Dysthymia / Persistent Depressive Disorder

[Weasel]

Hello. After 30ish years of wondering what the hell was wrong, I was finally diagnosed a few months ago with Dysthymia. A lot of things make a so much more sense now. For the longest time, I thought I wasn't depressed enough to be clinically depressed. I didn't even know that this diagnosis existed.

While now I feel empowered by knowing what has been wrong this whole time, I am becoming more and more frustrated with what seems like an impossible task. The weight of feeling sad, kinda always, for over 3 decades is has accumulated to become incredibly burdensome. While I feel I am better equipped to deal with my depression, it also seems like a ball of snow rolling down the hill, constantly becoming larger and larger and gaining more speed.

I have tried to maintain optimism, and perhaps am even better at this now than ever before, conversely all my problems seem so much larger and intractable than before. In the end, it basically comes out in a wash.

I try to keep telling myself that something's gonna break and it'll go right for me. But now I've been single for almost a decade, living on my own for nearly as long, underemployed for 4 years now, working hardly 5-10 hours a week, been in talk therapy for over 6 years with only moderate success and am now trying my 5th anti-depressant with still no improvement whatsoever. All my friends are married and are having kids and I feel so left behind.



I am profoundly lonely.




While I've more or less figured out how to handle things on a day to day basis, how do others with Dysthymia or persistent depression deal with never ending accumulation of negativity that builds up over the months and years and decades?


Thanks ahead for any and all advice you can give me,
Weasel

[AJ]

Welcome to the forum Weasel. I don't have Dysthymia but I do know what it's like to be in the dark depths of depression. You are doing some positive things to help cope with your dysthymia.

It can take some time to find an antidepressant that you can tolerate and at the same time helpful. If you've been on this one awhile without a good response, I'd consider talking to your doctor about trying a different one, perhaps in a different class. Unfortunately anti depressants aren't always effective. Used in conjunction with counselling or things like CBT can make a difference for some.

It's a tough place to be in. I didn't believe so at the time, but life can get better. Hang in there.

[Weasel]

AJ,

The good news with the medication is that I am now working with a Psychiatrist who I get along with, and I have had no major side effects with anything. The bad news is they seem to be completely ineffective. I believe we have tried 3 different SSRIs, 1 SSNRI and 1 of whatever class Wellbutrin is in. This last one I've been on for almost 12 weeks now, with no change, so I assume the next time I meet up with the Dr., we'll transition to a 6th option.




It's that last piece that I find the toughest now: "I didn't believe so at the time, but life can get better". This is something I've told myself before, and it was true. It was something I told other people when they were in a bad place, and it was true for them too. But for the last 10 years, things have slowly been on the downslide. Every time I try and tell myself that things will get better, because they always have before I think "Yeah, but that doesn't seem to be true anymore". And unfortunately every day that things continue to stagnate it lends more and more credence to that voice telling me it's hopeless.

Weasel

[AJ]

And unfortunately every day that things continue to stagnate it lends more and more credence to that voice telling me it's hopeless.

Weasel I totally get that. I had a therapist once tell me that feelings are not facts. I wanted to bop her on the head, even though in some ways she was right. However, when you're in a dark place then what you see is not a clear picture of what is. I always have gotten better, and yet in the middle of despair I don't believe it is ever possible to feel better again.

I'm glad you're working with a psychiatrist. I hope you the next option is the one that you find helpful.

[paul m]

Hello Weasel and welcome. Good to hear that you have a doc that you can work with. Sorry that it took so long to be diagnosed, that always sucks. In regards to being left behind by friends, I know how that can hurt, but fortunately I've lived long enough to be over take many of my former friends and found out that in the long run that my life seems to be going much better than theirs (keeping my fingers crossed as I've been known to have sudden down turns ). Not that I have much in comparison when it comes to material goods, but I wake up most mornings feeling pretty good and a lot of them can't say that.

It can certainly ne a long journey to wellness, but don't give up hope, it's often possible to get much better. You may want to ask you doc about some form of cognitive behavioural therapy. The usual CBT is far out of my price range, but over the years I was able to pick up freebies from various mental health groups and out patients. Not full CBT courses, but partial ones that helped. Take Care. paul m

[Weasel]

Hey Paul,

Thanks for the good feels.

