Will I Always Be Depressed?
It is not uncommon for a person who has been struggling with depression to ask, “Will I always be depressed?” Depression belongs to a class of illnesses categorized in the DSM-5 as mood disorders. As such, when someone is depressed, their general affective state (mood) is distorted, and this impacts their ability to function across many life contexts: whether in work, school, or responsibilities at home, and even in everyday family life.
While there are many well-known environmental risk factors for depression, such as trauma, grief, financial or relationship troubles, or stage of life changes (i.e. postpartum), there is not one singular cause for depression. Some may believe that depression means simply being sad and unmotivated, which many people will experience from time to time, but a true diagnosis speaks to the insidious nature of the disease to infiltrate all aspects of life, as well as the persistent and habitual presentation of its symptoms.
Research indicates that after experiencing one depressive episode, individuals are at increased risk for another episode later on in life. It was discovered that about 13 percent of people who recover from their first episode of major depression go on to have another episode within five years; 23 percent within 10 years; and 42 percent within 20 years, although some dispute these figures, and claim they are even higher.
One might be tempted to ask given the chronic disposition of the illness: “Will I always be depressed?”, “Is there hope for recovery?”, “Is there hope for me?”
Am I Alone?
In addition to the 16.2 million U.S. adults, 3.1 million adolescents are also reported to have experienced at least one major depressive episode, and the rate is only growing for this demographic. This is especially disturbing, as a recent study found that for individuals who were of a younger age, had a younger age of onset, and negative experiences in childhood, these factors were among others that were connected with a shorter time before a subsequent episode.
The same study also cited a severe last depressive episode, high emotionality, as well as environmental stressors as preceding a future episode. Although depressive symptoms may be more common in women (8.5 percent) than in men (4.8 percent), they may present differently for men and it is important that one is able to recognize the signs of depression in men.
Why do I think this way?
The hallmark feature that is generally associated with depression is the persistent sad, anxious, or “empty” mood. Often, this leads to irritability, especially in children and teens. These symptoms easily turn to apathy, and often unconsciously, depressed people will turn off their emotions, and live in a “numbed” state. Of course this may be due to chemical imbalances in one’s brain, or other environmental factors that stem from an inability to regulate emotions in effective ways. Emotion regulation skills can be taught, and medication can be prescribed to assist in managing moods, although engaging with emotions in new ways, and adhering to prescribed recommendations are key in managing symptoms.
In addition, when living in a chaotic emotional world, and when thoughts begin to ruminate regarding injustices in the world or those directed towards you, one who struggles with depression might begin to incorporate their own means of numbing behavior to deal with all the excess emotion. This may begin with increased use of alcohol or other substances to assist in emotion avoidance, as depression and alcoholism often appear to exist hand-in-hand. Other forms of self-medicating behavior exist, or attempts to numb the pain may even take form as increased suicidality: recurrent thoughts of death or suicide, or even suicide attempts.
Difficulty concentrating, remembering information, and making decisions are all aspects of depression that represent impaired cognitive functioning. While these symptoms may not be present in all cases, typically they result from mood disturbances and slowed thinking due to feeling unwell and employing maladaptive coping skills. This can make even the smallest decision difficult to make, and more serious ones impossible.
Why do I feel this way?
Less emphasized in the literature when discussing depressive symptoms is the physical toll that the disease takes on one’s body. In addition to unexplainable aches or pains, headaches, cramps and digestive problems, one will likely experience decreased energy and fatigue that is inconsistent with their ‘normal’ activity level.
The DSM-5 emphasizes that individuals with depression may also experience an observable difference in muscle retardation, resulting in moving and talking more slowly. This symptom in particular is important to be grounded in objective observations, rather than simply subjective experience of the individual. On the opposite end of the spectrum, one might report feeling restless or have great difficulty in sitting still.
Some chronic illnesses are also known to be linked with the experience of depression, due to illness-related anxiety, among other symptoms. While undergoing treatment for these medical diseases, it is important to address the often-resulting depression.
- Coronary heart disease
- Multiple sclerosis
- Alzheimer’s disease
- Parkinson’s disease
- Systemic lupus erythematosus
- Rheumatoid arthritis
Depression is known to affect nearly all aspects of one’s life, daily patterns of eating and sleeping notwithstanding. All experiences of insomnia are positively correlated with depression, including difficulty falling asleep, waking in the middle of the night or in early morning hours, or oversleeping and refusal to get out of bed.
These changes are often seen hand-in-hand with individuals unable to participate in daily acts of self-care or hygiene. Often individuals may require constant prompts to remember to take a shower, to commit to oral hygiene and to wear clean clothes.
Changes in appetite may be due to increased stress due to depression as it might be difficult to imagine stomaching any food, or conversely, food may be the only thing bringing comfort. Thus, rapid weight loss or weight gain are equally linked with an experience of depression. Although some fluctuations in weight are normal, noticeable changes in appetite are always cause for further investigation.
Is there hope for the future?
Perhaps the largest contribution of depression towards relapse and subsequent episodes are the persistent feelings of hopelessness, and pessimism that often characterizes the worldview of someone struggling with depression.
Whether it is forgetting to take a shower, get out of bed, or experiencing fluctuations in weight, nothing perpetuates the cycle of depression like the self-loathing one might experience through a failure in any one of these areas. Often times, getting angry with oneself does not offer a way to create any change, however only serves to reinforce one’s ideas about themselves as worthless or helpless in the face of difficulty.
Those with depression often experience heightened feelings of guilt, whether due to perceived past or present failings, and they may even be related to their awareness of their role in perpetuating their depressive symptoms, as described above. This guilt regarding one’s failure to change, when applied to one’s future creates the soul-crushing experience of despair that may lead someone to ask in the first place, “Will I always be depressed?”
Is there hope for me?
Research shows that with early intervention and in getting connected with the right treatment providers, recovery is possible. With a combination of medication and therapy, you can begin to effectively deal with your depression. By learning to identify triggers and ineffective core beliefs and to replace them with new, positive beliefs and behaviors, you may again begin to believe that hope is out there, and that it can work for you too.
To learn more about how we can help, call Nsight now at (949) 629-3730 or send an email to firstname.lastname@example.org.
Written by Rachel O’Connor, the counseling content specialist at Theory About That