What Are The Effects Of Long-Term Depression?

Persistent and unrelenting symptoms of long-term depression can cause physical, emotional, social, and economic repercussions that can severely impede a person’s life. This is especially true for those who have lived with untreated depression for years. Many people with any mental health disorder grow concerned about how the symptoms may affect their general health and well-being. While there are some negative repercussions to brain health when depressed for long periods of time, with early intervention and treatment, these effects can be relieved and even reversed. This article will help clarify the effects of long-term depression, sometimes called persistent depressive disorder, and outline potential paths you can explore to find the best type of treatment that meets your needs.

What Is Long-Term Depression?

There is no one definition or model for persistent depressive disorder or long-term depression. Several different diagnoses may be given depending on your situation. The diagnosis you receive for your long-term depression often depends on how long you have had depression, and the symptoms of depression with which your body and mind present. According to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), persistent depressive disorder refers to several chronic depressive presentations, including: 

Dysthymia

Dysthymia, also called persistent depressive disorder or long-lasting depression, is depression that lasts for two years or more even with treatment. With dysthymia, symptoms of depression may not be as severe as with major depressive disorder, but they are consistently present for a long period regardless of treatment.

Double Depression

Double depression is defined as a bout of major depressive disorder soon after a diagnosis of dysthymia. In other words, with double depression, you go from one milder but long-term depression into a more severe major depression. While this can be difficult to treat at the start, there are options such as therapy and counseling that can help improve your quality of life.

Chronic Major Depressive Disorder

Major depressive disorder is clinical depression that lasts for at least two weeks. For some people, major depression can last much longer than two weeks. Some people experience long-term depression that is extremely debilitating and can cause major problems for them in their lives. This is the most common form of long-term depression that leads to the most serious effects. Like double depression, there are ways to learn how to address this condition in a healthy manner.

Partial Recovery

It is not uncommon for relapses into major depression or lingering mild depressive symptoms to occur even after the depression is in partial remission. For many people, partial recovery may allow them to function better in society and the workplace, but it may not be enough of a recovery to stop the effects of long-term depression. However, depression is still a very treatable condition, and you are not alone in your search for solutions.

Effects On The Brain

There are many ways that long-term depression affects the brain. It is commonly believed that depression is the result of a chemical imbalance in the brain. However, this chemical imbalance, or side effects from the long-term depression itself, can cause additional changes to the brain and how it functions, particularly altering synaptic AMPA receptors, affecting Purkinje cells, and disrupting hippocampal synapses. The AMPA receptors control the speed of communication between nerve cells while Purkinje cells are known as the largest neurons in the human brain.   Much research has been done as to how long-term depression affects the brain, some effects of which are outlined below in relation to its associated brain part:

Hippocampus

The hippocampus is the part of the brain that plays a major role in learning and memory, among other things. People who are struggling with long-term depression can frequently encounter problems with memory loss and short-term memory problems. This is due to the chemicals that are produced in the hippocampus and how its synaptic activity affects brain function.

One of the chemicals produced in the hippocampus is cortisol. In times of physical or mental stress, such as the stress of depression, the hippocampus produces more cortisol than necessary. This is sometimes known as hippocampal long-term depression because excess cortisol in the hippocampus can have long term cortisol effects, leading to the production of new neurons slowing down. This can further cause neurons in the hippocampus to shrink. This pathway is what leads to memory problems.

Amygdala

The amygdala is the part of the that helps control emotions (especially aggression and fear) and encode memory. The excess production of cortisol from the hippocampus during long-term depression affects synaptic response and synaptic strength in this part of the brain as well. The result is that the amygdala becomes enlarged and overactive, which may lead to difficulty in managing stress and a cognitive bias toward perceiving the world and self as negative. An overactive amygdala can also cause sleep disturbances and changes in activity. 

Prefrontal Cortex

The prefrontal cortex is central to cognition and controls several important control processes in the brain, including impulse inhibition, attention, and cognitive flexibility. This crucial part of the brain also shrinks when there is an overproduction of cortisol. When the prefrontal cortex shrinks, it may stop people from being able to form new memories, make important decisions, or control emotions. All of which can affect other aspects of mental health. 

Risks Of Long-Term Depression For Physical and Mental Health

For those who are experiencing the effects of long-term depression or persistent depressive disorder, there are some additional risks that are not associated with brain changes or other physical factors. The longer a person is exposed to the effects of major depression, the higher the risk of these effects becoming acute. This means that it is important to seek options for proper care to prevent these effects from happening more frequently. 

If you are having suicidal thoughts, immediately reach out to National Suicide Prevention Lifeline (1-800-273-8255), Suicide and Crisis Lifeline (988 call or text), a licensed therapist, or other professional emergency help.

