PSYCH 101: Dysthymic Disorder

I don't like labeling people. My preference is for using labels, or diagnoses (that I'll be discussing in Psych 101), to describe collections of behaviors and/or thinking (and feeling) patterns, and/or ways of relating to people, that interfere with ones pursuit of a happy life. My way of thinking about this helps guide my Cognitive-Behavioral treatment approach. In Psych 101 I won't focus so much on the origins of the bad habits/patterns, though I am very familiar with them. My focus will be explaining the diagnosis, as defined in the Diagnostic and Statistical Manual (DSM-IV-TR), and offer some suggestions about treatment, the way I would do it.



"Dysthymic Disorder [is described as] a chronically depressed mood that occurs for most of the day more days than not for at least two years. In children the mood may be irritable, instead of depressed" for at least a year. I describe it as a mild depression (as opposed to a major depression), and it can influence sleep, appetite, energy level, self-esteem, cause poor concentration, difficulty making decisions, feelings of hopelessness and helplessness, negativity, pessimism, and self-isolation. Sounds pretty bad. It feels bad too.



Treatment can be successful without the use of medication, though I often suggest the use of St. John's Wort (a tea/herb) along with counseling. Recovery from Dysthymic Disorder can be difficult because it requires changing certain thinking, feeling, and behavior patterns at a time that the person is feeling low energy and motivation, feelings of helplessness and pessimism. And, as you know, habits are hard to break. You have to push yourself. Take a small step to start, and be persistent. It helps to have a support system, even though you don't want to be around people. Socialize, exercise, find other activities that distract you from the depressed thoughts and feelings. Learn to balance the negative thinking with positive thoughts and optimism. Often the feelings are triggered by unresolved grief. Explore that possibility, and commit to resolving those feelings of loss (and associated anger, guilt, and sadness) by talking and/or writing about them. The biggest culprit, I think, of triggering the depression is an overload of stress. Examine the sources of stress in your life, and control it better. You know my feeling about this. If happiness is not a part of your life you have got to fix that. If you suffer from Dysthymic Disorder, try some of the things I suggest here (also see my MENTAL NOTES blog of March 4, 2007, "Curing Depression...").