I have a beautiful friend from childhood who was always a little melancholy, sarcastic and pessimistic, but didn't really want to feel like that. She just didn't know how to change how she was feeling. She just thought that was who she was. Many people liked her but could only handle her for certain amounts of time. She brought them down.

So what's her problem?
Dysthymia has been defined as a disorder with similar but longer-lasting and milder symptoms than clinical depression. This disorder lasts for at least two years, but is less disabling than major depression; for example, people do not have what has been termed as a "nervous breakdown" where they need to be in a hospital. People with dysthymia can function normally such as going to work, getting married, raising children etc.

While dysthymia is not as common as general clinical depression, it does occur more in women than in men (what else is new:), and seems to be in greater numbers among the poor and single people. Personality problems, medical problems and ongoing life stress may also play a role.

What are the signs or symptoms? (*DSM-IV)

• persistent feelings of sadness
  
• feeling hopeless or helpless
  
• having low self-esteem
  
• feeling inadequate
  
• excessive guilt
  
• feelings of wanting to die
  
• loss of interest in usual activities
  
• difficulty with relationships
  
• sleep disturbances (i.e., insomnia, hypersomnia)
  
• changes in appetite or weight
  
• decreased energy
  
• difficulty concentrating
  
• a decrease in the ability to make decisions
  
• suicidal thoughts or attempts
  
• hypersensitivity to failure or rejection
  
• irritability, hostility, aggression
  
• frequent physical complaints (i.e., headache, stomach ache, fatigue)

How serious is this?
It's serious enough that you should seek some sort of intervention. Dysthymia can really suck the energy out of someone and cause them to abuse drugs and alcohol or feel suicidal as well. You should be vigilant in seeking treatment.

This sounds like me, what are my options?
Well, dysthymia is difficult to treat because it is difficult to diagnose. Most people won't even seek medical intervention until it ends up growing into a bout of major clinical depression. Others see their primary physicians who often misdiagnose it or only know enough to prescribe antidepressants and advise them to see a therapist. Which most people never do.

There are several treatment approaches to dysthymia which may include one or more of:

1. Talk therapy a.k.a. psychotherapy.
2. Behavioral therapy
3. Anti-depressants

There is no right or wrong solution to treatment. Try things until you find what works has always been my motto. There are no medical doctors, psychiatrists, psychotherapists etc. who can prescribe the perfect treatment plan. Especially when science is still researching the root of all forms of depression in people.

So what's my action plan?
1. Visit your physician to rule out any physical problems.
2. Tell him/her about your symptoms and ask what they know about dysthymia
3. Ask them for a referral to a mental health professional in your area
4. Go see the professional, and if there is no chemistry - ask your doctor or the
local hospital for another referral. Keep trying. Good chemistry with your therapist
can do wonders when you're in therapy.


*Alternative Treatments

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Lisa Angelettie, "GirlShrink" is an online advice authority. Her site GirlShrink.com is the #1 "Advice & Counseling" site on the web. Instantly get a FREE Bonus when you sign up for her free Better Choices Ezine. Please visit us for more discussion on this topic in the depression forum to talk about it further. Don't forget to subscribe to our newsletter for topics in the news, new articles, website & book reviews, and other useful mental health resources. Subscribe below.