2.5% of the Population Suffers From This Under-Recognized Disorder. Do You?

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Years ago, during a therapy session, I mentioned that I’d been feeling a strain of sadness that wasn’t going away.

Was it depression? Not exactly—I wasn’t sad in the traditional way, i.e., I wasn’t crying all the time. I wasn’t crying at all. What I felt was an un-feeling, not a deadness per se, but a flatness that threatened to overwhelm me with its weight when I went toward it. I was not doing as well as I thought.

I tried to explain the emotionless emotion, describing it as a low-grade monotony, as though the world and I were both wallpapered in a boring sameness, lacking dimensionality.

Imagine a persistently low hum that never oscillates or changes tone. That me.

When I tried pinpointing when it began, I was side-swept by an uncomfortable realization—maybe I’d been like this forever and was only now recognizing that, at my core, I am a perennially sad human person.

In response to all this, my therapist said it sounded like “Dysthymia,” a word I’d never heard of.

She explained that it’s a milder form of depression—it’s also referred to as Persistent Depressive Disorder (I’ll refer to it by both names in this post), but it expresses itself differently than clinical depression. 

Rather, it’s got its own personality and features that are distinct to the condition.

Mainly, it’s long-lasting and stubborn.

Dysthymia is a Greek word that means “bad state of mind.”

And, like depression, it can interfere with your daily life, which certifies it as a clinical disorder. But here’s the kicker: According to the DSM, depression is only diagnosable as a clinical disorder when a person experiences five or more symptoms in the same two-week window, unlike dysthymia, which is diagnosed as a clinical disorder only after suffering for TWO YEARS.

Despite how unfamiliar many people are with the word “dysthymia,” it’s a fairly common complex mood disorder and affects about 2.5% of the population.

And like so many other unpleasant things in this world, it mostly affects women and has a high incidence of comorbidity (meaning that more than one disease or disorder is present).

Symptoms

The main features of dysthymia include lasting sadness, or, as I had tried to describe it to my therapist, a constant state of “emptiness.” People with Persistent Depressive Disorder may have trouble concentrating and decision-making.

They have less energy and often feel fatigued. Similar to chronic depression, there is a sense of hopelessness that can interfere with a person’s hunger, causing them to either under- or overeat.

Sleep can be restless or not come at all.

Sleep can overwhelm a person, and staying awake becomes a challenge.

The dysthymic person suffers from low self-esteem and is irritable, negative, or has pessimistic thoughts.

While the criteria are different, children and adolescents can also suffer from Persistent Depressive Disorder (called Pediatric Persistent Depressive Disorder). 

If they’ve felt this way for a year and are experiencing two or more of these symptoms, they may suffer from dysthymia.

Cause

While the cause of Persistent Depressive Disorder is unknown, some biological and circumstantial factors can contribute to and increase your risk of developing PDD. These include (but are not limited to):

• Issues of imbalances in brain circuitry. Research shows that changes in neurotransmitters and how they interact with the neural circuits involved in maintaining mood stability might be at play

• There may be physical changes in the brain from trauma

• Stressful life events or trauma, such as losing a loved one or financial problems

• a family history of the condition

• a history of other mental health conditions, such as anxiety or bipolar disorder

• chronic physical illness, such as heart disease or diabetes

• drug use

Treatment

The typical treatment for dysthymia includes talk therapy and medication like Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclics, or Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs).

Like most things related to mental health, you might need to try a few different medications and dosages before you experience relief. If you don’t have a therapist right now, try to find one who makes you feel safe and understands this disorder.

You might also want to consider doing Cognitive Behavioral Therapy (CBT), which works to help challenge and change your thinking and behavior patterns.

Naturally, these things cost money, and money, as we know, is hard to come by. So, if you cannot pay for a therapist, look at some of these resources that link to more affordable options.

The combination of medication and therapy can be an especially effective way to combat dysthymia.

A good therapist will help you cope with your emotions, adjust to change and challenges, identify your emotions, thoughts, and behavior patterns that trigger or exacerbate symptoms, help you swap out negative beliefs for more positive ones, and set realistic goals for your mental, physical, and intellectual well-being.

Lifestyle choices could contribute to your sadness, so do an audit of your habits and try to adjust accordingly. Exercise always helps (the people who exercise tell me), but if you’re struggling to get off the couch, start slow; take a one-minute walk and build from there.

Avoid weed, alcohol, and too much coffee for a month, and see if that helps (I don’t make the rules). Look into slow-moving practices like meditation, Qi-Jong, Tai-Chi, or yoga. And, of course, eat your fruit and veggies. Music in the house is also helpful (according to me).

While symptoms must be present for at least two years, treatment is very effective once caught.

The good news: Dysthymia is conquerable. I’m proof that it can go away once it’s addressed. While I still get knocks of sadness, I decline its offer to move in.

We have more control over our feelings and emotions than any disorder wants us to believe.

Have you heard of dysthymia before this? Have you ever suffered from it?

Let me know in the comments!

Until next week, I will remain…

Amanda