Psycho-Babble Medication Thread 4913

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Difference between dysthymia and depression

Posted by Mare on April 15, 1999, at 8:41:59

I am confused about the difference. About 3 years ago I had some counselling (no meds yet) to handle the breakup with a long-time boyfriend. My therapist told me I had dysthymia, but described it to me as a pessimistic way of approaching life, NOT depression. She gave me a little bit of literature, mostly of the Good Housekeeping magazine type, that confirmed what she said. Well, my pessimistic outlook continued, and I blamed myself for not being more of an optimist. I recently returned to a DIFFERENT therapist (thank God). I told her I had been told I was dysthmic in the past. And this therapist diagnosed me as being clinically depressed. This was all within the first 10 minutes of our first appointment. I am now on Celexa, and feeling GREAT. Can sometime tell me, in LAYMEN'S terms, what happened. Was I misdiagnosed? Sounds like it to me! I am still confused about this issue. Thank you!

 

Re: Difference between dysthymia and depression

Posted by Sean on April 15, 1999, at 16:45:00

In reply to Difference between dysthymia and depression, posted by Mare on April 15, 1999, at 8:41:59

> I am confused about the difference. About 3 years ago I had some counselling (no meds yet) to handle the breakup with a long-time boyfriend. My therapist told me I had dysthymia, but described it to me as a pessimistic way of approaching life, NOT depression. She gave me a little bit of literature, mostly of the Good Housekeeping magazine type, that confirmed what she said. Well, my pessimistic outlook continued, and I blamed myself for not being more of an optimist. I recently returned to a DIFFERENT therapist (thank God). I told her I had been told I was dysthmic in the past. And this therapist diagnosed me as being clinically depressed. This was all within the first 10 minutes of our first appointment. I am now on Celexa, and feeling GREAT. Can sometime tell me, in LAYMEN'S terms, what happened. Was I misdiagnosed? Sounds like it to me! I am still confused about this issue. Thank you!

Psychiatry is getting closer to solving the
dysthymia-depression debate. Dr. Hagop Akiskal has
done some really good research into this and he
thinks that dysthymia is its own disease, rather
than just a muted form of major depression or
a personality "trait".

Dysthymia seems to hit people younger than maj.
dep. and is often characterized by "atypical"
symptoms. It also seems to be related to bipolar
disease in terms of physiology. Many people with
dysthymia, when questioned, do seem to have
periods of excessive energy and elation, though
not manic in the classic sense.

Dysthymics also seem to overshoot on their meds,
which also fits more in with the bipolar model.

The main thing I would like to communicate is that
dysthymia is not "your fault" and is not any less
of a diagnosis than major depression. In fact,
given the early onset and chronic course, not to
mention the possibility that dysthymia may be
an early marker for some forms of BPD, it exacts
an enormous toll on a persons life.

Does this help? Never blame yourself; just get
busy recovering and moving forward with your life!
The best part may be yet to come...

Sean.

 

Re: Difference between dysthymia and depression

Posted by Mare on April 16, 1999, at 10:53:41

In reply to Re: Difference between dysthymia and depression, posted by Sean on April 15, 1999, at 16:45:00


Thank you, Sean. Yes, your comments do help. Thanks for taking time to respond to me.

 

Re: Difference between dysthymia and depression

Posted by JohnB. on April 16, 1999, at 23:01:28

In reply to Re: Difference between dysthymia and depression, posted by Mare on April 16, 1999, at 10:53:41

Mare:
My heart goes out to you. Sean summed it up very well and I would only add a few observations from my own experience. Dysthymia seems to describe the kind of depressive disorder that worms it's way into all aspects of your personality after a prolonged (in some cases, years) major depressive episode. In my case, as an adolescent, the initial onset of depression was very gradual, was then complicated by anxiety/phobia/hyperattentiveness, and lasted for years. I was emotionally crippled all day long but was able to hide it from most everybody by becoming, you might say, "emotionally neuter," so as not to fall apart completely. About a decade of this torment finally lead me to see a psychiatrist after a brief hospitalization. Since I let this go on for so long, I feel that this horrible condition is now a permanent part of my personality, though some new research is showing that some dysfunction in the complicated neurochemistry of memory may be causal in many depressions and not just a side effect.

Either way, the depressive monster seems to weave it's way into your head to become a part of your every thought, even though you may not be "aware" of it consciously at every moment. So, it's important to obtain medical treatment immediately for any kind of psychiatric problem. And new treatments are around every corner these days.

My best.
John B.

 

Re: Difference between dysthymia and depression

Posted by Elizabeth on April 17, 1999, at 23:35:19

In reply to Re: Difference between dysthymia and depression, posted by Sean on April 15, 1999, at 16:45:00

Sean, that was very well put. I've been following Dr. Akiskal's work too and expect it to have a great deal of utility (though I remain unconvinced by the "bipolar connection").

Dysthymia has been conceptualized as "depressive personality" (see appendix B of DSM-IV, for example). Given the often pejorative implication of a personality disorder label, I think this probably isn't useful. For now, at any rate, dysthymia is indeed considered a form of "clinical depression."

But anyway, I have a question - how do you tell the difference between double depression (dysthymia with superimposed episodes of major depression) and major depression without full interepisode recovery?

 

Re: Difference between dysthymia and depression

Posted by Sean on April 19, 1999, at 18:11:14

In reply to Re: Difference between dysthymia and depression, posted by Elizabeth on April 17, 1999, at 23:35:19

> Sean, that was very well put. I've been following Dr. Akiskal's work too and expect it to have a great deal of utility (though I remain unconvinced by the "bipolar connection").
>
> Dysthymia has been conceptualized as "depressive personality" (see appendix B of DSM-IV, for example). Given the often pejorative implication of a personality disorder label, I think this probably isn't useful. For now, at any rate, dysthymia is indeed considered a form of "clinical depression."
>
> But anyway, I have a question - how do you tell the difference between double depression (dysthymia with superimposed episodes of major depression) and major depression without full interepisode recovery?


Of all the diagnoses, "double depression" does
seem pretty tough to figure out, but I guess there
is enough clinical consistency among trained
observers to justify the category. My guess is
that there is a qualitative difference in how
dysthymics relate and experience their symptoms.
Maybe that is what Akiskal means by "trait" or
"temperment". He tends to think these are really
important qualities to look out for.

But hey, what do I know!?!

Sean.


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