Yeah, the life you're talking about living is the sort of thing I'm pushing for. I've realized I don't give a crap about money as long as I have enough to feed and shelter myself. Just about everything I find fun can be done on the cheap. I'll take be content and poor over just about any sum of money you could hope to throw at me. (Note: This is just a metaphor. If ever you feel the urge to aid someone financially it's worth noting that it's probably far more efficacious just to do an e-transfer than to hurl cash at someone's face)

As to the CBT, I've been doing that for 6 years now. Fortunately my psychiatrist and my psychotherapist are both real good people. I trust them and feel like they care about me beyond their medical responsibility. But this is also where the frustration comes back. From what I understand the best approach to managing depression is a three-pronged attack consisting of exercise, medication and talk therapy. Some people respond better to one than the other two, some see no results with whatever, bladie-blah, etc. but the general idea is that hitting up these 3 things gives you your best chance at success. (If I'm wrong about this someone let me know, this is where all my research has led me.)

With that in mind, I've been taking this journey for almost a decade now. Like, actively trying to make some kind of improvement to my life. I've been in talk therapy for 6 years, I've been trying medicine for about 2 years, and while certainly I can exercise more, I have been pursuing a regimen that makes sure I do always get something done.


Now, of course, some progress has been made. I have a much clearer perception now about when the depression is talking to me, rather than my own rational brain. I have methods of dealing with the big pains to make them a bit briefer and be a bit less intense. That being said, this is either balanced or perhaps even slightly outweighed by how much worse the illness seems to affect me now.

As I said in my first post, the weight, the accumulation of all this pain for over 3 decades now is what is hitting me the hardest. I think I'm doing all the things I'm supposed to be doing and yet, my spaceship is still accelerating towards the constellation Depressia. (Yes, you can't really head 'towards' a constellation because it's a bunch of stars in three dimensional space, but 'Depressia' didn't really sound like a planet or a sun). All this work, all this effort, and hardly any results. What do I have to do better? How long do I have to wait? Is anything going to make a difference? Yes, these questions are all rhetorical.

Every day that nothing changes it gets just a tiny, tiny bit harder. But over days and months and years... tiny becomes huge.





I was hoping to have some kind of epiphany at the end of this post, but that seems not to have happened. Oh well.

Weasel

[AJ]

Weasel you sure are working hard for your health and well being.

Sometimes those 'ah ha' moments come when we least expect.

[paul m]

Hello Weasel. It can be tough working hard and waiting to get better and not seeing even the tiniest improvements. However you didn't get ill in a day, although it certainly may seem like it, and you won't get better in a day(or a mth or a yr) . Still it must be discouraging not to see any progress. I went through a long stretch like that myself and it was really frustrating. All of the following is strictly my opinion and is not intended as a criticism of anything that you or anyone else may have said. I have no medical background and I've been wrong a lot over the years, just ask my wife LOL.

You said " From what I understand the best approach to managing depression is a three-pronged attack consisting of exercise, medication and talk therapy." and I can't disagree with that, but rather than just exercise I would say life stlye changes and rather than talk therapy, I would say talk therapy along with CBT.

I found that for my illness(and even for those of us with the same illness everybody responds to treatment differently) that life style played a greater part in getting better than exercise. No doubt a good sweaty work out helps me a lot, but feeling guilty about missing that workout does not. Nor does it help if after the work out I don't pay attention to my diet, sleep patterns , stress levels etc.

Also I'm at a much different medication level now that my illness is more or less under control. I take much less medication than when I was at my worse. I have included links to a couple of website that you may or may not find helpful. The first one has a long list of items, I found # 19 particularly interesting, although I think that there suggesting of a few mths is more thana little optimistic http://www.depressionny.com/q&a.htm The Mayo Clinic also has some interesting things to say. http://www.mayoclinic.org/diseases-c...e/ptc-20166599

Lastly, sometimes a mood chart helps both you and the doctor figure out solutions. I have a hard time keeping one up to date, but when I do it is very helpful. An example of one can be found at http://www.dbsalliance.org/pdfs/tracking.pdf

I hope that you soon find something that works, but in the mean time please feel free to ask more questions, make comments , answer other people's posts and/or use the forum to vent out some of the frustrations that go along with having a mental illness. Take Care. paul m

[Weasel]

Hey Paul,

Thanks for the links. I was actually already tracking my mood beforehand, but I find it very difficult to do when I'm an extended down mood. Having to constantly question how I'm feeling and then mark things on the negative side, seeing all the empty spaces above wore down on me after awhile. Even hiding the results from myself didn't do much to change that.







someday.