Persistent Depressive Disorder (PDD) is largely a cognitive condition, a way of perceiving and thinking about events in your life in a negative way. If you think negative thoughts, especially about yourself, you are going to feel pretty rotten – you are going to avoid challenges and become more likely to get depressed. Imagine going through the day repeatedly telling yourself, “I’m incompetent; I’m going to fail; I can’t do anything worthwhile; I’m a disappointment to others; I’m such a klutz everyone feels sorry for me.” How do you think you will feel at the end of the day? Satisfied or kind of “down”?
If you feel you might suffer from depression but tend to write it off as just having some problems dealing with life, you could be one of the “silent sufferers” afflicted with PDD. You go to work or school, you care for your loved ones, and generally function in the normal range of activities. But you have this gnawing feeling that most people seem to enjoy life more than you do. You seem to have more than your share of pessimism, guilt, lack of interest, appetite fluctuations, low self-esteem, chronic fatigue, social withdrawal, and concentration difficulties. Whatever your particular profile, you have a chronic discontent with yourself, and your negative thinking has become a way of life.
Please note, the symptoms in PDD are subtle and moderate compared to disorders like Bipolar and Major Depression where symptoms are much more severe and dramatic. For instance, suicide attempts, psychiatric hospitalization, and the need for anti-depressant medication are much more common with major depression and bipolar disorder. The material on PDD in this entry is not intended for cases of Bipolar or Major Disorder, which require professional intervention, medication, and possibly hospitalization.
With PDD, it is important to remember that effective coping requires honest self-discovery and awareness of your strengths and weaknesses. Unfortunately, if you don’t work at translating your traits, even your weaknesses, into productive actions, you will have no anchor to reality. This process is crucial to confronting the moderate levels of depression found in PDD: If you cannot “translate yourself” into concrete positive actions, you will feel you have nowhere to go, and likely to remain depressed.
Ask yourself some important questions: Am I truly depressed or simply unhappy? Are my problems related to anger or anxiety that make me look and feel depressed? You’re a human being. That means you experience unhappiness, anxiety, anger, and other emotions brought about by current life circumstances. When that happens, do not simply tell yourself, “I’m depressed.” Instead, identify the conditions that prompt your emotional state. With that in mind, here are some concrete steps to take:
Become more vigilant about your health, and take a more active and assertive role toward life in general.Remember that there is no medication that will help you develop an action plan to navigate the challenges of life and develop more satisfying and productive actions.
If you are feeling “down” more often than usual, monitor your daily behavior to look for avoidance actions you may be taking to reduce stress in life.
Exercise, diet, frequent medical check-ups, an optimistic attitude – these are just a sample of things you can do to try and take some control of your life and walk through each day with some confidence, assertiveness, enjoyment, and satisfaction. These actions tend to inoculate you against feeling “depressed” about your current circumstances.
Identify those actions that bring you satisfaction and for which you are grateful. List situations in which you can express those actions and put yourself in those situations as much as possible. Also, seek out situations that relax you.
At the end of the day write down your activities and how they made you feel. Use that information to your advantage tomorrow.
Continue your normal exercise routines during the winter.
Get involved in charity projects. Volunteer at a homeless shelter during the coldest time of the year. Hit the road, get out there in the world, and be with people. Remember, you are not defined by your thoughts and feelings; and you are not likely to get out of depression or any other emotional dilemma simply thinking or feeling your way out. As we say often, you must develop a coping plan of action.
Barry was moping about one Saturday evening, thinking what a loser he is. Suddenly, he reminded himself of something: “Earlier today during my volunteer stint at the hospital, I took that patient in a wheelchair to the MRI center. She was so nervous and all worked up, just dreading it. I told her, ‘It’s OK to feel anxious. I would, too. But I guarantee you, you’re in good hands with the MRI folks. They know how you feel and are very supportive and reassuring. You’ll be nervous but they’ll help you get through it.’ And when I was leaving her, she said, ‘Thanks for helping me relax a bit. What you said really helped.’” Barry thought further: “Get off your pity kick, Barry. What you did there shows you’re no loser.”
Need a coping strategy? Remember: Your actions speak louder than your thoughts.