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What is Chronic Depression? How to Manage It

Vicky Davis

Reviewed by Vicky Davis, FNP

Written by Geoffrey Whittaker

Published 05/28/2021

Updated 05/29/2021

How long would you say you’ve been feeling depressed?

We’re guessing that, if you’re reading this, you’ve felt depressed before–or possibly, now—or a loved one is feeling low. 

Depression can be taxing and frustrating, and long-term versions of the mental health condition present an extra challenge: The longer the prognosis for improvement—the harder it can seem to find future light. 

Chronic depression is no joke, but it’s also manageable as long as you understand the condition well. Here are some basics about depression, including chronic depression symptoms, and ways to get help.

Depression, according to the National Institute of Mental Health (NIMH), is a mood disorder characterized by down or sad thoughts on an ongoing basis. 

Depressed thoughts are typically strong enough to affect daily behaviors such as sleeping, working, and even how you think.  

It’s very different from just “feeling bummed out.” 

There are different types of depression, including Seasonal Affective Disorder (SAD) which plagues people during the dreary winter months. 

And then there are the more common (and year-round) forms of the mental health condition: major depression and persistent depressive disorder.

Major depression is typically characterized as moderate to severe when it lasts for periods of around two weeks.

Persistent depressive disorder, though, is different—it’s chronic.

Put simply, chronic depression is an ongoing version of depression. The condition goes by several other names, including persistent depressive disorder, dysthymia or chronic major depression.

Chronic depression was mistaken for a personality disorder in the past, but the difference is that chronic depression is something that can be changed, rather than a permanent pervasive nature.

It’s commonly agreed that chronic depression lasts for a minimum of two years. That’s in comparison to normal depression, where symptoms are generally present daily for about two weeks. 

Chronic depression symptoms, by contrast, can range from more to less severe on a varying, daily basis, yet they cannot be absent for more than two months in order to be considered chronic.

 Chronic depression symptoms typically also include at least two of the following:

  1. Poor appetite or overeating

  2. Insomnia or hypersomnia

  3. Low energy/fatigue

  4. Low self-esteem

  5. Poor concentration/decision making

  6. Hopelessness

The symptoms and telltale signs of chronic depression are very much in keeping with normal signss of depression.

According to the NIMH, the causes of depression can be biological, genetic, psychological or environmental. 

Diabetes, poor exercise, a lack of social interactions and low sunlight are all potential contributors.

Depression symptoms are equally as varied and nebulous. 

It’s also perhaps unfair to say “normal symptoms,” since every person’s depression is a little different. It can vary by gender—for example, men exhibit irritability, anger and exhaustion. 

Sleep and motivation problems can also pop up during depression. 

A depressed person may also use illegal substances and act recklessly, lose interest in things once enjoyed, have suicidal thoughts or feel hopeless. 

It’s also not uncommon for a depressed person to experiences cramps, headaches or stomach issues.

Sounding familiar? Probably a good time to read up. If you’re wondering if you have depression, check out this “Am I Depressed” Checklist, along with this complete guide to depressive symptoms to learn more.

Because chronic depression is so similar to “regular” depression, the treatments are nearly identical. 

The exceptions are few—yet as you might suspect, you’ll likely be treating chronic depression for longer than other forms of the condition. 

Chronic depression symptoms can be managed by both medications and therapy. 

In fact, medication and therapy are considered equal in terms of effectiveness, and doing both is likely a necessity for effective chronic depression treatment.

Antidepressants for Chronic Depression

Antidepressants are medications that modify the serotonin levels in your brain and how your neurons interact to regulate depression. 

And while all antidepressants are generally considered effective, there are a few that stand out. 

Tricyclic antidepressants (TCAs) and serotonin reuptake inhibitors (SSRIs) were the most effective medications according to a comprehensive study

TCAs keep more serotonin in your brain for extra supply, and SSRIS, which are the most commonly prescribed antidepressant, block serotonin from being reabsorbed by neurons, leaving more available for transmission. 