There are ways to reduce the symptoms of depression or lessen their impact on your life. If treatments such as medications (typically selective serotonin reuptake inhibitors or SSRIs) and psychotherapy (talk therapy) have not worked to reduce your symptoms, other inpatient treatments such as low frequency stimulation or ECT* to improve synaptic plasticity might be available to you.

*Please consult with your doctor or primary care physician before considering any medication options or inpatient medical treatments.

Substance Use Disorder

Another common risk for people living with long-term depression is substance use or drug addiction. Sometimes when medications and therapy do not work, people may turn to illegal drugs or alcohol to try to alleviate their mental health symptoms or low self-esteem. If such substances turn out to be successful the first time, they may soon become dependent on them to continue with their daily lives.

Substance use comes with its own physical and mental problems, including an increased risk for persistent depressive disorder and bipolar disorder. Substance use can cause severe physical limitations and illnesses, even leading to a high risk of neurodegenerative diseases and premature death. It is important that if you have depression, you do not try to self-medicate, but instead work to find other options with a licensed healthcare provider, therapist, counselor, or psychiatrist.

Physical Health And Long-Term Depression

People with long-term depression may often find themselves thinking about the thoughts and emotions that their depression is sponsoring, including low self-esteem, sadness, guilt, shame, and more. It is not unusual to think that depression is mainly a mental and psychological issue. The effects of long-term depression on physical health are perhaps the ones that are not often considered by those with depression.

However, living with depression increases the risks of these impacts on physical health. 

Cardiovascular Deterioration

One of the things that researchers have found is that people with long-term depression are at risk for cardiovascular deterioration. People who experience depression for longer periods of time are at higher risk for heart attack. Also, once a heart attack or other heart problem has occurred, those with major depression find it much more difficult to recover.

Malnourishment

Depression can often cause changes in appetite. People living with long-term depression may find it difficult to eat anything at all, or they may eat unhealthy and highly processes foods. If an individual’s diet is inconsistent in terms of both nutrition and schedule, it can be very easy to become malnourished over time. Long bouts of depression that go without treatment often increases the risk of malnourishment.

Obesity

Appetite changes from depression can also cause obesity. Persistent depressive disorder can lead to inadequate eating behaviors that can cause people to gain a large amount of weight over time. Long-term use of antidepressants can also cause weight gain. Many doctors recommend regular exercise to those experiencing depression as part of a holistic approach to health. Regular exercise does not only counteract the risk of obesity but improves mood and relieve other symptoms of depression.

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Socioeconomic Effects Of Long-Term Depression

There are a few socioeconomic effects of long-term depression that may affect your way of life. These social and economic effects of long-term depression are frequently common in people who live with depression for many months or years. Like many of the aforementioned issues, the risk for these effects increases as exposure to the stresses of depression continues without care.

Social Isolation

If you are living with long-term depression or persistent depressive disorder and feel socially isolated, you are not alone. Many people who have long-term depression report low self-esteem and losing interest in activities and things that they once enjoyed. Both a lack of interest and a lack of energy can contribute to a disinterest in going out to social engagements. For example, you may tire of talking to your friends and having them ask you what wrong all the time is, so you may be tempted to disconnect. A common line of thinking is that you are doing them a favor. But there are healthy and effective strategies to counteract this type of thinking, including reaching out to a trained mental health professional.

Workplace Performance

Long-term depression can also impact your finances by affecting your workplace performance. Many studies have been done showing that workplace performance often decreases significantly when an individual is has major depression, persistent depressive disorder, or other mental health issues. Reciprocally, workplace performance often goes up with just a few weeks of treatment. If you feel are unable to handle the stress and pressure of work, your workplace performance may take a direct impact. You may also be thinking about the financial repercussions of missing work. Sessions with therapists who are trained in helping people handle depression can provide you with guidance to work through these difficult times and help you develop strategies that work for you.

Getting Help

If you have been living with major depression, bipolar disorder, persistent depressive disorder, or double depression for a long time without relief, consider reaching out to a healthcare provider. If you are unsure about where to start, you can contact an online therapist or psychiatrist to discuss treatment options. While online counseling is relatively new in the field of psychological care, it may benefit you greatly. Online therapy is usually more flexible and accommodating of busy schedules than in-person therapy. Most online therapists are available not only during the business week, but also weekends and nights. Additionally, online therapy platforms such as BetterHelp are generally more affordable than traditional therapy sessions. BetterHelp offers different models of cost while providing a diverse of high-quality resources, such as video conferencing and live chatting options.

The symptoms and conditions associated with long-term depression and persistent depressive disorder are very treatable. For example, one study by the Berkeley Well-Being Institute found that people who used BetterHelp experienced a significant decrease in the severity of depression symptoms. You may not be able to relieve all symptoms with medication and psychotherapy completely. There are many treatment plans available. Also, even lessening your depressive symptoms so that they go from severe to mild can make a big difference in how long-term depression affects your life.

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