Is dysthymia curable? What does that look like?
June 5, 2013 4:13 PM Subscribe
Please describe the experience of going from "usually slightly depressed" to "usually reasonably happy".
My baseline mental state seems to be somewhere between "meh" and "blah". I don't have major depression, just persistent low-level dissatisfaction/dysthymia/anhedonia. There are lots of days when my mood is basically fine, but still if you asked me whether life is worth living I would have trouble finding any reason to answer yes. This has been the case since I was a teenager (about 20 years now), so I think of it as part of my basic personality and find it hard to imagine that it could change. I don't want advice. What I want is to hear (preferably) first-person accounts from people who have made this change: both what you did that was effective and, as importantly, what the process felt like subjectively.
My baseline mental state seems to be somewhere between "meh" and "blah". I don't have major depression, just persistent low-level dissatisfaction/dysthymia/anhedonia. There are lots of days when my mood is basically fine, but still if you asked me whether life is worth living I would have trouble finding any reason to answer yes. This has been the case since I was a teenager (about 20 years now), so I think of it as part of my basic personality and find it hard to imagine that it could change. I don't want advice. What I want is to hear (preferably) first-person accounts from people who have made this change: both what you did that was effective and, as importantly, what the process felt like subjectively.
I am in my 30s and did this, although it was going from "unpredictable mood swings between 'anxious' and 'depressed'" to "usually happy and of level mood" sans qualifiers on either part.
Therapy, medication, exercise and a proper diet (with vitamin supplements) was what did it. No one here can tell you if you need medication, but if you don't make the other three a serious priority, a priority as important as "going to work," you won't feel better.
Now regarding therapy: it is the easiest thing in the world to go to therapy, talk about your mother, go home ignoring everything the therapist said and then complain about how its not working, and write it off as an effective means of self-improvement. If you follow AskMe you'll see it a lot: "oh I tried therapy, it didn't work, hence therapy does not work for me." If you believe that, you believe nonsense.
It is really fucking hard to work through effective therapy that forces you to examine parts of you that you'd rather not, an to change behaviors you feel are natural. It is the psychic equivalent of going to the gym and busting your ass on the free weights, rather than going to the gym and pedaling on a bike for a half hour (and complaining you're not getting any fitter.) It is grueling but if you find the right mode of therapy, and get a therapist with whom you can actually speak honestly, it works and it works wonders. But nothing about it will be quick, easy or painless.
But when it works, you will get into the habit of making better choices about your life than you do at the moment. Better choices about how to react to stressors. Better choices about what to do with yourself. Better choices about how you feel about yourself and treat yourself. It's as virtuous a circle as depression is vicious.
posted by A god with hooves, a god with horns at 4:29 PM on June 5, 2013 [12 favorites]
Therapy, medication, exercise and a proper diet (with vitamin supplements) was what did it. No one here can tell you if you need medication, but if you don't make the other three a serious priority, a priority as important as "going to work," you won't feel better.
Now regarding therapy: it is the easiest thing in the world to go to therapy, talk about your mother, go home ignoring everything the therapist said and then complain about how its not working, and write it off as an effective means of self-improvement. If you follow AskMe you'll see it a lot: "oh I tried therapy, it didn't work, hence therapy does not work for me." If you believe that, you believe nonsense.
It is really fucking hard to work through effective therapy that forces you to examine parts of you that you'd rather not, an to change behaviors you feel are natural. It is the psychic equivalent of going to the gym and busting your ass on the free weights, rather than going to the gym and pedaling on a bike for a half hour (and complaining you're not getting any fitter.) It is grueling but if you find the right mode of therapy, and get a therapist with whom you can actually speak honestly, it works and it works wonders. But nothing about it will be quick, easy or painless.
But when it works, you will get into the habit of making better choices about your life than you do at the moment. Better choices about how to react to stressors. Better choices about what to do with yourself. Better choices about how you feel about yourself and treat yourself. It's as virtuous a circle as depression is vicious.
posted by A god with hooves, a god with horns at 4:29 PM on June 5, 2013 [12 favorites]
My husband did this by switching from a 45-minute car commute to a 1-hour bike commute. The exercise and the additional natural light exposure pretty much did the trick. Probably wouldn't work for everyone, but it worked for him.
