COVID pandemic got you down?

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

“If you, then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him!” – Matthew 7:11

 “A cheerful heart is good medicine, but a crushed spirit dries up the bones.” – Proverbs 17:22

 “Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God.” – Philippians 4:6

 “Above all else, guard your heart, for everything you do flows from it.” – Proverbs 4:23

 “For God has not given us a spirit of fear, but of power and of love and of a sound mind.” – 2 Timothy 1:7

 “Consider it pure joy, my brothers and sisters,[a] whenever you face trials of many kinds, because you know that the testing of your faith produces perseverance.” – James 1:2-3

 “In all your ways acknowledge him, and he will make straight your paths.” – Proverbs 3:6

 “Commit your actions to the LORD, and your plans will succeed.”- Proverbs 16:3

 “Consider the ravens: They do not sow or reap, they have no storeroom or barn; yet God feeds them. And how much more valuable you are than birds!” Luke 12:24 – Luke 12:24

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