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Can Chronic Depression be Cured?

Can chronic depression be cured?

This psychologist with chronic depression aims to find out.

I’m a psychologist, and I’ve tried these six research-backed ways to cope with my own chronic depression. Here’s how they worked.  

What is Chronic Depression?

Chronic depression is also called dysthymia and/or persistent depressive disorder. The symptoms of chronic depression are the same as those of major depression, but fewer in number and not as intense. They include symptoms like sadness or depressed mood most of the time, insomnia or excessive sleep, fatigue, feelings of hopelessness or worthlessness or excessive guilt, and concentration problems.

Coping With Chronic Depression

Before I was ever a psychologist, I dealt with chronic depression. In fact, I can trace my chronic depression back to childhood and certainly early adolescence. I didn’t even realize I had it until I was a young adult. I just thought it was normal to feel chronically tired and sad, and that everyone else was faking it too.

Over the years, I’ve tried many ways to cope with or cure depression, with varying results. Research supports many factors that can help those living with chronic depression feel better and improve their overall quality of life. 

Six strategies for treating chronic depression that have strong research support include therapy, medication, exercise, nutrition, social support, and avoiding alcohol use.

Here are how these six research-backed methods have fared in my attempts to cure or reduce my own chronic depression. 

1. Therapy for depression

Therapy for depression

What the research says about therapy for depression:

Psychotherapy offers you the chance to identify the factors that contribute to your depression. Also, in therapy you can learn to deal more effectively with the psychological, behavioral, interpersonal, and situational causes of your depression. 

On a more scientific level, psychotherapy alters the brain, by causing changes in gene expression. These changes alter the strength of synaptic connections, which changes the actual pattern of interconnections between nerve cells in the brain.

The actual changes in your brain stay with you after therapy ends, which is way cool and one of the reasons I love treating people as a psychologist myself.

Skilled therapists can help you:

  • Identify life problems and find ways to manage them.
  • Pinpoint negative thinking patterns and help alter them.
  • Work through historical issues to help improve your perspective.

One of the most important and robust research findings about therapy is that the quality of the therapeutic relationship is the best predictor of positive outcome. That is, you need to find a therapist you “click with” (often referred to as “goodness of fit”) to get the benefits of therapy.

My experience with therapy for chronic depression:

As closely as I can recall, I have seen nine therapists on and off over the past 35 years. The results have ranged from neutral to extremely helpful. The “goodness of fit” of the therapist has everything to do with how well my therapy has gone.

I have never been harmed by therapy, but I have had some “meh” therapy experiences with nice and well-intentioned therapists who I did not feel really understood me. However, I have also had therapists who were so helpful and insightful that I still carry their voices with me.

The best therapy I’ve had helped me work through family of origin and trauma stuff that made sense out of why I trend toward depression. At my lowest of times, therapy helped support me and get me back on track.

I can honestly say that therapy has changed the trajectory of my life for the better. I have used therapy on and off my entire adult life, and I plan to continue to do so.

Conclusion: therapy has been a game changer for me. I will use it my entire life, but it MUST be with a therapist who is a good fit.

2. Medication for depression 

Medication for depression

What the research says about medication and chronic depression:

One scientific study showed that 70 percent of patients taking an antidepressant felt better after eight weeks, compared to 10 percent of those taking a placebo. A combination of medication and counseling is fairly standard treatment for depression, and the combination can go a long way towards treating depression.

With treatment-resistant depression, standard treatments may not help significantly, or the symptoms may improve but return later. Those living with chronic depression or treatment-resistant depression often need to incorporate other strategies to manage symptoms effectively.

My experience with medication for chronic depression:

I didn’t try antidepressant medication until I was 29. I kept trying to cope in other ways, thinking that medication was for people worse off than me.

When I finally decided to give it a try, antidepressant medication was a revelation. This sounds dramatic, but when the meds kicked in, I felt like a veil was lifted that I had been peering through my entire life.

Prior to medication, I was pushing myself to go through the motions all the time. I thought everyone else experienced life that way, too.

