Can depression last years


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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

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Last Updated: 08/30/2022

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Types of depression - iFightDepression [EN]

There are different types of depression, which are different.

Signs and symptoms vary in number, time, severity and frequency, but are generally very similar. Because different types of depression are treated differently, it is important to pinpoint the type of depression. Depending on gender, age and cultural characteristics, people have different symptoms and severity of depression.

Neurotic, reactive (minor) depression is treated with psychotherapy.

Somatic and psychotic - medication. These terms are used by psychiatrists.

Studies have shown that depression has a phasic course. Periods of normal mood alternate with depressive episodes. Sometimes, instead of a depressive phase,

there may be a manic phase, which is manifested by irritability and high mood. If so, then it is not depression, but bipolar disorder (a more serious illness).

1. Depressive episode

The most common and typical form of depression is the depressive episode. An episode lasts from a few weeks to a year, but is always longer than 2 weeks. A single depressive episode is called a unipolar episode. Approximately one third of affected people experience only one episode, or "phase", during their lifetime. However, if a person does not receive appropriate treatment for depression, there is a risk of recurrent depressive episodes in the future. Depressive episodes always affect a person's performance to one degree or another.

2. Intermittent (recurrent) depressive disorder

When a depressive episode recurs, it is recurrent depressive disorder or major depressive disorder, which usually begins in adolescence or early adulthood. With this kind of depression, depressive phases, which can last from several months to several years, alternate with phases of normal mood. This type of depressive disorder can seriously affect performance and is unipolar in nature (no manic or hypomanic phase). This is the so-called "classic" or "clinical" depression.

3. Dysthymia

Dysthymia presents with milder and less severe symptoms than a depressive episode or recurrent depression. However, the disorder is permanent, with symptoms lasting much longer, at least 2 years, sometimes decades, which is why it is called "chronic depression". This disorder is unipolar and also affects performance. This type of depression sometimes develops into a more severe form (major depressive episode) and if this happens it is called double depression.

4. Bipolar depression, type I

This is the type of depression in bipolar disorder, formerly called manic-depressive illness, and is less common than unipolar depression. It consists of alternating depressive phases, phases of normal mood and so-called manic phases.

Manic phases are characterized by excessively high mood associated with hyperactivity, anxiety, and decreased need for sleep.

Mania affects thinking, judgment and social behavior causing serious problems and difficulties. When a person is in a manic phase, he makes frequent casual unsafe sex, makes unwise financial decisions. After a manic episode, such people often experience depression.

The best way to describe these "emotional upheavals" is "to be on top of the world and fall into the depths of despair".

Symptoms of the phases of depression in bipolar disorder are sometimes difficult to distinguish from unipolar depression.

5. Bipolar depression type II

More like recurrent depressive disorder than bipolar disorder. In this disorder, multiple depressive phases alternate with phases of mania, but with less pronounced euphoria. During these phases, family and loved ones may even mistakenly assume that the person is doing well.

6. Mixed anxiety-depressive disorder

In anxiety-depressive disorder, the clinical picture is very similar to depression, however, in depression, depressive syndromes always come first. In this case, both anxious and depressive symptoms are evenly combined.

7. Depressive psychotic episode

A special form of depressive episode is psychotic or delusional depression. Psychosis is a condition in which people see or hear things that do not exist (hallucinations) and/or have false ideas or beliefs (delusions). There are various types of delusions such as self-accusation for no reason (delusion of guilt), financial ruin (delusions of poverty), feeling of an incomprehensible illness (hypochondriac delusions). People with delusional depression almost always require inpatient psychiatric treatment. Psychotic episodes can be either unipolar or bipolar.

8. Atypical depression

This type of depression is characterized by hypersensitivity and mood swings, overeating and drowsiness, panic attacks. This type of depression is mild and can be bipolar.

9. Seasonal depressive disorder

This type of depression is similar to atypical depression and comes on seasonally with climate change, usually in autumn or winter. Usually, when the season ends, people return to normal functioning again.

10. Brief depressive disorder

This is a milder variant of depression that more often affects young people and is characterized by short depressive episodes lasting less than 2 weeks.

“We were taught not to whine”: how to accept and overcome depression

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Video caption,

Awkward questions: what does it mean to live with depression?

Many people live with depression for years without realizing it. Everyone has autumn blues, bad days, self-doubt, but depression is not just a bad mood.

In modern society, this is one of the most common mental disorders, in the worst cases ending in premature death. According to the latest WHO estimates, more than 300 million people worldwide suffer from depression.

The BBC Russian service talked to people who have experienced depression about the stereotypes and myths associated with it, as well as about how to overcome this disease.