posted by KathrynT at 4:42 PM on June 5, 2013
posted by KathrynT at 4:42 PM on June 5, 2013
I had dysthymia and it turned into major depression. The two things that have helped me the most are
1) A psyCHCIATRIST (not psychologist) who could give me the RIGHT prescription, and
2) a hom-made sun lamp that I have on my office desk. PM me if you want details. I made mine for $60.
posted by SarahBellum at 6:05 PM on June 5, 2013
1) A psyCHCIATRIST (not psychologist) who could give me the RIGHT prescription, and
2) a hom-made sun lamp that I have on my office desk. PM me if you want details. I made mine for $60.
posted by SarahBellum at 6:05 PM on June 5, 2013
I technically carry the diagnosis of dysthymia. I've probably been that way since I was a teen, but a period of feeling like I was stuck in a particularly ill-suited job brought me to the 'I need professional help' state of situational capital-D depression. We're talking 2008 or 2009 since a proper diagnosis.
Step 1:Recognizing it. Going to my doctor for an ear infection and they recognized it and sent me to a talk therapist.
Step 2: Talk therapy.
Step 3: Making a major life decision that led to
Step 4: Quitting my ill-suited job.
Step 5: Continue going to therapy. Still do.
Step 6: Situational depression = SSRI. I think I'll probably go off it in 9-12 months, depending on what my life does in that time. If I can't, I accept it. But my talk therapist and I both think I won't need to be on it forever, just as some stuff settles down.
I agree with this comment in part because therapy, doing right, is totally hard. In fact, last week, I ended up physically sinking into my seat and saying "I am feeling exhausted from talking about this issue." That's how I knew it was a big issue and something I needed to do something about. But now..I actually did the thing suggested to do. Would I have done that 4 years ago? Hell no.
So here's what it feels like: It's not as intimidating to get things done, or even work on them. You notice things like 'hey, that person looks happy' and 'it's a nice day' and HOLY SHIT YOU ARE SMILING JUST BECAUSE IT IS NICE OUT. And it doesn't feel stupid or fake.
It's hard for me to say more than that, because I made a major life change that I can't really separate from the changes that came about from working on it with a therapist and now with some mild meds. Among those include: I sleep better now. New people don't intimidate me just by their very newness. I don't mind trying new things that I might suck at at first.
Has my personality changed? Well, I think if we are necessarily the same person we are as a teenager, that's not necessarily the best. Some of us have a lot of emotional and psychological growing to do that is changable. One of the hardest things to change is people who have known you a long time expect you to be, say, Weighted Crankypants Cube, and you're just not anymore. That can be sometimes a challenge, but I actually called some people on it and it's not a problem anymore.
Do I still like sarcastic British comedies and my hobbies and my friends? Absolutely. I don't think my personality's changed, but I do think I'm less of an asshole/sinkhole to be around, and that's worth something in our culture.
posted by Weighted Companion Cube at 6:28 PM on June 5, 2013 [4 favorites]
Step 1:
Step 2: Talk therapy.
Step 3: Making a major life decision that led to
Step 4: Quitting my ill-suited job.
Step 5: Continue going to therapy. Still do.
Step 6: Situational depression = SSRI. I think I'll probably go off it in 9-12 months, depending on what my life does in that time. If I can't, I accept it. But my talk therapist and I both think I won't need to be on it forever, just as some stuff settles down.
I agree with this comment in part because therapy, doing right, is totally hard. In fact, last week, I ended up physically sinking into my seat and saying "I am feeling exhausted from talking about this issue." That's how I knew it was a big issue and something I needed to do something about. But now..I actually did the thing suggested to do. Would I have done that 4 years ago? Hell no.
So here's what it feels like: It's not as intimidating to get things done, or even work on them. You notice things like 'hey, that person looks happy' and 'it's a nice day' and HOLY SHIT YOU ARE SMILING JUST BECAUSE IT IS NICE OUT. And it doesn't feel stupid or fake.
It's hard for me to say more than that, because I made a major life change that I can't really separate from the changes that came about from working on it with a therapist and now with some mild meds. Among those include: I sleep better now. New people don't intimidate me just by their very newness. I don't mind trying new things that I might suck at at first.
Has my personality changed? Well, I think if we are necessarily the same person we are as a teenager, that's not necessarily the best. Some of us have a lot of emotional and psychological growing to do that is changable. One of the hardest things to change is people who have known you a long time expect you to be, say, Weighted Crankypants Cube, and you're just not anymore. That can be sometimes a challenge, but I actually called some people on it and it's not a problem anymore.
