Depression that never goes away

Persistent depressive disorder - Symptoms and causes


Persistent depressive disorder is a continuous, long-term form of depression. You may feel sad and empty, lose interest in daily activities and have trouble getting things done. You may also have low self-esteem, feel like a failure and feel hopeless. These feelings last for years and may interfere with your relationships, school, work and daily activities.

If you have persistent depressive disorder, you may find it hard to be upbeat even on happy occasions. You may be described as having a gloomy personality, constantly complaining or not able to have fun. Persistent depressive disorder is not as severe as major depression, but your current depressed mood may be mild, moderate or severe.

Because persistent depressive disorder is long term, coping with depression symptoms can be challenging. A combination of talk therapy and medicine can be effective in treating this condition.

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Persistent depressive disorder symptoms usually come and go over a period of years. The intensity of symptoms can change over time. But symptoms usually don't disappear for more than two months at a time. Also, major depression episodes may occur before or during persistent depressive disorder.

Symptoms of persistent depressive disorder can cause major problems in your life and may include:

  • Sadness, emptiness or feeling down.
  • Loss of interest in daily activities.
  • Tiredness and lack of energy.
  • Low self-esteem, self-criticism or feeling you're not capable.
  • Trouble focusing clearly and trouble making decisions.
  • Problems getting things done well and on time.
  • Quickly becoming annoyed, impatient or angry.
  • Avoidance of social activities.
  • Feelings of guilt and worries over the past.
  • Poor appetite or overeating.
  • Sleep problems.
  • Hopelessness.

In children, symptoms of persistent depressive disorder may include depressed mood and being irritable, which means easily becoming annoyed, impatient or angry.

When to see a doctor

If these feelings have been going on for a long time, you may think they'll always be part of your life. But if you have any symptoms of persistent depressive disorder, seek medical help.

Talk to your health care provider about your symptoms or seek help from a mental health professional. Or you can reach out to someone else who may be able to help guide you to treatment. This could be a friend or loved one, a teacher, a faith leader, or another person you trust.

If you think you may hurt yourself or attempt suicide, call 911 in the U.S. or your local emergency number immediately. Or contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential. The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 888-628-9454 (toll-free).

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The exact cause of persistent depressive disorder is not known. As with major depression, it may involve more than one cause, such as:

  • Biological differences. People with persistent depressive disorder may have physical changes in their brains. It's not clear how these changes affect the disorder, but they may eventually help determine the causes.
  • Brain chemistry. Neurotransmitters are naturally occurring brain chemicals. Research indicates that changes in neurotransmitters may play a large part in depression and its treatment.
  • Inherited traits. Persistent depressive disorder appears to be more common in people whose blood relatives also have the condition. Researchers are trying to find genes that may be involved in causing depression.
  • Life events. As with major depression, traumatic events such as the loss of a loved one, financial problems or a high level of stress can trigger persistent depressive disorder in some people.

Risk factors

Persistent depressive disorder often begins early — in childhood, the teen years or young adult life — and continues for a long time. Certain factors appear to increase the risk of developing persistent depressive disorder, including:

  • Having a first-degree blood relative, such as a parent or sibling, with major depressive disorder or other depressive disorders.
  • Traumatic or stressful life events, such as the loss of a loved one or major financial problems.
  • Personality traits that include negativity, such as low self-esteem, being too dependent or self-critical, or always thinking the worst will happen.
  • History of other mental health disorders, such as a personality disorder.


Conditions that may be linked with persistent depressive disorder include:

  • Lower quality of life.
  • Major depression, anxiety disorders and other mood disorders.
  • Substance misuse.
  • Relationship difficulties and family conflicts.
  • School or work problems and trouble getting things done.
  • Continuing pain and general medical illnesses.
  • Suicidal thoughts or behavior.
  • Personality disorders or other mental health disorders.


There's no sure way to prevent persistent depressive disorder. Because it often starts in childhood or during the teenage years, identifying children at risk of the condition may help them get early treatment.

Strategies that may help reduce or prevent symptoms include the following:

  • Take steps to control stress, to increase your ability to recover from problems — which is called resilience — and to boost your self-esteem.
  • Reach out to family and friends, especially in times of crisis, to help you get through rough spells.
  • Get treatment at the earliest sign of a problem to help prevent symptoms from worsening.
  • Consider getting long-term treatment to help prevent a relapse of symptoms.

By Mayo Clinic Staff


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    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.

