When Depression Lingers |
"I don't remember ever not being depressed," says Harold, a 52-year-old video editor who lives in downtown Toronto. "I've just learned to live with it." Harold is a classic case of someone with dysthymia, a disorder with similar but longer-lasting and milder symptoms than clinical depression. As he indicates it is less disabling than major depression; he is able to go on working and doesn't need to be hospitalized. Instead of crashing and burning, those with dysthymic disorder are worn down day in and day out to a point where they just can't seem to enjoy life. "It's like there is always a black cloud following me", says Harold. Dysthymia comes from a Greek word meaning "bad state of mind" or "ill humor". It is essentially a chronically depressed mood that occurs for most of the day for more days than not over a period of at least two years, without long, symptom-free periods. "People often describe themselves as too serious and not enjoying life," says Dr. Jean-Claude Bisserbe, a psychiatrist and Clinical Director of the Royal Ottawa Hospital's Mood Disorder Program. "Low self esteem is also very common." Symptoms of dysthymic disorder include:
Many people with dysthymia have had it for so long that they can't say when exactly it began and, because they may have periods of normal mood, often family members and friends may be unaware their loved one is depressed. (People with dysthymia may also suffer occasional bouts of major depression.). Dysthymia can begin in childhood or in adulthood. It is more common than one might think with studies reporting that between 3% and 6% of adults will experience dysthymia during their lifetime, although many won't even know it. "Most of these patients are not diagnosed thus not treated or treated with inappropriate treatment," says Dr. Bisserbe. No one knows for sure what causes dysthymia. It may be related to some changes in the brain that involve serotonin, a chemical that helps you handle emotions and make judgments. Personality problems, medical problems and ongoing life stress may also play a role. If you think you might have dysthymia, talk to your doctor. He or she will ask you questions about your health and any symptoms you might be experiencing. It is possible that your symptoms may be related to a problem with your thyroid or certain medicine you may be taking. Your doctor will want to rule this out before deciding if you actually have a mood disorder. If you do have dysthymia, treatment is readily available. Because of the chronic nature of dysthymia, your doctor may prescribe an antidepressant. However, don't expect an overnight change in your mood. It may take weeks, or even several months, before you notice an improvement. If you do begin to feel better, continue to take the antidepressant until your doctor tells you to stop. In spite of a high recovery rate, the risk of relapse is significant. Your doctor might also refer you to a psychotherapist who can help you deal with your feelings and develop better coping skills. It might also help to:
Additional Resources: Mental Health Information (Royal Ottawa Health Care Group) |