Wednesday, October 24, 2012

Dysthymia or Dysthymic Disorder

So far we’ve talked about Depression and Major Depressive Disorder. So today I want to talk about Dysthymia.

Yanno how sometimes it feels like everything has a veil of gloom permanently settled on top of it? It can be sunny outside, but inside it’s always dim. You can’t remember what it’s like to get excited or happy about anything?  Everything, no matter what it is, has the exact same impact… practically none. Nothing really seems dire, but nothing really seems important either. It’s a constant slow trudging through the muck and drone of daily life. Then one day you realize that those “sometimes” have actually turned into years.

Dysthymia is a chronic type of depression in which a person's moods are regularly low. However, symptoms are not as severe as with major depression. It presents as having a low or depressed moods for most days, for more days than not, and for at least 2 years. For it to be Dysthymic Disorder, no Major Depressive Episodes should have been present during the first two years and there should not have been any Manic Episodes ( Bipolar), a Mixed Episode, or a Hypomanic Episode. In short, Dysthymic Disorder is characterized by an uncomplicated, long-term, low-grade depression for two or more years.[1] And like all disorders, it has to cause a significant distress or impairment in social, occupational, educational or other important areas of function. Significant and lasting, not just occasional.

That doesn’t mean there can’t be contributing factors or periods of MDD though. Many people with dysthymia have a long-term medical problem or another mental health disorder, such as anxiety, alcohol abuse, or drug addiction. About half of people with dysthymia will also have an episode of major depression at some point in their lives.

In fact, they call this Double-depression. Double-depression occurs when a person experiences a major depressive episode on top of the already-existing condition of dysthymia.

"It is difficult to treat as people accept these major depressive symptoms to be a natural part of their personality or as a part of their life that is outside of their control. Because people with dysthymia may accept these worsening symptoms as inevitable, it can delay treatment. If treatment is sought out, it is commonly treatment-resistant due to the fact that the major depressive symptoms are addressed, but often not the dysthymic symptoms."[8]

So far the exact causes of dysthymia are unknown though it does tend to run in families. It also occurs more often in women than in men and affects up to 5% of the general population.[2]

Unlike most disorders I’ve talked about that say you need to have something for at least a certain amount of time, with Dysthymic Disorder you shouldn’t have gone without experiencing two or more symptoms for 2 months.

Typical symptoms include:
·         Poor appetite or overeating
·         Insomnia or hypersomnia, meaning, too little or too much sleep.
·         Low energy or fatigue
·         Low self-esteem
·         Poor concentration or difficulty making decisions
·         Feelings of hopelessness

Not much different than any of the other types of depression. It’s strictly a matter of degree. On a scale of 1 to 10. With 1 being happy/content and 10 being the darkest grip of gothic suicide… here you’re living at a pretty consistent 3 to 5 where everything is just kind of crappy all the time. It especially translates to self-image and how a person views themselves, which is tyipically negative and discouraging. Since this is chronic…. Very, very persistent, a person will have actually lived with this for years, making it almost impossible to view the future as anything different than what the past has already been. The future is as bleak and hopeless as the past has proven to be.

Finding that hope, where there just hasn’t been any, seems like an impossible feat. And because it also doesn’t present with that urgent direness that Major Depressive Disorder does it can often go overlooked, or be passed off as not as big of an issue.

In my country we like to judge things, and say something isn’t as bad because someone, somewhere is suffering with worse. This is an awful perception, b/c you, as an individual, or not someone else, somewhere else. Your circumstances are your own. When it comes right down to it, you are the center of your world, and your perspective is all you have to view the world with. You can’t view it through someone else. So while your circumstances may not be the same as what anyone else is going through, that doesn’t mean that what you’re going through isn’t important, and isn’t worth taking care of.

It may not be life threatening, but it is life diminishing. No one wants, or deserves, to live a diminished life, so you owe it to yourself to do what you can to live the fullest life you can.

I wonder if this is where I’m heading towards now. Or more of a dysthymic-like depression instead of the type of depression I’m used to dealing with. Too soon to tell, and I’m not actually sure this is how mental health progression works, but at least I feel like I’m changing in a better direction. I honestly don’t feel the crushing depression that I used to. I do attribute this to a combination of my medication and the major changes I’ve made in my life. I’ve worked really hard to kick out the negative and disruptive influences in my life, and I can honestly say I’ve been more at peace with myself and my life than I’ve ever been.

But. There’s always a but isn’t there? I still don’t feel “happy”. I still feel baseline kind of low.

Maybe it’s dysthymia (but probably not since I had major depressive episodes during my first 2 years suffering with depression, and I have occasional hypomania). Maybe I’ve just had a shitty life so it’s a natural response. Maybe it’s just that my life is in a transitional phase. I still have things to work on. Less than I did before, but life doesn’t stop, and hopefully growth and personal evolution won’t either. I’m not at an end point, so maybe I’m just not there yet, but still getting there. That’s the most frustrating thing… the not knowing. The amorphous blob of potential that is the future.  Because it can be potentially bad, or potentially good. It’s important to gain self-awareness so we can gain more control over ourselves. When we have greater control over ourselves, we have more control over where our future can go as well. 


  1. Maybe you can try hypnotherapy. It's effective treatment for all types of disorders.
    Depression Gold Coast and brisbane

  2. "Maybe I’ve just had a shitty life so it’s a natural response."

    I am far from being an expert in these things, but it seems to me that until clinical depression is reliably quantifiable in biological terms, it's likely to be over-diagnosed. A lot of people are simply lonely and their lives suck. They don't necessarily have a chemical or hormonal imbalance, they're just having a rational response to sad circumstances. But so many doctors see these symptoms and hand out pills, when what many of these people need are friends, if they could get them.

  3. I think out of all of the depresions this is the worst. I am glad you shed light on the differences of each disorder. I have a friend that is in this cycle of dystyemia very tough to watch. The key is finding he right diagnosis. Out of all the disorders out there these are the ones that go misdiagnosed so often.


Leave me a comment! It makes me feel good and less paranoid about talking to myself =)

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