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"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. nine0018

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 9 within a year0005

Stereotypes about depression

"Depression doesn't 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. nine0005

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!"

Skip the Podcast and continue reading.


What was that?

We quickly, simply and clearly explain what happened, why it's important and what's next.


The End of the Story Podcast

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. nine0005

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. nine0005

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 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 cool, 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 have depression, I would advise either to help or to move away altogether. nine0005

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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? nine0005

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 do. 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. nine0005

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 years0005

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

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. nine0005

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. nine0005

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. nine0005

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. nine0005

Yana Mandrykina: You drive, 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. nine0005

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. nine0005

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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. nine0005

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. nine0005

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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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 need 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 also had it, 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." nine0005

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: I heard the statement that any fool can take a pill, I 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. nine0005

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. nine0005

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. nine0005

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. nine0005

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? nine0005

Yana Mandrykina: There were a lot of 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. nine0005

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. nine0005

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How did you 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. nine0005

Kirill Cheremisov: After I confessed 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. nine0005

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 didn't ask for help, it was scary to go to a psychiatrist. Because there is an attitude that going to the doctor will affect your life, it will be written down somewhere, it will not let you get a good job. In general, it will be a stigma for life. The second time she applied at the peak, because she could no longer cope on her own, and went to the hospital. nine0005

And what's next?

Yana Mandrykina: Like all people, now I feel joy and sadness, but I feel it! And this is a great happiness, because depression is the absence of any emotions at all.

Sasha Mashin: Great happiness to do what you love. I am even glad that such an episode happened in my life, because I began to look at everything differently. Appreciate life much more. And now I have an insatiable thirst to live, to play drums, to become better. nine0005

Beware of depression! Should I tell my boss about my illness?

The difference between a depressed person and a healthy person is very simple: in the case of depression, it is almost impossible to enjoy life, be active and experience positive emotions. This mental disorder brings bad mood, fatigue, mental retardation and lack of desire to do anything. It is extremely difficult to work in such a state. Recognizing depression and explaining your condition to others is even more difficult. We share with you the stories of people who have gone through this. nine0005

A neurologist diagnosed me with an anxiety disorder a year ago. By autumn, it seemed that the anxiety had gone into remission - I was calm. But on New Year's Eve there was a short and very stressful project. The working chat in Telegram was bursting with messages. They came constantly - both at 3 am and at 8 am. I dreamed that this chat would just stay in 2020 and never appear again. Then I took sedatives because it was impossible to sleep, but I did not think that I was depressed.

The January holidays passed calmly and routinely. After returning to work, everything started spinning again - and the stress returned.

In the spring, I found out that I had health problems that required an operation. The blues and melancholy continued, but now I thought that the reason was in the diagnosis. In addition, the first priority was urgent medical matters - preparation for the operation. It seemed that as soon as everything ended well, I would become a happy person.

Before the hospitalization, I decided to ask for a week's vacation in order to take all the tests and have some rest. Colleagues picked up communication with clients. But as the guys kept writing and asking questions, I kept doing a lot of work. Now I understand that I overdid it. Colleagues could manage on their own. nine0005

After the sick leave, when I went to work, it turned out that I had a new client in addition to the existing ones - a colleague quit for family reasons, and her project was transferred to me. In the office, this girl was condemned for dropping her business and leaving. She was not understood. It also made me angry at the time. As a human being, I sympathized with her, but I got her projects in poor condition, and this made me angry.

The first week, when I was waiting for the results of the operation and was in touch with the doctors, I was constantly shaking. I thought about taking a break and telling my superiors about my condition. I consulted with one of my colleagues. He replied: “You can only say that it’s hard for you if you are ready to say goodbye to this job.” At the same time, he himself had problems, because of which he was depressed, but also did not say anything to his superiors and did not take a break. nine0005

Depression interferes with work. Any work task causes panic. The body gives out a constant physical reaction - trembling or heat, tension presses on the temples. Super inefficient. Realistically do only something very simple or work with familiar projects. It is difficult to take on large clients, conduct large deals and launches.

There are flashes. Suddenly you become very efficient, like performing well or doing a lot of tasks on your way up. In this state, it is dangerous, for example, to subscribe to KPIs with clients - the view of things is not entirely realistic, and then the depressive mood returns anyway. nine0005

It becomes hard not only to work, but also to hang out. There is stiffness, and alcohol does not help to relax. Probably 70% of jokes are impossible to understand and you just have to smile when everyone laughs. The feeling that all the good that is in me, in my head, is hidden under a layer of darkness and it is impossible to break through it.