Image caption,

Sasha Mashin was diagnosed with clinical depression and was fully rehabilitated a year later. Yana Mandrykina overcame depression within a year

Stereotypes about depression

"Depression does not exist. Psychotherapists invented it to make money"

Zhenya Golomuz: I have changed enough psychotherapists and I can say that many of them really use depression to make money. They increase the number of sessions, make them come twice a week, supposedly one session is not enough. But there are also decent people, they really understand your problem, because very often they themselves went through depression before becoming psychotherapists. As in any profession, there are charlatans among psychotherapists and psychiatrists.

Irina Urnova: I had a psychotherapist who started doing things that shouldn't be done. He started belittling my problems, saying that my problem is not a problem. We stopped dating.

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"It's a disease of selfish"

Sasha Machine: Rather, it is a disease of perfectionists. It often happens to those people who are trying to achieve a cool result in some kind of activity.

Kirill Cheremisov: I know a lot of selfish people who don't get sick. On the contrary, during depression you do not love yourself, but in order to recover, you need to love. One of the points of psychotherapy, psychoanalysis and other techniques is to develop self-love.

Image description,

Anastasia Tropp (left) had several periods of depression, the longest one lasting a year and a half. Zhenya Golomuz (right) was clinically depressed for almost two years and recovered from it for three years

"Stop feeling sorry for yourself. Do something useful!"

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Zhenya Golomuz: I am always doing something useful, I am constantly helping people. If I don’t benefit people, I figure out how to benefit people, because it really helps in life.

Kirill Cheremisov: We were taught not to whine. This is a weakness. You have to be strong. Boys shouldn't cry. You need to feel sorry for yourself. This is fine. Why not?

Kristina Butaeva: We must admit this. Yes, I do feel sorry for myself at the moment. Why should I stop doing this?

Sasha Mashin: Imagine that you broke your leg. And you say to yourself: dude, pull yourself together, you're not a rag. A real man. Depression is not laziness in you. This is a disease that requires professional treatment.

Yana Mandrykina: By the way, I broke my leg this year. It would have been strange if I hadn't called an ambulance.

Vera Kornakova: I want you to be sorry, but you cannot accept this concern for yourself.

Irina Urnova: And this care is never enough. She is annoying. Everything is not right.

Photo caption,

Vera Kornakova (left) suffered from depression twice, of which she was hospitalized once. Irina Urnova (right) has borderline personality disorder

"You've become so boring, you can't go out anywhere!"

Zhenya Golomuz: You need to be able to explain depression to people, because it seems to them that nothing is visible, nothing hurts, which means that everything is all right with you. And why are you even lying on the bed again? The concert is great, let's go for a drink.

Irina Urnova: I had friends and acquaintances who said: "You are dragging me down with you." Perhaps it was, it was hard for them, but it does not help. For friends of those who are depressed, I would advise either to help or to move away altogether.

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"Stop pretending. You have to pull yourself together!"

Zhenya Golomuz: Stop pretending - that's the worst thing you can say, because at some point it began to seem to me that maybe I'm actually pretending? Maybe I'm really a lazy pig?

Kristina Butaeva: These phrases devalue a person's feelings. Wait, I just wanted to tell you that I am really weak at this moment. Why don't you want to admit it? From the phrase "be strong" in a state of depression, you become weaker. On the outside you can't confess, but on the inside you're helpless. Such phrases drive.

Kirill Cheremisov: Of course, they are driven. They make it even weaker, as if they are saying: you should be ashamed. These are all models of behavior imposed by society that prevent you from understanding your condition.

Sasha Mashin: Chemistry in the head is changing - some substances have become less, others have become more. You can no longer help yourself. You need to change this chemistry by contacting a doctor. It's impossible to take control of yourself. There is no chance for this.

Vera Kornakova: Many people think that you are pretending, but this is due to a lack of understanding of what is happening. The degree of empathy in a person is not such as to feel what is wrong with you.

Image caption,

Kristina Butaeva recovered from her depression thanks to her work with a specialist. Kirill Cheremisov managed to cope with depression in 9 years0003

"This is weakness, be strong! There are people who are much worse"

Zhenya Golomuz: I had my first episode of depression at the age of 14. I came home and said: I have depression. My parents say to me: Zhenya, are you completely crazy? Here, read "Robinson Crusoe", he was much worse. He was generally alone, but you have everything: an apartment, a cool school, English from morning to evening. Depression is definitely not for the weak, because to admit that you have depression, you need to be super strong.

Kristina Butaeva: At the very beginning it was embarrassing to whine, embarrassing to admit it to myself. After all, life goes on. And I would like to say: I'm sad now. But you are so expected to smile when you go somewhere or participate in a party. We have to comply, and there is great disharmony in this. For the first time, I could only have a nap with a specialist. Finally I was able to say: I feel bad, yes!

