I've felt this way for a long time. About dysthymia
You cannot remember when you last felt noticeably better. There are calmer days, but most of the time you lack energy. It is hard to become interested in anything. You think about the future and do not expect much that is good.
You do not see a sudden change. It has been like this for a long time. You begin to consider it part of your character.
Dysthymia involves chronically low mood. In DSM-5, it falls within persistent depressive disorder. In adults, one criterion is depressed mood for most of the day, more days than not, for at least two years.
This does not mean you have to wait two years for help. That duration matters for diagnosis. For a consultation, it is enough that symptoms persist and make your life difficult.
Alongside low mood, there may be fatigue, sleep or appetite problems, low self-esteem, difficulty concentrating and feelings of hopelessness.
Symptoms may be less severe than in a clear depressive episode. That does not mean their impact is small, especially when they have limited relationships, rest and decision-making for years. There can also be periods of significant worsening within these chronic difficulties.
Your history of wellbeing is important during the consultation. How long have you felt this way? Were there longer periods of improvement? What were sleep, energy and daily functioning like?
It is also worth mentioning periods of unusually high energy, little need for sleep or uncharacteristic impulsivity. This information helps consider other diagnoses and choose treatment.
Not every prolonged low mood means dysthymia. Health conditions, other disorders and life circumstances need to be taken into account.
Having symptoms for a long time does not mean you have to accept them. Help includes psychotherapy and, depending on clinical assessment, medication as well.
At the meeting, you can simply begin with: “I have felt this way for a long time and no longer know whether it was ever different.”
Hanna Swierczewska
Psychologist, psychotraumatologist, psycho-oncologist
If you would like to talk about your situation, you are welcome to book an online consultation.
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