Do I still like sarcastic British comedies and my hobbies and my friends? Absolutely. I don't think my personality's changed, but I do think I'm less of an asshole/sinkhole to be around, and that's worth something in our culture.
posted by Weighted Companion Cube at 6:28 PM on June 5, 2013 [4 favorites]
Yes I have this (the actual diagnosis too), but I feel better now. I'm 44. I used to be so damn crabby. Now people make fun of me for being too cheerful (except in the morning). I still get a bit of road rage occasionally, but more often I just sit back and let people go ahead if it's so important to them. Wouldn't that be sad, if one of the things that was so important to you was getting ahead of one car in a line of traffic going ten miles an hour? I used to do little else but watch tv and play video games because I felt tired and sad most of the time.
In any case, two things helped the most. I had my thyroid issue taken care of, and I take 5 mg. of Citalopram (Celexa). I'm on Synthroid because I no longer have a functioning thyroid, but it has essentially no side effects. But I can't stop taking it. I have actually stopped taking the Celexa for a year or more in the past, but found I feel better on it.
I wasn't particularly happy with either decision, to be honest. I read horror stories from people who'd had the thyroid radiation treatment and I really didn't want to do it, but I gave other medication a chance for several years and it didn't work. I even worried, because I am a crazy dork, about what I would do if an apocalypse happened and I couldn't get the fake thyroid medication. (I do still worry a teeny bit.)
And I'd rather not be on Celexa, either. I don't really relish the idea of changing my brain chemistry essentially permanently. But I'm lucky because it's a very low dose that works. It also helps me sleep, though I'm still a light sleeper. I used to have a lot of trouble getting to sleep.
I procrastinate less now (though I'm still a poor housekeeper). I've been working on my art for more than two years straight and I mean, 5-7 days per week, in addition to my regular job. And it's a really big source of satisfaction. I think people need that, a source of personal satisfaction. And I don't mean because I'm a great artist - long way to go for that - but because I decided to do something and I am following through with it and experiencing progress. I'm sure some people can get their personal satisfaction from children, but I don't have children. I also found a fine, fine fellow, and that doesn't hurt!
So I say yes, of course it's possible. It may start slowly, and it may take a while. But you'll probably need a doctor, at least to start.
posted by Glinn at 7:24 PM on June 5, 2013 [2 favorites]
In any case, two things helped the most. I had my thyroid issue taken care of, and I take 5 mg. of Citalopram (Celexa). I'm on Synthroid because I no longer have a functioning thyroid, but it has essentially no side effects. But I can't stop taking it. I have actually stopped taking the Celexa for a year or more in the past, but found I feel better on it.
I wasn't particularly happy with either decision, to be honest. I read horror stories from people who'd had the thyroid radiation treatment and I really didn't want to do it, but I gave other medication a chance for several years and it didn't work. I even worried, because I am a crazy dork, about what I would do if an apocalypse happened and I couldn't get the fake thyroid medication. (I do still worry a teeny bit.)
And I'd rather not be on Celexa, either. I don't really relish the idea of changing my brain chemistry essentially permanently. But I'm lucky because it's a very low dose that works. It also helps me sleep, though I'm still a light sleeper. I used to have a lot of trouble getting to sleep.
I procrastinate less now (though I'm still a poor housekeeper). I've been working on my art for more than two years straight and I mean, 5-7 days per week, in addition to my regular job. And it's a really big source of satisfaction. I think people need that, a source of personal satisfaction. And I don't mean because I'm a great artist - long way to go for that - but because I decided to do something and I am following through with it and experiencing progress. I'm sure some people can get their personal satisfaction from children, but I don't have children. I also found a fine, fine fellow, and that doesn't hurt!
So I say yes, of course it's possible. It may start slowly, and it may take a while. But you'll probably need a doctor, at least to start.
posted by Glinn at 7:24 PM on June 5, 2013 [2 favorites]
I've dealt with the blahs for my entire life and have tried various combos of things, but one thing really surprised me:
A couple years ago I started eating sardines everyday because I otherwise am pretty much vegetarian(not for any particular reason, I just don't eat much meat) but I had so much brain fog all the time, which I had just chalked up to being normal me, that after some experimentation I realized my diet wasn't working for me even though I'm kind of a health nut. I think I was deficient in some combination of omega 3s/vitamin D/vitamin B12 - sardines are a good source of all 3. So I was trying anything and everything that might alleviate it and I'm really amazed at how I pretty much don't have the brain fog now and my moods overall have improved...it took several months for me to notice any effects though.
