Almost everyone goes through rough mental patches. You may feel down, sad, and lethargic. Most people bounce back with no problem, but if these feelings become more frequent and linger longer, you could have a mild, yet still serious form of depression called persistent depressive disorder (PDD), also known as dysthymia.
Older adults are especially vulnerable to PDD, and more so during the COVID-19 pandemic, says Dr. David Mischoulon, a psychiatrist at Harvard-affiliated Massachusetts General Hospital. “While the COVID pandemic affects everyone, older adults have experienced increased stressors like economic issues, prolonged isolation, and the threat of getting sick, all of which can trigger feelings of anxiety and depression beyond the norm.”
In fact, a survey published online Sept. 2, 2020, by JAMA Network Open found that one in four adults has experienced depressive symptoms during the pandemic. Data from the nonprofit advocacy group Mental Health America showed that online mental health screenings were up by 406% in May and 457% in June, as compared with January, before the pandemic began.
Tough to diagnose
Persistent depressive disorder can be tough to recognize because it often doesn’t interfere too much with everyday life. “People ignore it because they feel it’s normal, or they have grown accustomed to the symptoms coming and going,” says Dr. Mischoulon.
You may suffer from PDD if your depressed mood is present more days than not and has been around for about two years without at least two months of interruption. Another criterion for diagnosis is the presence of at least two of the following symptoms:
- weight gain or loss
- sleep problems like insomnia, waking up too early, or sleeping too much
- low self-esteem
- fatigue or loss of energy
- loss of enjoyment in favorite activities
- trouble concentrating or making decisions
- feelings of hopelessness.
“Be mindful that PDD can manifest in other ways, too, like upset stomachs or headaches, irritability, and frequent disagreements with family and friends,” says Dr. Mischoulon.
Persistent depressive disorder can raise your risk of more serious health issues if left unchecked. According to the National Alliance of Mental Illness, about 75% of people with PDD at some point also experience a major depressive episode, a phenomenon called double depression.
PDD also has been linked to a higher risk of cardiovascular disease and may exacerbate existing problems like high blood pressure.
|Antidote to prevent feeling lowHow can you keep up your spirits, even if you don’t have persistent depressive disorder? Stay engaged in life as much as possible. Even small efforts can be beneficial. For example, a daily walk can lift your mood. “Also, use the current situation as an opportunity to engage in new indoor activities that challenge you and keep your brain active,” says psychiatrist Dr. David Mischoulon with Harvard’s Massachusetts General Hospital. “Learn a musical instrument, read a book a day, or do a physical challenge — like a recent trend of performing 25 push-ups a day for 25 days.” But make sure to check with your doctor before embarking on any new course of strenuous exercise.|
Enlist a support team
The first step toward treatment is to recognize the symptoms. Of course, self-analysis can be a challenge — some people are more aware of their changing moods than others — which is why you may need help. Ask a friend, spouse, or relative to monitor you for any signs of changes in your behavior. Offer to do the same for someone else, too.
“You can learn a lot about your own behavior by noticing changes in other people,” says Dr. Mischoulon.
If you or someone else notices signs of PDD, don’t try to manage it independently. “Get a professional evaluation from a mental health expert like a psychiatrist or counselor,” says Dr. Mischoulon. “They are better qualified to make a clinical diagnosis and offer the best course of treatment.”
PDD responds well to psychotherapy (talk therapy), antidepressants, or a combination of the two. Many mental health care professionals have begun offering online therapy during the pandemic. Make daily exercise a priority, as many studies have shown its effectiveness in helping people with depression.
“Whatever you do, don’t ignore the signs,” says Dr. Mischoulon. “It’s never right to not feel right.”
Bible verses for today’s meditation and inspiration: Matthew E. McLaren
1 Corinthians 13:1-13 If I speak in the tongues of men and of angels, but have not love, I am a noisy gong or a clanging cymbal. And if I have prophetic powers, and understand all mysteries and all knowledge, and if I have all faith, so as to remove mountains, but have not love, I am nothing. If I give away all I have, and if I deliver up my body to be burned, but have not love, I gain nothing. Love is patient and kind; love does not envy or boast; it is not arrogant or rude. It does not insist on its own way; it is not irritable or resentful; …
Luke 11:28 But he said, “Blessed rather are those who hear the word of God and keep it!”
James 1:2 Count it all joy, my brothers, when you meet trials of various kinds,
Ecclesiastes 7:14 In the day of prosperity be joyful, and in the day of adversity consider: God has made the one as well as the other, so that man may not find out anything that will be after him.
1 Corinthians 13:4 Love is patient and kind; love does not envy or boast; it is not arrogant
Micah 6:8 He has told you, O man, what is good; and what does the LORD require of you but to do justice, and to love kindness, and to walk humbly with your God?
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