Is It Pandemic Fatigue or Persistent Depressive Disorder?

After a year in quarantine, does this sound familiar? Numbness, overeating or a loss of appetite; insomnia or excessive sleep; low energy or fatigue; poor concentration or indecisiveness; low self-esteem and hopelessness. You’re not alone.

Over 40% of Coloradoans report symptoms of anxiety or major depressive disorder, according to the Kaiser Family Foundation. While many in our community will recover as new hope arrives with vaccines, many more will continue to suffer from Dysthymia or what’s known as “Persistent Depressive Disorder” long after our community reaches herd immunity.

The American Psychiatric Association defines Dysthymia as a consistently depressed mood for at least two years, along with at least two of the symptoms mentioned above. Even before the pandemic, studies have shown that about 6% of the population of the US experienced an episode of Dysthymia at some point in their lives. Because it can last for years, the impact the condition can have on relationships, employment, education and other daily activities, can be even more severe than clinical depression.

Most patients with Dysthymia are undertreated because their symptoms are not as acute as those associated with clinical depression, such as suicidal ideation or not being able to get out of bed. Harmony Wright, a psychiatric nurse practitioner a shares her observations about Dysthymia patients, “Many people who have Dysthymia believe this is just who they are and how life is, especially because the pandemic provides such a ready explanation. Often times, the stigma of mental health care can prevent people from seeking help.”

Untreated Dysthymia, however can be devastating. At least 3/4s of patients with Dysthymia also have a chronic physical illness or another psychiatric disorder such as anxiety, drug addiction, or alcoholism. For many people, Dysthymia will feel as though they’re still in the middle of the pandemic for years after the world recovers from COVID-19.

There is hope. Recovery usually starts with an evaluation at a mental health clinic or with another clinical provider. Some people choose a pharmacological route to treatment but there are non-drug options such as psychotherapy, acupuncture, diet and exercise and transcranial magnetic stimulation (TMS) to help patients recover with fewer side effects. For many patients who choose newer, evidence-based tools like Ketamine and Spravato, anti-depressive medications are no longer necessary after a short course of treatment, meaning that a lifetime of psychiatric medications is not necessarily the outcome of seeking mental healthcare.

No one is immune from the pandemic, or the mental health crisis that looms. But there is hope and as a community, destigmatizing mental health treatment will help all of us recover and regain normalcy. Chris Perez, clinical director of Alleviant Healthcare Centers of Denver and a Denver resident stated, “Looking normal and feeling normal are two separate things. We need to acknowledge that for many of our friends and family, the post-traumatic stress of the pandemic is real and they may be needlessly suffering. Encouraging our loved ones to seek the help they need with empathy and compassion helps not only them, but all of us to return to true normalcy.”