Medication did not cure my chronic depression, but it reduced it significantly. Meds raised my baseline in a way that nothing else ever did. I have tried going off of meds, but the veil descended again and I was not interested in going back to that place.

Conclusion: antidepressant medication improves my mood, boosting it into a range where I am much less depressed, less often. I have taken meds for 24 years and I will continue to take them.  

3. Exercise to help depression

Exercise for depression

What the research says about exercise and depression:

Regular physical activity helps to invigorate the mind and improve overall mental health. When you work out, your body releases chemicals called endorphins, making you feel happier. Exercise affects other processes in the brain that increase your resilience to stress and make you more sensitive to joy. Additional benefits include improved sleep, clearer thinking, more energy, and a better outlook on life.

Study results suggest that exercise interventions consisting of three sessions a week for 12 to 24 weeks typically result in a medium to a large reduction in the severity of depression and can result in a 22% higher likelihood of remission from depression.

My experience with exercising to treat chronic depression:

My inner sloth is pretty pissed off, because it turns out that regular exercise is non-negotiable for me in managing my mood. I am more of a bookworm than a gym rat, so this was not a happy discovery for me.

However, the good news is that I don’t need to be a gym rat to reap the antidepressant effects of exercise. Because I am lazy, I have experimented with how little exercise I can get away with and still manage my mood. It turns out that I get the same mental health benefits from going on a daily half-hour walk, as I do if I train hard for a triathlon or half-marathon.

Exercising does not cure my depression. But, when I go without it for several days, I notice things like sleep problems, decreased energy, and increased negative thoughts. If I go a few weeks without exercise, I start to feel like I’m entering a depressive episode. Getting back to regular activity snaps me out of it.

Conclusion: Exercising is a non-negotiable part of my life, but it doesn’t mean I have to be super fit or spend a lot of time at the gym.

4. Nutrition to help depression

Nutrition and chronic depression

What the research says about nutrition and depression:

Have you ever heard of the gut-brain connection? Digestive issues may not be the first thing you associate with chronic depression symptoms. Still, the research describes the gut-brain relationship links to depression, anxiety, and other mental health conditions. Therefore, the food your body absorbs plays a critical role in mental wellbeing.

Research suggests eating a low-inflammatory diet with plenty of omega-3 fatty acids, fiber, and antioxidants can significantly improve symptoms. And while dietary changes cannot alone cure chronic depression, many people found them to be a foundational step towards symptom relief.

My experience with nutrition and depression management:

It made sense to me for years that eating a balanced diet would be helpful for my mood. So, I just sort of did my best to eat plenty of fruits and vegetables, and keep junk food to a minimum.

In the past few years, however, I went “next level” on dietary interventions. I learned about inflammation, the gut-brain connection, and research connecting depression (and many other diseases) with inflammation. Sugar and other processed foods (including flour) might be delicious, but they are inflammatory.

Curious to see how an anti-inflammatory diet would affect my mood, I implemented a sugar- and flour-free diet with lots of anti-inflammatory foods like green vegetables and healthy fats (avocado, nuts, seeds are my favorites).

And wouldn’t you know it, the effect was dramatic.

Cutting out sugar and processed carbs dramatically improved my mood.

In fact, it was the closest thing to a cure that I have experienced, although I can’t discount that it occurred after lots of therapy, years on medication, quitting alcohol, and continued regular exercise.

The dramatic positive effects of a whole foods, sugar-free diet was good news for my quest to manage my chronic depression. However, it was sad in terms of my love of sweets. Did I mention I have a pastry chef in the family? Yeah.

Weirdly, I don’t miss sugar when I haven’t had any for several days. When I slip up and eat some, then I start to crave it. I tend to avoid sugar and processed food for weeks or months at a time. Then, I lapse into eating them and it affects my mood. Rinse and repeat.

Conclusion: Eating whole foods and cutting out sugar and processed carbs (including flour) is an incredibly powerful antidepressant for me. But, it has also been the hardest intervention for me to stick to consistently.

5. Social Support to help depression

Social support and chronic depression

What the research says about social support and depression:

Research shows that social support protects mental health in many ways. It is a multidimensional concept that refers to emotional, instrumental, or informational assistance.