Talk with your healthcare professional about other medications you’re taking to avoid negative interactions, and ask about side effects, which vary among drugs.

You may find that you have to try more than one antidepressant to find the right fit for you. Your healthcare professional can help with this, too. 

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talk to a psychiatry provider. it’s never been easier

Cognitive Therapy

Therapeutic practice is an effective way of discussing and analyzing your thoughts and patterns of behavior to help improve your life. 

One of the best forms is Cognitive Behavioral Therapy (CBT), which focuses on recognizing and reordering disordered thought patterns.

Therapy isn’t all couches and talking about your childhood though. Meditation is also an effective technique in reducing certain depression symptoms, especially when practiced with mindfulness.

A mental health professional may suggest other treatments, but that’s after you speak with them. The first step to feeling better is making an appointment. 

Lifestyle Changes for Chronic Depression

This is probably a great time to remind you that, in any situation where you feel less than yourself, it’s a good idea to contact a general healthcare provider. 

They may give you therapeutic or medicinal referrals, but they will also help you narrow down possible causes of depression and sources of continued struggles. 

Several lifestyle factors can contribute to depression and mood disorders, including your health, weight, diet, habits, and blood pressure. 

Cutting some bad habits like smoking or drinking might help raise your mood, and the added benefit of exercise might do wonders—it’s been shown in some cases to be as effective as medication

Severe chronic depression may sound like a longer, steeper uphill battle, butthe r

eality is that you don’t have to climb the whole mountain all in one go. 

Trusting the process and using the tools provided to you is going to help you win the long war, even if every day feels like a tough battle. 

There are plenty of resources available for people struggling with chronic depression symptoms, and if you’re feeling down today, talk to a friend, family member, or trusted contact about those feelings. 

Better yet, take the next step toward a more positive future, and schedule an online psychiatry evaluation and contact a mental health professional for personalized advice and treatment. 

The first step is the hardest, but the help you get will give you a lot of momentum for the journey ahead. 

10 Sources

  1. Craft, L. L., & Perna, F. M. (2004). The Benefits of Exercise for the Clinically Depressed. Primary care companion to the Journal of clinical psychiatry, 6(3), 104–111.
  2. Goyal M, Singh S, Sibinga EMS, et al. Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis. JAMA Intern Med. 2014;174(3):357–368. doi:10.1001/jamainternmed.2013.13018 Retrieved from
  3. Ng, C. W., How, C. H., & Ng, Y. P. (2017). Managing depression in primary care. Singapore medical journal, 58(8), 459–466. Retrieved from
  4. Selective serotonin reuptake inhibitors (SSRIs). (2019, September 17). Retrieved January 08, 2021, from,other%20types%20of%20antidepressants%20do
  5. Moraczewski J, Aedma KK. Tricyclic Antidepressants. [Updated 2020 Dec 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from
  6. Depression Basics. (n.d.). Retrieved January 08, 2021, from
  7. Klaus Linde, Levente Kriston, Gerta Rücker, Susanne Jamil, Isabelle Schumann, Karin Meissner, Kirsten Sigterman, Antonius Schneider: The Annals of Family Medicine Jan 2015, 13 (1) 69-79; DOI: 10.1370/afm.1687. Retrieved from
  8. Patel RK, Rose GM. Persistent Depressive Disorder. [Updated 2020 Oct 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from
  9. Patel RK, Rose GM. Persistent Depressive Disorder. [Updated 2020 Oct 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from
  10. Men and Depression. (n.d.). Retrieved January 08, 2021, Retrieved from
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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Vicky Davis, FNP

Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education. 

Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families. 

She is a Florida native who obtained her master’s degree from the University of Florida and completed her Doctor of Nursing Practice in 2020 from Chamberlain College of Nursing

She is also an active member of the American Academy of Nurse Practitioners.

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