Dysthymic Disorder (often called Dysthymia in therapy) is a strange sounding word for the diagnosis most commonly given by dysthymia therapists for what we, in everyday language, refer to as depression. Dysthymia is used in therapy when describing a prolonged period of depressed mood that, while painful, is not as severe as that characterized by Major Depression. In practical terms, when engaging in dysthymia therapy, the question of severity is subjective–depression is depression, in and out of therapy. While the shape of depression is particular to each person, the need for therapy for depression isn’t lessened by a perception of that depression as somehow “less severe”. In fact, too commonly those with so-called “milder” symptoms may be more inclined to dismiss them and not seek therapy for dysthymia.
While diagnoses can over-determine the scope of the intervention for depression when seeking dysthymia therapy, a diagnosis of depression or dysthymia in therapy can also be a useful jumping-off point in exploring the various sorts of pain people are in. Your experience need not fit precisely into a given set of diagnostic criteria to justify getting help with depression. If you are in pain, regardless of how you or others might characterize that pain, you can get help. For many who experience Dysthymia, this is a non-incidental question. Patients often come to us for dysthymia therapy and say something along these lines: “I’ve just felt sad most of my life (for the past few years, etc) and I can’t really explain it.” Others comment that they never thought there was “enough wrong” for them to seek therapy.
Many people live with sadness and unhappiness, and don’t seek dysthymia therapy or any sort of therapy for depression, but it’s never the case that we have to live our lives that way. Sadness, however incidental it may seem–and regardless of our ability to get by in spite of it, does not have to be a fact of life.
Dysthymia therapy, depression, and psychiatric medication
There is much discussion over whether or not exploring psychiatric medications is of value. Many fear the long-term side effects or see a decision to take medication as weak. While we don’t view a decision to take medication as “weak,” we certainly respect those who would rather move forward without medication; we commonly work with people who’ve decided to forgo medication and are looking for an alternative. While each decision is quite personal, we frequently consult with patients on the question of adding psychiatric medication as well as supporting patients who are already taking medications to reduce or stop taking those medications. We are not qualified to prescribe or advise people on the medical implications of psychiatric medications–your primary care doctor, or a psychiatrist or psychiatric nurse practitioner are the only ones who can do that and should be at the center of any decision regarding taking or stopping taking psychiatric medications. That said, psychotherapy is a great context for exploring alternative ways of growing and creating a happier, more sustaining, and more meaningful life.
Group therapy as an option for Dysthymia therapy and depression therapy
Regardless of your decision about medication, the best outcome for those who struggle with Dysthymia, or depression of any kind, involves an active, aggressive commitment to building your life. Group therapy is a context to consider.
Being sad is a part of life. Being sad all the time or most of the time (even only a “little bit sad”) doesn’t have to be the case. Dysthymia isn’t less serious than depression and too often therapy isn’t sought for dysthymia soon enough.