People with chronic clinical depression experience emotional, cognitive and physical symptoms for at least two years. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published by the American Psychiatric Association, has specific criteria for a chronic clinical depression diagnosis.
To make a depression diagnosis, your doctor will observe your symptoms and review your medical and personal history. If you show chronic depression symptoms, your doctor may refer you to a psychologist or psychiatrist for a chronic clinical depression diagnosis and to evaluate treatment options.
Chronic Clinical Depression Risk Factors
Certain risk factors may increase your risk of developing chronic depression, including:
- Family history of mood disorders
- History of substance abuse
- Past emotional trauma
- Previous diagnosis of another mood or anxiety disorder.
Answers to medical questions will also help your doctor rule out other possible explanations for what may appear to be depression symptoms.
Chronic Depression Symptoms
Chronic depression symptoms are similar to episodic major depression and other short-term depression symptoms, although they last for at least two years. Chronic depression symptoms include:
- Aches and pains
- Anger or irritability
- Changes in diet or sleep
- Chronic fatigue
- Depressed mood
- Difficulty initiating or completing tasks
- Feelings of guilt
- Loss of interest in once-enjoyed activities
- Reduced productivity
- Self-destructive or suicidal thoughts.
Chronic clinical depression sufferers may experience any combination of the above symptoms, which may vary in severity and fluctuate over time.
Chronic Clinical Depression: Differential Diagnosis
Mental health specialists often consult symptom checklists when performing a chronic depression diagnosis. They will also review how your depression symptoms have changed over time; chronic clinical depression types are classified according to symptom severity and duration.
Symptoms of dysthymia, a mild form of chronic depression, may begin as early as childhood. This type of depression can be particularly difficult to diagnose, since some mistake symptoms as personality features. Dysthymic individuals may appear constantly melancholy or indifferent. Though its symptoms are considered mild, dysthymia can have a devastating effect on quality of life, social fulfillment and professional success.
Chronic major depression causes more severe symptoms. A chronic major depression diagnosis is made when an individual exhibits major depressive symptoms for a period of longer than two years. Though there may be periods of lessened symptoms, depression symptoms donâ€™t resolve fully during these partial remissions.
Chronic depression symptoms and diagnosis may fluctuate over time. For example, dysthymia may develop into chronic major depression. Dysthymic individuals may also be diagnosed with double depression, characterized by shorter periods of major depression followed by a return to milder dysthymia symptoms.
Harvard Health Publications Staff. (2009). Managing chronic depression. Retrieved June 6, 2010, from the Harvard Health Publications website: www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2009/December/managing-chronic-depression.
Mayo Clinic Staff. (n.d.). Dysthymia (dysthymic disorder). Retrieved June 5, 2010, from the Mayo Clinic website: www.mayoclinic.com/health/dysthymia/DS01111.
Medline Plus Staff. (n.d.). Major depression. Retrieved June 7, 2010, from the Medline Plus website: http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm.
The Mood Disorders Research Program Staff. (n.d.). Q and A about dysthymic disorder (chronic depression). Retrieved June 5, 2010, from the Columbia University Medical Center website: www.depressionny.com/q&a.htm.