Kirill Cheremisov: Yes, there are starving children in Angola, and this factor should work, but it doesn't.

Anastasia Tropp: Many of my friends still don't know that I had depression. For some reason, I was so ashamed to tell my friends that I was in this state. I was embarrassed to dump my problems on them. When they found out, they made round eyes and said that I had thought of something.

Living with depression: a personal experience

How does it happen?

Zhenya Golomuz: You stop going to work, then you stop leaving the room, getting out of bed, then you stop rolling over, then you just look into the pillow. Friends say: "Zhen, you could write what is bad." But I couldn’t, because communication takes a lot of strength and energy, it’s really hard to do.

Kirill Cheremisov: Constant physical fatigue and emotional exhaustion. In the morning you wake up, having slept, but you are broken and do not want anything. In the evening you come home from work barely alive. The only thing you want to do is turn off the light, lie down on the couch and turn off your phone.

Kristina Butaeva: Feeling the bottom. A wide black streak in life. Several times I caught myself thinking that it could not be worse. But it gets worse. Then I admitted to myself that I could no longer fight. Fatigue from the struggle overcame.

Yana Mandrykina: You drive and cry in the car and don't understand the reason. The condition was such that now it would crash somewhere and that's it. And I also worked all the time, about 24 hours a day. Sometimes I slept a little.

Irina Urnova: There is no special meaning in life. No need to get up in the morning, no need to go to bed earlier or later. There is no need to invent, do something, set some goals.

Vera Kornakova: An infinitely long sleep that does not bring peace. Pain that is not relieved by painkillers. And panic attacks.

Sasha Mashin: I had a concert and I couldn't figure out what to do, what to play. Everything goes out of focus, you can't focus on anything. There is a growing feeling that something is not right. I didn't have the strength to show any emotion. Cry? No strength to cry. You make a lot of claims. There is a void. It's like your brain has been de-energized. It takes a lot of time to admit that something is wrong with you. That is the problem - why people do not seek help. They think: well, that's something with the mood, somehow things are not going well.

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What is the worst thing about depression?

Zhenya Golomuz: I don't know. What's worse than the fact that you just can't get up?

Kristina Butaeva: Expectation from people. I think my depression dragged on because I honestly believed that help should come from outside. Well, now they will see how bad I am. I have a running line on my forehead.

Kirill Cheremisov: To despair and start thinking that it is impossible to get out of this state.

Yana Mandrykina: Stop appreciating life.

Sasha Mashin: During clinical depression, a lot of people come to the conclusion that ending their life is perhaps the only way to end the suffering they are experiencing. And the suffering is intense. At times you feel an ax that sticks out in your chest, a tearing sensation. And you're willing to do anything to make this feeling end. Perhaps that is why they think that the soul is in the chest. The worst thing is not knowing what is happening to you.

Anastasia Tropp: Probably when your call for help will be answered with ridicule or a frivolous attitude. If you need a person, and the person distances himself, it is very difficult. It might get you into a loop.

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Antidepressants

Zhenya Golomuz: This is horror, horror, horror! Because you become a little bit of a vegetable, but at the same time a functioning vegetable. If you have to get up because they stopped paying salaries and it’s time to earn some money, then antidepressants are the best thing to go out into the world. I do not recommend it on a regular basis, because you stop getting any pleasure from life, but at least you exist with them.

Yana Mandrykina: In Russia, this is just some kind of barrier. I had it too, because it is generally accepted that if you start taking antidepressants, then it means finally cuckoo. In fact, properly selected antidepressants return to normal life. What's the difference - weak or strong? Happy! Or live in fear. This is some kind of Soviet stereotype, like "guys don't cry."

Sasha Mashin: If you are thinking about a window or a chandelier, then this is absolutely the situation when you need to take antidepressants. But you don’t need to prescribe medicines to yourself, this should be done by a doctor.

Irina Urnova: The statement that any fool can take a pill, I have heard more than once. People are afraid to eat pills and there is a resource that cannot be replenished simply by rest, it must be replenished at the chemical level.

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Video caption,

Colors against depression: how makeup helped restore self-confidence

Can depression be cured?

Kirill Cheremisov: According to statistics, people who seek treatment for depression, 80-90% of them are cured. There are many techniques, great statistics. In my opinion, the most effective is psychoanalysis and cognitive therapy. If it's a severe case of illness where you can't function normally, then antidepressants and some additional medication.

Kristina Butaeva: It is important not to diagnose yourself. You'll have to try different paths. In meditation, I was strongly thrown in different directions, and I understood that I could not cope on my own. My way was - a conversation with a specialist. There was a feeling that I was alone in the room and talking to myself out loud, but she sat in front of me and periodically asked the question "why?"