I often compare myself with other people who are also in a difficult situation and cope with it. It seems that it is not possible to export only from me alone. It seems that I am afraid to face not only external stigma, I blame myself internally for what is happening. nine0005

Now I have changed my psychotherapist, I am taking antidepressants and waiting for the result. At work, I never said that I had a depressive-anxiety disorder.

* The heroine's name has been changed

My depression has lasted 16 years in total. Exacerbations happen quite often and take several months. I worked in the office for about 6 years. I did not tell the employer, I was shy. The official hospital with a diagnosis of "depression" did not ask the doctors and just drank the medicine. Therefore, when exacerbations occurred, she often lied that she was poisoned or something else happened. Or came home from work, overeat, drank wine and slept until the morning. Then it was necessary to suffer for 8 hours at work and you can sleep again. But, in general, this is a so-so strategy. Because of this, she left the office for project work and freelance work. nine0005

Freelancing is easier: in remission, I try to earn a financial cushion and do not take long-term projects. If all of a sudden I am running a long-term project and an aggravation begins, I finish everything on moral and strong-willed efforts and do not start anything new. It was difficult to accept that my resource is limited and sometimes I can’t work at all, but only stare at the wall. There are signs by which I already understand when the battery is running out and it is necessary to complete current obligations and look for something that will give a resource. Or, if there is no strength for this, the doctor corrects the therapy - and I'm waiting for improvement lying down. nine0005

The employer, with whom I constantly do projects, knows about my depression — I honestly told him everything when it came to transferring me to a permanent salary instead of project work. He does not always understand, but he accepts and for some reason still works with me. Although he himself adheres to the position "in the army it becomes easier for everyone." I keep stubbornly refusing the constant so as not to let him down and drive myself into a corner with guilt.

In terms of money, of course, it comes out less and not so stable. But my life is dearer to me, and in general, for 5 years now I have been able to balance and twist. nine0005

When the depression started, I was 18 and in college. Then there were more episodes. One happened when I was working in a publishing house. Due to the fact that we had a friendly team, I was able to transfer most of the processes, push everything away from me to just lie down. But even then I had to work, just less. It was terrible anyway. Each action - such as opening the mail - already required tremendous efforts, it seemed unbearable, and even writing a letter ... I told the authorities about depression in general terms, it didn’t particularly bother anyone and didn’t affect the attitude towards me. nine0005

Depression was difficult, I had to overcome myself. Managed with the support of family and friends. I tried to relax, put off work, contact people.

To minimize the risk of depression, I try to listen to the slightest bells, and it is even better not to bring them to my attention. I try to make my life varied and fulfilling. Quite simple things help: food, sleep, walks, people, books, sports.

If you don't have the strength for it, you have to lie down. It's so hard to work, I can't do much in this state and therefore I try not to take projects. As soon as strength appears, I try to invest it in something useful - try to cook something balanced (vegetables, cereals) or walk, go out, maybe even swim in the pool - in general, do something that will fill me up later and let it last for a while. I try to do something simple - wash my face or wipe the table - and be sure to praise myself for it. It is important not to devalue your condition. nine0005

I took antidepressants for a long time, but I have already stopped taking them. I'm lucky that I can somehow manage without them, but for many without the support of pills, it's completely impossible, and this is also normal.

I have been diagnosed with a depressive disorder. At that time I was already in psychotherapy, and my therapist referred me to a doctor who prescribed antidepressants.

At work I didn't say anything, didn't consider it necessary. Actually, the work saved me: I had to go to it, and then one question appeared, another - you look, and already got involved. It was rather scary to go home, where I was alone and everything could worsen. Here, probably, the key point is that I like what I do, and my company is very humane. Elsewhere, the situation could only get worse. nine0005

In a state of depression, sometimes it took a lot of strength to get together to do something. Especially new and incomprehensible. The illness lasted for about a year. I took medication and continued to go to therapy. I hope that this material will help other people, I think this is an important topic.

In world practice, more and more people openly talk about depression and adjust their professional plans because of this disease. For example, Japanese tennis player Naomi Osaka recently refused to participate in Roland Garros, and the youngest British MP, Nadia Wittom, went on vacation due to post-traumatic stress disorder and tweeted about it. nine0005

In Russia, the disease is still surrounded by stigma and guilt. Usually it is not customary to talk about it at work, where the employee is expected to effectively fulfill contractual obligations. The problem is that an employee with depression needs the help and support that the company can provide, and ignoring the problem affects not only the person's personal life, but often also business performance.

