Cyclical Depression and Barriers to Treatment

For many, depression feels like a constant sadness, gnawing away at fleeting moments of happiness in life, an ever-present melancholy always there in the background. Depression, however, doesn’t necessarily present in such a predictable way in every person. For some, depression manifests in cycles. The waves of sadness come and go on repeat, sometimes in noticeable patterns, other times in random bursts. For those with cyclical depression, diagnosis and treatment may be more difficult.

Cyclical depression is more common in those who have PTSD or chronic illness but is not limited to these populations. There are three main types of cyclical depression, including cyclothymia, dysthymia, and seasonal affective disorder.

How can cyclical depression limit treatment options or make it tougher
to seek treatment?

When depression appears suddenly and vanishes days or weeks later, the condition may be tough to diagnose. In some cases, cyclical depression may not even be recognized as depression. When feelings of depression subside, those affected may believe they are cured and won’t bother to seek treatment.

Treatment can also be difficult if there’s a lack of understanding on the part of mental health practitioners. The illness doesn’t manifest in a predictable manner, so it’s more difficult for mental health professionals to check off the boxes and make a quick diagnosis. Diagnosis of cyclical depression may require more time than diagnosing someone with traditional depression.

Cyclical depression can also be misdiagnosed as bipolar disorder or any number of other mental illnesses because it presents differently than depression and is not as common.

If depression is not constant, traditional treatment options may not feel right or work correctly. In some cases, medications may worsen the issue and have detrimental side effects.
Because of its ebb and flow, there’s also a perception that this form of depression is less severe than traditional depression. While feelings of sadness and despair are often milder in persons with cyclical depression compared to classic depression, it does not make the illness any less debilitating or less deserving of treatment.

When depression is constant, it can be easier to notice symptoms in oneself. Others around you may also be more apt to pay attention to changes in behavior. If depression comes and goes, however, it becomes difficult to self-diagnose because of fluctuating feelings and symptoms.

People may then be less inclined to seek help.

It’s essential to recognize that there exist two distinct types of depression and that these mental illnesses do not present identically in different people. Increased awareness is critical in providing people with the tools to recognize depression in themselves and empower them to seek treatment when necessary. It’s also vital for practitioners to recognize that forms of cyclical depression may require more time and patience in terms of treatment.

Written by: Steph Coelho

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