Summary

The web content discusses the connection between chronic depression and codependency, emphasizing the prevalence of persistent depressive disorder (PDD) among codependents and the potential for it to go undiagnosed for years.

Abstract

Chronic depression, often linked to codependency, is characterized by a long-term, low-grade depression known as persistent depressive disorder (PDD) or dysthymia. This condition may not severely impair daily functioning but can significantly diminish the quality of life, making it feel empty and joyless. Symptoms, which must persist for at least two years (one year for children and teens), include low energy, sleep disturbances, and changes in appetite, among others. People with dysthymia may not seek help until they experience a major loss or life problem that intensifies their symptoms, potentially leading to a diagnosis of "double depression"—major depression atop dysthymia. The causes of chronic depression are multifaceted, involving biological, genetic, and environmental factors, and it is more common in women and those with a history of divorce or chronic illness. The article highlights that codependents, who often struggle with self-esteem and validation issues, may not realize that their depression stems from internalized feelings of inadequacy and childhood emotional neglect. Treatment options include psychotherapy, antidepressant medication, and participation in support groups or Twelve-Step Programs, with a focus on healing the root cause and changing shame-based beliefs.

Opinions

The article suggests that many codependents are unaware they are depressed due to the subtle nature of chronic depression symptoms.
It is implied that individuals may mistakenly attribute their depressive symptoms to personality traits rather than recognizing them as manifestations of an illness.
The article posits that codependency and depression can be traced back to adverse childhood experiences, as supported by the Ace Study.
There is an emphasis on the effectiveness of cognitive therapy in treating depression by addressing negative thinking patterns.
The author advocates for a comprehensive treatment approach that includes lifestyle changes, such as exercise and healthy sleep habits, to complement psychotherapy and medication.
The article promotes the idea that healing from codependency and depression involves developing better coping skills, increasing self-esteem, and restructuring dysfunctional thinking and relationship patterns.

You Might Not Know You’re Depressed. Discover the Link Between Depression and Codependency

Chronic depression is a common symptom of codependency; however, many codependents are unaware that they’re depressed. Because the symptoms are not severe, most people with chronic depression wait ten years before seeking treatment. They may even start in adolescence. Teens might act irritable, moody, or pessimistic over an extended period. They may also have behavior problems, perform poorly academically, and difficulty in social situations. Symptoms may be periodic, and the severity may fluctuate.

Persistent depressive disorder (PDD) also referred to as dysthymia doesn’t usually impair daily functioning, but it can make life feel empty and joyless. Sufferers have a diminished capacity to experience pleasure and may withdraw from stressful or challenging activities. Their emotions are dulled, though they may feel sad or melancholy or be irritable and anger easily.

Unlike with major depression, they’re not incapacitated, yet they may have difficulty trying new things, socializing, and advancing in their career. Some may believe that their lack of drive and negative mood is part of their personality, rather than that they have an illness. Like codependency, dysthymia causes changes in thinking, feelings, behavior, and physical well-being.

Symptoms

Dysthymia was renamed “persistent depressive disorder” in the 2013 edition of the Diagnostic Statistical Manual V. (I use the terms “dysthymia,” “persistent depressive disorder,” and “chronic depression” interchangeably.) Symptoms must have persisted for at least two years (one year for children and teens) and include at least two of the following:

• Low energy or fatigue • Sleep disturbances • Increased or decreased appetite • Irritable or angered easily (for children and teens) • Low self-esteem • Difficulty concentrating or making decisions • Feeling hopeless or pessimistic

The symptoms must create significant distress or impairment in social, occupational, educational or other important areas of functioning. Although mood remains persistently “down,” it may improve for several weeks of feeling better. Untreated, depression soon returns for longer periods.

When people experience a major loss or a relationship or work problem that triggers more intense symptoms, they’re more motivated to seek help. If their symptoms rise to the level of major depression, which can often occur in people with dysthymia, the diagnosis is “double depression” — major depression on top of dysthymia. Unlike chronic depression, an episode of major depression may only last a few weeks, but it makes a subsequent episode more likely.

Cause of Dysthymia

The cause of chronic depression may be biological, genetic, and/or environmental. This disorder affects approximately 5.4 percent of the U.S. population age 18 and older. The numbers may be much higher, since it often goes undiagnosed and untreated. Over half of dysthymic patients have a chronic illness or another psychological diagnosis, such as anxiety or drug or alcohol addiction. Dysthymia is more common in women (as is major depression) and after divorce. There may not be an identifiable trigger; however, in cases of onset in childhood or adolescence, research suggests that there is a genetic component.

Although stress and life events can be a factor in depression, some people can’t name one that triggered their depression. There are individuals with chronic depression who blame their mood on their relationship or work, not realizing that their outer circumstances are only exacerbating an internal problem.

Depression and Codependency

Some people may believe that they will feel fine when they achieve a goal or when they find a relationship or a loved one returns their love. They’re unaware that the real cause is that they’re striving to find validation or prove themselves to compensate for feeling inadequate. They may have no life of their own, have sacrificed self-care for someone else, or feel unlovable and unworthy of love. They don’t realize that their depression and emptiness stem from their childhood and codependency.

Codependents, by nature of their addiction to people, substances, or compulsive processes, have lost touch with their innate self causing their symptoms. This drains their vitality and over time is a source of depression. Denial, the hallmark of addiction, and guilt can also lead to depression. Codependents deny their feelings and needs. They also deny problems and abuse and try to control things that they can’t, which add to feelings of hopelessness about their life circumstances.

Other codependent symptoms, such as shame, intimacy issues, and lack of assertiveness and autonomy contribute to chronic depression. Internalized shame from abuse or emotional abandonment in childhood causes low self-esteem and can lead to depression. Untreated, the stages of codependency worsen over time, and feelings of hopelessness and despair deepen. (For more about shame and a recovery plan, read Conquering Shame and Codependency: 8 Steps to Freeing the True You.)

Codependency and depression can be caused by growing up in a dysfunctional family that’s marked by abuse, control, conflict, emotional abandonment, divorce, or illness. The Ace Study demonstrated that adverse childhood experiences lead to chronic depression in adulthood. All subjects with a score of five or more were taking anti-depressants fifty years later. Other causes of dysthymia are isolation, stress, and lack of social support.

Treatment

Psychotherapy is the treatment of choice. It is more effective when combined with antidepressant medication. Research shows that women suffer from depression much more than men, and are more likely to seek therapy and get medication. Cognitive therapy has been shown to be effective be eliminating negative thinking to prevent recurrence of depressive symptoms. It may mean healing trauma and PTSD from prior abuse.

In addition, patients need to develop better coping skills, heal the root cause, and change false shame-based beliefs that lead to feelings of inadequacy and unlovability. Goals should be to increase self-esteem and confidence, self-efficacy, assertiveness, and restructuring of dysfunctional thinking and relationship patterns.

Group therapy or support groups, such as Codependents Anonymous or other Twelve-Step Program are effective adjuncts to psychotherapy. Lifestyle changes, such as exercise, maintaining healthy sleep habits, and participating in classes or group activities to overcome isolation are also ameliorative. Take these five evidence-based actions to lift your mood and Raise Your Self-Esteem.