Sasha Machine: He is being treated. Although a person who has experienced depression once, the chances of a repeat are seriously increased. But in this case, the problem is not to cure it, but to know what happened to you and seek help. Therefore, even if this happened again, you no longer panic, but write a message to your doctor. Literally a week and you're fine.

Yana Mandrykina: I agree. You can break your leg several times in your life. You will treat her every time, not selectively.

Zhenya Golomuz: Personally, I have never seen someone who was completely cured. It's always that kind of Alcoholics Anonymous club.

Why were you depressed?

Anastasia Tropp: This is the biggest secret. It comes from nowhere, and you don't understand at all what it could be connected with. This is a paradox, because you look at everything and want to slap yourself in the face and say: kamon, why did you arrange all this? I changed my lifestyle when I went on maternity leave and all my surroundings began to perceive me as a mother. And my old social history seemed to cease to exist for other people. For me it was a big crisis, but now everything has passed.

Kristina Butaeva: It is generally accepted that good emotions should be shared. We consider them good because our parents told us it was right. When you experience bad emotions - aggression, stress, it feels like you don't know how to express them. Getting angry is uncomfortable. You forbid yourself, you say - I'm normal, adequate, everything is in order, I read smart books. For example, take the feeling of resentment. You want to complain, but it is not clear to whom. The husband offers to pull himself together, a friend has a lot of problems at work. And it seems that the whole world is not up to you.

Kirill Cheremisov: You can't be angry with your parents, with your relatives - that's bad. You can't be angry with a child. And you hide these emotions deep down, and they accumulate. No one has ever taught us psychology how to deal with stress. Over time, you drive yourself into this state. I had a long enough stress. Anxiety causes depression, depression causes anxiety. And now you are already lying at the bottom and thinking: why did this happen to you?

Yana Mandrykina: There were many prerequisites for this. And the final trigger was the loss of friends in a disaster. This shock worked for the acute phase. I may have had a sluggish phase and then a shocking event kicked in.

Sasha Mashin: I seem to have an endogenous history and it's not about the way of thinking, but partly about genetics. There were uncomfortable conditions, but the clinical case was three years ago. He was triggered by an obsession with living in another country. And I was so focused on this thought ... I was very scared to try it and at the same time I really wanted to, because it would bring incredible results in my professional career. And these scales are a constant comparison: what is there and how is it here. What happens if I go, and if I don't? This is the state that started the process.

Irina Urnova: I am not diagnosed with bipolar disorder or manic-depressive psychosis, but I always balance between hypomania and depressive episodes - the so-called borderline personality type. In hypomania (also called atypical depression), you are alert all the time: you don’t need to sleep, you don’t need to eat, everything is fine anyway. Then this state passes and exhaustion sets in. The trigger was the death of my father and then studying abroad, where I was alone. There began a serious condition. Everyone copes with the death of a loved one differently, but many try to get through it faster and do not let themselves grieve.

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How did you manage to get out of depression?

Anastasia Tropp: Willpower. You take the will into a fist and try your best.

Zhenya Golomuz: My friends suddenly realized that I needed help. They came up with a system where one person called in the morning, the other drove to work. Therapy, pills and sports helped. Now I do not go in for sports at all, I do not take pills. Routine and reactive psychotherapy helps. As soon as you realize that it starts to cover, you remember that you need to do 12 squats, buy tickets to Europe, somewhere warm.

Kirill Cheremisov: After I admitted to myself that I was depressed, it was very difficult to tell anyone about it. But relatives understood and believed. And working with a specialist helped.

Kristina Butaeva: A conversation with a specialist and identification of a resource - I need life, I need myself, and then everyone else. And when all this becomes necessary, it helps to overcome.

Sasha Mashin: In my case it was friends who convinced me that I needed to talk to a doctor. I started treatment. It is believed that after the start of medication, somewhere in two weeks it becomes easier. I literally felt better within a week. Three weeks later I was already playing concerts. Although it seemed that everything was over in this life. I fully recovered in six months. In total, it took a year. I had clinical depression when I could not eat, wash, get out of bed. Interestingly, after the treatment, my assimilation of new information increased many times over and my working capacity increased many times over. There are people who are in a sluggish depressive state and think that their life just somehow does not add up and their mood is not very good. This is also a type of depression. There are many types of depression.

Yana Mandrykina: My friend helped me, she gave me the phone number of her doctor, who diagnosed and prescribed the right treatment. Moreover, he diagnosed not only by conversation, but conducted clinical studies. After all, treatment is not only properly selected drugs, but also a regimen, nutrition, lifestyle.

Vera Kornakova: The first time I did not ask for help, it was scary to go to a psychiatrist.


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