helps depression by stimulating the release of endorphins and neurotransmitters like serotonin and dopamine, which promote mood elevation and reduce symptoms of depression. Exercise can also have cognitive and nervous system benefits that can contribute to bringing a person out of a depressive cycle. It also helps sleep by regulating body temperature, reducing anxiety, promoting the release of sleep hormones, enhancing sleep structure, and increasing physical fatigue, leading to improved sleep quality.
But just saying the obvious is often no help to chronically depressed patients, there’s generally no actual structure to help them get into high intensity exercise, or do anything beneficial for their health . Most people rely on motivation and energy to do difficult tasks, and when you are chronically depressed, those tools are taken away from you, and you’re stuck unable to make progress. In this respect, many doctors deal with depression by throwing ineffective medication and obvious advice at their patient and that’s all the patient gets.
If they are lucky(or financially able), they often get referred to different forms of psychological therapy, and if they are severely depressed they might get urgent referral to psychiatric units. Due to the spread of awareness, access to psychological treatment has definitely increased, but the quality of this treatment varies wildly, and there is a historic problem with abuse in psychiatric units because of how vulnerable patients are, often unable to advocate for themselves or believed if they do.
Ultimately a skilled psychologist tries to get their patient to realise a solution for themselves rather than simply to tell and convince them of a solution. The therapist in this situation helps the patient navigate to a solution by steering them conversationally to various self-realisations. They use various psychological techniques to find their way into a person’s psyche and pull apart what the issues are, in this way, the patient themselves confronts what the issues are through conversation and thought.
Therapy is definitely important and likely more effective than a pill which might simply raises serotonin whilst giving the person detrimental side effects. But it’s not always a solution, because if the issues in people’s lives could just be talked and thought about in order to be solved, then depression would be easily cured.
Solutions require actions, and indeed therapists do realise this. They often help a patient make an action plan, to strategically plan, step by step, what they can do to deal with their problems. The issue here is that patients by themselves are often completely unable to deal with their problems on their own or even with family support. In reality many patients require far more support to solve their problems, especially monetary support, and society’s will to invest in this simply doesn’t exist at scale.
One important treatment for depression is animal companionship which can provide emotional support. It can reduce feelings of loneliness and isolation, promoting physical activity through caregiving responsibilities, and increasing the release of oxytocin and endorphins, which contribute to improved mood and well-being.
Diet, particularly one rich in whole foods, omega-3 fatty acids, and nutrients such as folate and vitamin D, can play a role in managing chronic depression by supporting neurotransmitter function and inflammation regulation in the brain.
Low vitamin D levels can exacerbate chronic depression by disrupting neurotransmitter function, contributing to alterations in mood-regulating pathways, and increasing inflammation in the brain, all of which are implicated in the pathophysiology of depression.
In our society, the prevailing system is that everyone is out for themselves, or at least themselves and their family. So the people with weak family support often simply don’t have the support to turn to. There are charities, and good people in government and the medical community, but these few people can’t possible cope with the avalanche of needs concerning the populace’s mental and physical health.
People end up falling through the gaps in each country’s support system, and some countries barely have anything you could call a support system in the first place. This creates a problem that no one with power is really stepping up to solve, because the solutions require immense effort and wealth. Many people are mostly concerned with enriching their own life, and this lack of motivation to help people in need is getting even worse in society as we move towards an unequal dystopian technocracy. More and more people are being dropped into a position where they can’t help others because they can’t even support themselves and their family.
Whilst there is no easy solutions, there are ways to try and treat chronic depression, including medication, exercise, diet, therapy, animal companionship, family support, seeking support from charities and the scant few government policies designed to help people.
The journey to recovering from this type of depression is fraught with traps, and a person can easily succumb to the hopelessness that pervades this issue mentally and realistically.
Awareness of what helps and what doesn’t is key to dealing with depression. You need to be aware what the causes are and what your choices are in your situation. Seeking support is obviously better than dealing with this difficult issue on your own, but can be a hard step to take. Many people convince themselves that no one cares about them, and that no one will help them. They convince themselves that the world and their family will be better of without them. This is the trap our mind sets upon us, because depression isolates you and convinces you that no one cares. It might even be true that you are so isolated that no one cares about you, but it’s still a fact that you can reverse this situation, and find caring people somewhere.
Chronic depression requires incredible strength to move forward, all the easy mental tools that people use to solve problems, are taken away from you and you have to drive forward often based on pure stubbornness. Stay stubborn and keep trying everything you can, whilst remembering to rest and relax still, and realising that self-care is the most important aspect you need to attend to even if you don’t want to care about it.