Perceived levels of support have been associated with better outcomes across various psychiatric disorders including depression. Scientists have found that minimal emotional support heightens symptom severity in individuals with depression.

My experience with social support and depression:

I know I need social support. The only times chronic depression has veered into major depression were when I was isolated and lonely.

Two instances stand out to me to help illustrate this point. First, I had a stint of long distance marriage in my late twenties, when I moved to a new city and left my husband and friends behind for a year-long pre-doctoral internship. Second, many years later I moved to a new city and my husband was traveling a lot.

In both of these circumstances, I got way more depressed until I made friends and developed a support network. Even though I’m quite introverted and pretty independent, I am no exception to the human need for social support.

Conclusion: Having good social support is a necessary but not sufficient condition for me to manage chronic depression.

6. Avoiding Alcohol to help depression

Avoiding alcohol to help depression

What the research says about alcohol and depression:

Excessive alcohol consumption is one of three major risk factors for depression. People who drink a lot have increased rates of developing depression and are more likely to develop a depressive disorder than those who don’t.

A clinical review found that alcohol consumption interferes with recovery from depression. Furthermore, even mild to moderate drinking appears to worsen depression, with depressed patients who consumed low levels of alcohol experiencing worse outcomes from pharmacological treatments.

My experience with alcohol and depression:

I was a moderate social drinker until two years ago, when I experimented with quitting to see if it reduced my chronic depression. (By moderate social drinker, I mean that I had two or three drinks, several nights a week.)

As a psychologist, I know that alcohol is a depressant, and that it’s associated with increased depression. But, I always told myself that since I didn’t have a drinking problem, a couple of drinks with dinner was not going to make a difference to my mood. I was dead wrong.

When I quit drinking, the improvement in my mood was dramatic. After a month of zero alcohol, I realized I was popping out of bed in the morning, when I had never popped out of bed before in my life. I needed less sleep, and I felt more optimistic and energetic. I felt more creative, and, well, happy.

Ever the experimenter, I had a couple glasses of wine one night after a few months, to see if the improvements I noticed were really related to quitting alcohol. The next morning I woke up with a familiar “hangover” of negative intrusive thoughts. All day I felt that cloud of depression, and I went through the motions of the day while feeling like a shell of myself.

That experiment sealed the deal. My experimental break from alcohol became a permanent state of being a non-drinker.

Conclusion: Quitting all alcohol is a game changer for my mood. I’m off alcohol and I don’t miss it at all.

Coping With Chronic Depression: The Bottom Line

All six of the above interventions have been very helpful for me. However, none of them, alone or in combination, have cured my chronic depression. Instead, I rely on all of them, working together, to keep the hours or days that I spend feeling down to a minimum.

Basically, I have to work pretty hard to manage my mood. I stopped drinking alcohol. I try to rarely eat sugar and flour. (When I do, I pay for it with a dip in my mood.) I exercise regularly, even though I’m a lazy sloth at heart. I make a point to stay connected to family and friends, even though I am very introverted. The easiest things I do are take antidepressants and seek therapy on a regular basis.

When I am doing all of these things consistently, I feel pretty normal. I have isolated bad days like everyone does, but I avoid the worst of it. There are a lot of balls to keep in the air, though. A lot of my bandwidth is devoted to managing my mood on a daily basis.

It sucks knowing that when and if I drop one or more of these balls, depression is right there, waiting in the wings. The fact that I’m willing to put in all of this work speaks to how much depression is really just the pits.

Depression remission, rather than cure

Research suggests that chronic depression is an illness to manage rather than cure. Based on my personal and professional experience, that makes sense to me. I think of chronic depression as something that can go into repeated temporary remissions.

It is not uncommon for people to require a fair bit of trial and error to find their best strategies for managing their own depression. The goal is to find whatever methods work for you, so the impact of depressive symptoms is kept to a minimum. I hope that my sharing the progress I have made in managing my depression is helpful to you,

If you are dealing with depression and you need support, please do not hesitate to contact me. If I’m not the right fit for you as your therapist, I will help you find someone who is. 

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