I think eating the actual fish is what helped...I have taken bucketfuls of omega capsules, cod liver oil, all of that stuff, and never noticed anything like this.
posted by fromageball at 8:09 PM on June 5, 2013
A couple years ago I started eating sardines everyday because I otherwise am pretty much vegetarian(not for any particular reason, I just don't eat much meat) but I had so much brain fog all the time, which I had just chalked up to being normal me, that after some experimentation I realized my diet wasn't working for me even though I'm kind of a health nut. I think I was deficient in some combination of omega 3s/vitamin D/vitamin B12 - sardines are a good source of all 3. So I was trying anything and everything that might alleviate it and I'm really amazed at how I pretty much don't have the brain fog now and my moods overall have improved...it took several months for me to notice any effects though.
I think eating the actual fish is what helped...I have taken bucketfuls of omega capsules, cod liver oil, all of that stuff, and never noticed anything like this.
posted by fromageball at 8:09 PM on June 5, 2013
Just a quick brainstorm of things I do now which seem to help:
-exercise almost every day, even if it is just for a walk
-smile and laugh and surround myself with media that I find bright and happy
-found a therapist which worked for me
-surrounded myself with happier people
-started doing things I wanted even before I felt like I was ready for it emotionally
-got busy and started meeting more people
-changed my attitude a bit, was ok with messing up, and looked at social interactions as 'dress rehearsals' where I can practise ACTing happy
posted by dinosaurprincess at 12:04 AM on June 6, 2013
-exercise almost every day, even if it is just for a walk
-smile and laugh and surround myself with media that I find bright and happy
-found a therapist which worked for me
-surrounded myself with happier people
-started doing things I wanted even before I felt like I was ready for it emotionally
-got busy and started meeting more people
-changed my attitude a bit, was ok with messing up, and looked at social interactions as 'dress rehearsals' where I can practise ACTing happy
posted by dinosaurprincess at 12:04 AM on June 6, 2013
I was able to reverse 20 years of this with a dedicated yoga and meditation practice.
posted by corn_bread at 5:42 AM on June 6, 2013
posted by corn_bread at 5:42 AM on June 6, 2013
Oh yes! I forgot to mention Vitamin D like a few other have said. Definitely get that checked. Mine was really low and I needed (and still need) a prescription. Some of the symptoms of Vitamin D deficiency can include muscle weakness and depression.
posted by Glinn at 7:23 AM on June 6, 2013
posted by Glinn at 7:23 AM on June 6, 2013
Well, you can certainly improve. I think I'm reasonably happy most of the time. Things I do now that I didn't used to:
Go for a walk almost every day.
Take fish oil every day.
Do yoga often (we try for ~4 times a week)
Read/reread Seligman's books on optimism (basically DIY CBT), for about 15 min before bed. Sometimes I switch out with other introspective/self help type books.
Reading Seligman's Learned Optimism might have made the most difference. I had some pretty gloomy self talk, especially catastrophizing over any negative event. I still have that tendency, but I check it much better than I used to.
posted by mattu at 5:31 PM on June 6, 2013
Go for a walk almost every day.
Take fish oil every day.
Do yoga often (we try for ~4 times a week)
Read/reread Seligman's books on optimism (basically DIY CBT), for about 15 min before bed. Sometimes I switch out with other introspective/self help type books.
Reading Seligman's Learned Optimism might have made the most difference. I had some pretty gloomy self talk, especially catastrophizing over any negative event. I still have that tendency, but I check it much better than I used to.
posted by mattu at 5:31 PM on June 6, 2013
This thread is closed to new comments.
It sounds weird, but I find myself looking up more often-- at the tops of buildings and trees, noticing nice weather. I never used to think -- much less comment to other people! -- "Man, it is a great day for a walk!" I made such a comment twice this week. (This is my first Spring on the meds.)
I have the same personality. I still have kind of an acerbic streak with other people (though I generally more enjoy being around people I don't know as well now). I'm just... happy more. Not "fine" but actually happy. I'm not happy all the time, just... more. It's hard to put into words, because it's subtle, especially on this drug. And it takes a while to work, so I didn't notice it kicking in (other than the appetite suppression side effect).
I wish I had done it earlier, since I've been like this for 15+ years before getting on meds.
posted by supercres at 4:27 PM on June 5, 2013 [6 favorites]