Thursday 12 June 2014

Chronic Moderate to Severe Depression

I would like to discuss some questions and feelings that I have about depression - in general and also relating to my own experience of depression.

First of all, I would like to clarify that I have always suffered from depression - for as long as I can remember. I remember having these feelings as a small child of two or three years old. Often when I tell people this, they simply refuse to believe me. The next question is always whether or not it was diagnosed. No, I was not diagnosed with depression at two years old, but I know that I have always had the feelings of depression. 

When I was around eight years old, my mother told me that I mustn't pull the bed covers right over me, as I could suffocate and die. I had apparently done this unknowingly. After this, I deliberately tried to do the same, but it didn't work, because she always checked on me at night. I don't know if it could really have worked anyway, but it has always stayed in my memory, as this shows how young I was when I actually started to have suicidal thoughts and feelings.

In the process of researching the subject of this blog post online, I have come across more information, which is of interest, and may to some degree, be the answer to some of my questions. My concern has been that most information given about depression, in books and online, describes two specific types of depression: major depressive episodes, and dysthymia, with the latter term basically referring to chronic mild depression. To me, this simply fails to address the fact that depression can often be both chronic and moderate or severe. 

Even the fact that "double depression" is occasionally acknowledged - episodes of major depression, occurring in those already suffering from chronic depressive disorders - doesn't entirely cover what I am talking about, although it's a start, and I certainly wish that double depression was more frequently mentioned. However, I have to say that I have now come across the term "persistent depressive disorder", which does seem to make more allowances for longer-term cases of major depression. This term apparently came into use in May 2013, although this appears to be in the USA. I don't know if this term is current here in the UK and elsewhere, although I am hoping that it is.

I have to say that I don't find that the distinction between mild, moderate and severe depression is always appropriate. If you suffer from mood swings as I do, it is actually possible to make the transition rapidly from mild depression, which could easily be missed altogether, and which can often be "covered up", to being literally suicidal. Dramatic mood swings are a well-known feature of bipolar disorder, but they also occur in unipolar depression, particularly when someone has Borderline Personality Disorder, or BPD features. 

My own mood swings would be between my "normal" (for me) state, and severely depressed or/and angry or/and agitated or/and panicky. They occur more frequently just before, during, or just after my period, but happen enough at other times to mean that they can't be attributed entirely to my menstrual cycle. Sometimes, the mood changes are very sudden. Since I do not get "highs", I do not consider that my mood swings relate to bipolar disorder, although it's true that the distinction between unipolar depression and bipolar disorder is not always as clear as is often imagined, especially when considering forms of bipolar such as cyclothymia. 

By the way, with regard to BPD - I am not currently diagnosed with this, but I am trying to get my diagnosis reviewed. However, that subject would require a blog post of its own, which I may consider writing in the future.
I do get frustrated, to say the least, by talk of "serious mental illness", which somehow excludes depression. Severe depression can actually be classed as a serious mental illness, and it is a misconception that it is not. 

Also, I think that there should be more recognition for the specific struggles of people suffering from both depression and anxiety. It is not easy to live with either depression or anxiety, but to suffer from both can be much more disabling than people often realise. I will talk more about anxiety disorders in a future post, and possibly cover the specific difficulties that many of us have when we deal with both anxiety and depression.

Thank you for reading. I do have several ideas for possible future posts, so watch this space. If you are struggling with depression, know that you are not alone, and there is always hope.

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