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Persistent depressive disorder (PDD) is characterized by at least two years of ongoing depression that does not respond to multiple treatment attempts, including medication and psychotherapy, or an extended period of time with no significant improvement in mood or functioning. Patients with PDD may struggle with symptoms of chronic sadness, guilt, or hopelessness; they may have difficulty getting out of bed or maintaining an interest in activities they used to enjoy. As many as 30% of patients who experience one major depressive episode will go on to develop persistent depression.

The adaptive diary method is a popular research method in psychology and medicine. A week before the study, participants write down daily events in a private notebook. Then they are randomly assigned to either an experimental group (those who receive treatment) or a control group (those who don’t). Experimental group members receive treatment based on the information they’ve gathered, while control group members do not.

The adaptive diary method is designed to help researchers create accurate case studies. The method helps participants accurately track their daily lives, making it possible to identify exactly what caused a change in symptoms or behavior. It is commonly used in clinical psychology and psychiatry to study anxiety disorders, depression, PTSD, and many other mental illnesses.

Focus your thoughts on what you can control

After a certain point, you can’t control what happens to you, but you can control how you react. While persistent depression may not be something you have full control over, there are still things that you can do to manage it—and try to regain some of that self-control.

For example, if your chronic sadness/ persistent depression is a valid response to modern life and work pressures, then maybe changing your lifestyle is more important than changing your treatment plan. This might mean switching jobs or careers (if possible), reducing work hours or finding new hobbies and activities outside of work. But this advice is almost useless. Most of us work and live the way we do because we have no other options. Financially, socially, community-wise or elsewhere.

Recent studies that have used patient-reported outcome measures (PRO) suggest that people with treatment resistant depression "tend to report greater levels of sadness and less social activity than those with non-resistant depression".

"Experts don’t fully understand" why patients with treatment resistant depression (severe persistent depression) are reporting worse QoL (Quality of Life). This is an egregious understatement. They have NO EARTHLY IDEA WHY YOU'RE DEPRESSED AND ZERO TO NO INTENTION TO IMPROVE THAT SITUATION.

Some doctors would say something along the time of "It’s possible that patients are simply struggling more and thus perceiving their QoL as lower". Smdh. Yes, that's absolutely correct because perception is 100% of everything that means anything to anybody.

(Re-read that last line, brah, I'm super proud of it; mostly because it is the honest truth.)😊

Isn't it amazing what technology can do?

It can show you "invisible" things without anyone even breaking a sweat. So why when I go to the doctors or the ER for a serious medical issue, do I always get denied the use of this mystery removing machinery?

It could save lives! Or at least help people feel better about themselves and their illness. It's a good thing we live in a free country where any citizen can do whatever they want with their money...right?

Wrong!

There are many types of brain scans that have been proven to be effective in treating depression. The most common is called functional magnetic resonance imaging (fMRI). In an fMRI scan, you lie on your back inside a large cylinder-shaped machine while wearing earplugs to block out noise and headphones to listen to music or white noise (which blocks out extraneous sounds). You'll also wear goggles that make everything look dark so you don't get distracted by light while doing your task.

As I said before, these types of scans can reveal invisible things without anyone even breaking a sweat. For example, let's say you're feeling down about yourself because no one has noticed how hard you've been working lately... but there's really nothing wrong with you other than a chemical imbalance in your brain.

Some of you may be surprised to learn that gaslighting is often perpetrated by loved ones in an attempt to help—no matter how misguided. If your doctor dismisses your persistent depression or offers only a treatment plan that doesn’t work, understand you aren’t alone. You need to fight back and insist on acceptance and commitment therapy, otherwise known as ACT.

If you want to stop gaslighting and get your treatment plan in gear, opt for ACT.

ACT helps you combat persistent depression and increase both acceptance of situations you can’t change as well as your willingness to commit to positive behaviors that will lead to a happier life. Acceptance is key to overcoming depression because it helps you deal with reality rather than turning away from it with distractions or substances.

Acceptance and commitment therapy is a psychological intervention that helps people who struggle with persistent depression accept things they can’t change, increase their level of commitment to goals and behaviors that will lead to a more positive outlook on life, and resolve feelings of helplessness.

In order to succeed with ACT, you must first understand what acceptance really means. 

In the case of melancholia that doesn't get better with medication, therapy or self-awareness, it may be time to offer yourself the palliative care your clinical team refuses to discuss: How do I deal with this SADNESS IF IT REALLY IS FOREVER?

You can always feel free to send us an email if you need a confidant or and advocate. Just don't forget, you're not alone , you just need an advocate.

Some mood music to have you leaving this blog to go off and live your life in a GOOD mood (hopefully) and not a rude dude(ette), but it doesn't rhyme. Sad Face.

Peace, fam. Stay Strong.