# Dysthymia I’m five years older than my parents were when they had me, and by the measure of parenthood, I feel like I am falling behind. Five years ago, I was living in a house I shared with two-to-four strangers, depending on who had significant others over and when. I was so deep into depression I was finally about to start looking into treatment options. Depression is hard. It makes it hard to realize you have depression, and then it makes it hard to seek help for depression, and then it makes it hard to work on managing the symptoms of depression. I thought that I had depression for almost five years, at least from the time I started treatment, and it may still be the DSM-accurate way to describe my condition, but my therapist introduced me to another diagnosis that I feel fits better. It’s called *dysthymia*.  ## What the Hell is Dysthymia? The term is from Ancient Greek δυσθυμία, meaning “bad state of mind,” and it was replaced by “persistent depressive disorder” in the DSM-5[^1]. It’s a state of chronic depression that lasts for at least two years. Although it is less severe than major depressive disorder, people with dysthymia can experience “double depression,” when they have a depressive episode as well. > Dysthymia characteristics include an extended period of depressed mood combined with at least two other symptoms which may include insomnia or hypersomnia, fatigue or low energy, eating changes (more or less), low self-esteem, or feelings of hopelessness. Poor concentration or difficulty making decisions are treated as another possible symptom. Mild degrees of dysthymia may result in people withdrawing from stress and avoiding opportunities for failure. In more severe cases of dysthymia, people may even withdraw from daily activities. They will usually find little pleasure in usual activities and pastimes.[^2] Diagnosis includes evaluating the presence of two or more of these symptoms on a majority of days for two years or more: 1. Decreased or increased appetite 2. Decreased or increased sleep 3. Fatigue or low energy 4. Reduced self-esteem 5. Decreased concentration or problems making decisions 6. Feelings of hopelessness or pessimism Fortunately, treatment for dysthymia works similarly to treatment for depression, so I was taking the right medications and implementing the right coping strategies, but it took me a while to get all of the gears turning at the same time. I would say it took me until about June or July of 2018 to really start to get it under control. My work environment was exacerbating my condition by adding stress, disrupting any regularity to my sleep cycle, and disrupting my ability to create and sustain lasting social relationships. I remember feeling irritable all of the time and just waiting to see what would incur my wrath next. I don’t feel that way anymore. Dysthymia can go undiagnosed and undetected even by people who have it because it’s subtle and long-term. Most people with dysthymia, myself included, feel that it is just an aspect of their personality, that they’re just a moody person. I don’t want to discount all of the varieties of personal characteristics people can identify with, but if you feel this way too, I encourage you to talk to a mental health professional about getting an evaluation. Through the combination of medication, solutions-based therapy, and regular exercise, I have reached a place where I don’t feel so burdened by my mental illness as I once did, and I feel––for the first time––like I’m capable of doing something meaningful with my life. If you’d like to learn more about dysthymia and other forms of depressive disorders, you can read all about them at the [National Institute of Mental Health](https://www.nimh.nih.gov/health/topics/depression/index.shtml/index.shtml "National Institute of Mental Health––Depression") [^1]: [https://psychcentral.com/disorders/dysthymic-disorder-symptoms/](https://psychcentral.com/disorders/dysthymic-disorder-symptoms/) [^2]: [https://en.wikipedia.org/wiki/Dysthymia](https://en.wikipedia.org/wiki/Dysthymia) *Published as "Dysthymia" on [[W! IanLHayes Weblog Workbench 20230905|www.ianlhayes.com]], [[2017-08-06]]*