The diagnosis at the bottom of my bill said, dysthymia.. My psychiatrist had told me that he was going to send that diagnosis to the insurance company. "What is it?" I asked.
It was many, many years ago. I was in my 30s and re-starting therapy after moving across the country. My mood was not good. I felt inadequate to the task of finding work. I felt that people didn't like me. I felt that I wasn't going to succeed in life. All of this ran somewhat counter to the fact that I'd had a very good job for some years, that I'd risen to the top of my particular field at that company, and that I was married with two beautiful young daughters.
So what was going on?
Dysthymia, said my psychiatrist.
Dysthymia is one kind of depression, a mild kind, but a chronic one - which means your depression will come back, go away, come back, go away again.
Dysthymia means that you're not mired in the terrible depths of what's often called "clinical depression," a serious mood disorder that robs you of energy, self-love, and the will to move ahead with life - and even can rob you of the will to live itself.
While it doesn't do all of that, dysthymia can make even the most cheerful people - at times - feel unworthy, uninterested in love or life or eating, in other words, plain miserable.
So, that's the bad news. People with mild depression, like myself, often can't believe that they deserve the next job or pay raise. They often can't find it in themselves to praise their children or make love to their spouse. They get irritable or outright angry and are surprised when they're told that it's not justified. Well, you know some of those symptoms.
But dysthymic people can often feel like life isn't worth living, either. They have what's called suicidal ideation; a wish to end it all, and maybe even an idea as to how they'd go about it. This doesn't mean that I've actually ever contemplated suicide. It does mean that I've been in enough of the dumps to wish I could contemplate suicide.
Just as for people with serious depression, it's best for people with dysthymia to seek help; not to say, "Oh, well, this will pass." Or to think, "I'm a bad person for feeling this way, so I won't do anything about it; I'm too ashamed." Or, "I deserve what's happening to me: I did a bad job on that last piece of work." Or, "I knew I wasn't lovable."
Psychotherapeutic counseling or medication can help dysthymic people as much - sometimes more - than people with deep and long-lasting clinical depression.
So, when it comes to depression: a little can hurt.
C.L.
