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Re: Dysthymia Book

Posted by John on June 5, 1999, at 14:34:53

In reply to dysthymia, melancholia, posted by Elizabeth on June 5, 1999, at 13:28:24

> I've been reading a book, _Dysthymia and the Spectrum of Chronic Depressions_, that I wholeheartedly recommend. It goes into all the different forms that chronic depression can take - sometimes it manifests as life-long low energy and disinterest, other times as chronic rejection-sensitivity and irritability. Dysthymics usually don't show the prominent "vegetative" (somatic) symptoms that you see in major depression, though I think that chronic sleep problems are probably common.
> Usually there's at least some degree of mood reactivity (ability to be cheered up when good things happen) in chronic depression, whereas total anhedonia is the main defining feature of melancholia. FWIW, the other symptoms and associated features of melancholic depression (besides the general features of major depression that we all know and love :-P) are: waking up early in the morning ("terminal" insomnia - a rather scary-sounding name!), loss of appetite,
> guilt (culture-bound?) or self-reproach, feeling worst first thing in the morning, and psychomotor changes (appearing slowed-down or agitated). It responds well to tricyclics and ECT, possibly not as well to SSRIs (although I wonder if high-dose SSRIs have been tested).
Dysthymia and the Spectrum of Chronic Depression is indeed an interesting book, though I find I have to re-read parts to understand and abosrb. I don't think I fit any particular diagnosis, which is pretty much what the book says anyway, that they are kind of mixed and ever-changing states. I've been to that hellhole of deep suicidal psychotic depression, and maybe 4 days a year actually feel wonderful, perhaps too wonderful, but most often am just totally anhedonic without many other depressive symptoms. I would pay a million $$$ to have joy/interest/pleasure. Others take those feelings for granted. Anyway, according to the book, a mood stabilzer seems warranted, perhaps one of the newer ones that are claimed to have marked antidepressent properties, and I'm still leaning toward MAOI. I live 4 hours from Canada and may go there to get some Moclobemide. We'll see. Would be nice to have a good doc, like the ones I read about here, to lead me on this journey, but they don't exist around here. I'm kinda on my own, and maybe off to Canada for a day. Any doc I see is fairly perplexed and perfectly willing to write a prescrip for whatever I want. Gotta take care of myself I guess. Hey, I rambling. Nice to hear from you. I'll look for your postings which are always interesting. John.




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