“There is no definitive answer as to whether or not to tell management that you are clinically depressed. It all depends on the culture of the company and how it relates to human health, says Marina Lvova, Director of Organizational Development HeadHunter .

Marina Lvova, Director of Organizational Development HeadHunter

If the company culture allows you to explain what is happening to you, and you trust your manager, you definitely need to talk about it and get support. Perhaps the company has access to psychologists or the HR department knows where to turn.

If you work in an organization with a fairly rigid structure and understand that you will be pressured after such a recognition or that you may lose your job, I would recommend not to speak, but to think about why you are in such an environment at all. nine0005

In any case, first of all, you need to take care of your health, because depression requires treatment. Only a doctor can diagnose it. If you are at the stage where you can combine treatment and work, keep working. If it’s hard for you and you can’t get out of bed, take sick leave or write an application for leave without pay - in this case, your condition is primary.

If you decide to take a breather, it is important to know that an official sick leave with a diagnosis of depression can only be issued by a neuropsychiatric dispensary or a psychiatric hospital. In other cases, sick leave may be issued for another reason. nine0002 In the fall of 2020, the State Duma proposed giving paid days off with a doctor's report on depression. The initiative is based on data from the Organization for Economic Co-operation and Development, according to which the productivity of an employee who is in a state of depression is reduced by four times. Whether this proposal will be accepted is not yet known, but it is a good step to help employees of companies experiencing this problem.

Being depressed and being forced to continue working is, of course, difficult. This is confirmed by the stories of our heroes. If you find yourself in this situation, the most important thing is to take care of yourself as much as you can now. nine0005

Talks about how you can support yourself Maria Shumikhina, psychologist, executive coach, member of the board of the International Association for the Psychoanalysis of Business and Organizations :

Maria Shumikhina, psychologist

“If you find symptoms of depression in yourself, try to seek professional help as soon as possible. Of course, you will be told stories about how depression was cured by meditation and douches, but it’s not a fact that you have enough time to try all the random recommendations. Unfortunately, very often depression, which is not treated, ends with a loss of working capacity. nine0005

Once diagnosed, it is important to understand that depression is a long marathon and how you take care of yourself and your ability to keep running will determine your destiny. You are the author of the most important part in the recovery process. A psychiatrist selects medicines, and your part of the job is not only to drink them, but also to be aware of the process of change, learn to listen to yourself.

Psychotherapy will help process traumatic experiences and teach sensitivity to one's condition. Often people, especially those most prone to burnout, lack self-compassion, and without self-support, we can rarely handle high overload. nine0005

In the process of psychotherapy, among other things, we learn not to succumb to the cognitive distortions that we find ourselves in during depression. They are quite easy to identify if you understand this mechanism: depression makes a person think in a certain way, gives him a specific view of reality.

This “voice of depression” says:

  1. “You are the problem” (guilt and shame come to the fore during depression).
  2. "Everything makes no sense, there is no solution, everything is already useless." nine0044

In a healthy person, such experiences are balanced by a more complete picture of the world and oneself. If the drugs are chosen effectively, these cognitive distortions disappear, “tunnel thinking” goes away, and the ability to look for new solutions appears.

If you need to look for new solutions in your work, healing will allow you to keep this skill. But, if depression is not treated, you can lose the ability to make any decisions.

The state of depression is a period when the body's resources are depleted, and this determines life strategies. Time to invest wisely everything you have: energy and physical strength, money and social connections. The restoration of the body is no less important than the restoration of the psyche. In some countries, recovery through regular physical activity is a prerequisite for receiving insurance-based psychotherapy. A good doctor will also give advice on improving sleep and nutrition. There is, for example, a high correlation between depression, neuroinflammation processes and an increased amount of carbohydrates in the diet. The microbiome (yes, the one that lives in the gut and prefers greens) is on your side in the fight against depression. nine0005

Process optimization is required to be able to remain operational. It's hard to do it alone when you're depressed. Is it possible to discuss at work how tasks will be temporarily redistributed? If yes, this will help you a lot. And a supportive atmosphere at work provides much more loyalty to all employees than forced sick leave or dismissal because it was not possible to redistribute tasks.

If you suspect depression and are unsure whether to see a doctor, the first step may be to complete a questionnaire.

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