Interpersonal Psychotherapy for Chronic Depression

JOHN C. MARKOWITZ

Acute major depressive disorder is an impairing, painful, and potentially lethal condition. It is a debilitating state, characterized by low mood, low energy, constant selfdoubt, and a sense of oneself as personally defective and inadequate, in addition to sleep and appetite disturbances, anxiety, and guilt. Chronic depression[1] is even worse (Wells et al., 1992). The miseryjust continues: chronicityitself compounds the individual’s problems. The person becomes resigned to feeling terrible, accepting depression as part of who he or she is: part of life, part of personality. Although the DSM definition requires a duration of at least two years for depression to be considered chronic (APA, 2000), it frequently lasts for decades. Individuals may not recall a time when they did not feel depressed. No wonder, then, that individuals with chronic depression come to see depression as part of who they are.

  • [1] As the DSM-V is planning to discard the diagnosis of dysthymic disorder because of itsminimal distinctions from chronic major depression, this chapter will follow that lead andconsider chronic major depression as a single diagnosis.
 
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