**I notice that we - including myself - spend a lot of time on this site talking about depression and medication, depression and psychotherapy, depression and support groups.
That may be because most of you write in about major depression, and for major (clinical) depression, medication and psychotherapy are very important.
But there is a whole group of people - in the millions - who have dysthymia, which is defined on this site as:
a chronic form of depression characterized by moods that are consistently low, but not as extreme as in other types of depression.
Alternative Names: Neurotic depression; Dysthymic disorder; Chronic depression; Depression - chronic
I have dysthymia, and have had it for 50 years. And, yes, I've been on medications and in psychotherapy for many years. And they both help.
But there are times when I am aware that the depression comes on suddenly, without warning, and is due to a specific cause. Sometimes it comes on as irritation or anger; sometimes it comes on as anxiety. It used to be that I thought this was one of those things I had to discuss with my therapist, or that my medication wasn't working properly.
Now, however, since my therapist has retired, and my meds have been working very nicely, thank you, for ten years, I look for the proximal cause of that anxiety or anger.
The other day, for instance, I went to my physician to have her look at a large lump under my skin on my wrist. She sent me to a specialist in arm and hand surgery. He sent me for an M.R.I.
"Just to be sure," he said. I knew what he meant. As someone who has a history of cancer, I was more likely to have a malignant lump than a benign one.
When I returned last week, he said the M.R.I. wasn't clear enough; perhaps the lump was benign, perhaps not. It should be operated on.
My anger was instantaneous, along with anxiety and a terrible heaviness in my chest. I knew what that was about: it was my psyche's practiced drop into depression whenever something is not to my liking or when I'm forced to do something I'd rather not do, or when the future is frightening. My anger, by the way, was at the doctor, my wife, the nurse - everyone
Is it normal to be frightened about possible cancer? Of course. But the anger and depression are not everyone's reaction to such things. Some people are more sanguine. Most people don't get angry because a doctor is looking out for them or when a partner says it's best to get the operation done quickly, so we can go on with our lives.
By recognizing that my anger and depression were a result of a particular life event, and not something that was permanent or required psychotherapy, I was able to talk myself out of most of the anger and depression and anxiety, and get on with what I had to do.
So, next week, I'll have the operation, and we'll see what happens.
By the way, for those of you for whom anxiety does not go away with this kind of talking-to-oneself, HealthCentral's anxiety site (Anxiety.com) can be very helpful. . .Check it out.**