Most people think they know what it’s like to be depressed. We’ve all had a day or two when we’ve felt down and hopeless, had a hard time sleeping at night and dragging ourselves out of bed in the morning, and had a decreased or increased appetite. While these all are symptoms of depression, in major depressive disorder they are severe and occur for weeks or sometimes months on end. They also manifest as a clear deviation from one’s normal functioning
On the surface, dysthymic disorder (or dysthymia) seems less severe, which is why I’m using the metaphor of a lighter shade of blue. Dysthymic disorder, as it was described in the previous edition of the psychiatrist’s manual, DSM-IV, manifests itself in a depressed mood most of the day, on more days than not, accompanied by at least two of the following symptoms:
- Poor appetite or overeating.
- Insomnia or hypersomnia.
- Low energy or fatigue.
- Low self-esteem.
- Poor concentration or difficulty making decisions.
- Feelings of hopelessness.
However, while the symptoms of major depression need to last for at least two weeks, those of dysthymia last for at least two years (or one year in children and adolescents). Therefore, while everyone can probably tick off some (or even most) of the symptoms mentioned above every now and again, that is quite different from having dysthymic disorder. I have had symptoms of depression on many occasions, but I can’t say I’ve had them for most of the time persistently over a two-year period.
In the current edition of the psychiatrist’s manual, DSM-5, dysthymic disorder has in fact been replaced with persistent depressive disorder. This category includes both the “lighter shade of blue” of dysthymia, as well as chronic major depression. After all, the creators of DSM-5 felt there is no meaningful difference between chronic major depression and dysthymia. The difference between persistent depressive disorder and major depressive disorder is, thereby, no longer one of severity but one of pattern or course of development. In major depressive disorder, individuals tend to relapse and remit (get better and worse). Persistent depressive disorder tends to linger for years.
I do not have dysthymia. Why, then, am I writing this post? Quite frankly, just for the sake of raising awareness. When I found out that Mumturnedmom’s prompt for this week is “blue”, this is what I thought of. I hope I have educated a few people, including myself. I am a member of some groups on Facebook for depression, and I don’t know that I should be. I, after all, do not know what it is like to be severely depressed or persisistnetly depressed for a long time.