"Do I have dysthymia? I read an article on dysthymia and started to think I might have this condition. I think most of my friends would describe me as a really nice, guy, easy-going, pretty social.

In general, I operate at a low energy level. Sometimes I feel like I totally lack emotion. My memory in general isn't great. It has probably been five years since I've woken up and really felt energized and ready to go.

I remember I used to have days like this--maybe six times a year--and really thinking it was strange that I felt so good. This was my first clue that I was maybe not feeling the way I should. When I was younger, in grade or middle school, I remember crying over simple things, and feeling lots of anxiety over performing in school.

Drugs are a big turn-off for me and the thought of talking about my feelings to a therapist isn't appealing at all to me. Any advice would be appreciated."

Answered by: David Hellerstein

It's possible that you have dysthymia, a form of chronic depression, but of course you would have to seek an evaluation from a mental health professional in order to get a definite answer to your question.

Dysthymia, also known as dysthymic disorder, is an extremely common condition, found in about 3% of the general population. It is a paradoxical condition, because on a day-to-day basis it may appear to be fairly mild--with symptoms that include ongoing low mood, low energy, poor concentration, and so on. But on a long-term basis it is a severe condition.

Untreated dysthymia has been shown to lead to a very high risk of developing 'major depression'--in one study, over a 75% chance in the next 5 years. Also it often leads to work impairment and problems with dating and close relationships. It has even been shown to lead to more risk of suicide attempts than short episodes of major depression.

As I mentioned, if someone has chronic depression it is important to get a good evaluation, including seeing your primary care doctor to make sure that these symptoms don't result from an untreated medical condition. Assuming that your diagnosis is dysthymia, there are a number of treatment options. However, they will likely involve either taking medications or talking to someone!

Antidepressant medications have been shown to be helpful for most people; also, certain types of therapy such as cognitive behavioral therapy or interpersonal therapy can also work. Generally, a treatment for dysthymic disorder should start to show some benefit within a few months; if not, then it is worth considering what treatment changes can be made.

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David J. Hellerstein, MD
Director of Medical Communications, Columbia U. Department of Psychiatry 

Dr. David J. Hellerstein is Director of Medical Communications at the Columbia University Department of Psychiatry. He is a research psychiatrist at the New York State Psychiatric Institute, New York, NY, and Professor of Clinical Psychiatry at Columbia University.

He was formerly the Clinical Director of the Institute. He specializes in the treatment of mood and anxiety disorders, with a particular focus on the medication treatment of persistent depressive disorder, or chronic depression.

Dr. Hellerstein is also Director of the >>> Read more info

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