Dysthymia

So, apparently, I have a disorder called "dysthymia." It's known as mild to moderate depression. Read the criteria:

Diagnostic Criteria
Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year. 

Presence, while depressed, of two (or more) of the following: 
poor appetite or overeating 
insomnia or hypersomnia 
low energy or fatigue 
low self-esteem 
poor concentration or difficulty making decisions 
feelings of hopelessness 

During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in Criteria A and B for more than 2 months at a time. 

No Major Depressive Episode has been present during the first 2 years of the disturbance (1 year for children and adolescents); i.e., the disturbance is not better accounted for by chronic Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission. 
Note: There may have been a previous Major Depressive Episode provided there was a full remission (no significant signs or symptoms for 2 months) before development of the Dysthymic Disorder. In addition, after the initial 2 years (1 year in children or adolescents) of Dysthymic Disorder, there may be superimposed episodes of Major Depressive Disorder, in which case both diagnoses may be given when the criteria are met for a Major Depressive Episode. 


There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode, and criteria have never been met for Cyclothymic Disorder. 

The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophrenia or Delusional Disorder. 

The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism). 

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

NOW READ A FAIRLY GOOD DESCRIPTION OF WHAT IT'S LIKE:

"There is a silent killer amongst us. With little fanfare it ruins lives and even ends them. At any given time, some three percent of the population is under its spell, mostly women (by a ratio of two to three to one). The experts call it dysthymia. We know it as mild to moderate depression.

If we think of major depression as a spectacular brain crash, milder depression can be compared to a form of mind-wearing water torture. Day in and day out it grinds us down, robbing us of our will to succeed in life, to interact with others, and to enjoy the things that others take for granted. The gloom that is generated in our tortured brains spills outward into the space that surrounds us and warns away all those who might otherwise be our friends and associates and loved ones. All too frequently we find ourselves alone, shunned by the world around us and lacking the strength to make our presence felt.

The symptoms are similar to major depression, with feelings of despair and hopelessness, and low self-esteem, often accompanied by chronic fatigue. This can go on for years, day in, day out. 

Still, we are able to function, a sort of death-in-life existence that gets us out into the world and to work and the duties of staying alive then back to our homes and the blessed relief of flopping into our unmade beds.

All too often, we are told to snap out of it. That the invisible water torture we carry in our heads is our own fault. And shamed into thinking something is wrong with our attitudes, we fail to seek help. Or, if we do, it's our family physician who confuses a very real chemical imbalance in the brain with some imaginary defect in our personality. And so we are sent away with a stupid happy pill such as a tranquilizer (whose depressive effect only adds to our quiet misery).

Some of us turn to the bottle or illegal drugs. Others seek a more permanent solution. Yes, even milder forms of depression can be lethal (experts estimate anywhere from 3 to 12 percent of dysthymics cure themselves by suicide).

And, sooner or later, it happens, the brain crash. Major depression. That's how most of us wind up, according to the experts, sometimes with a double depression, a depression on top of a depression that never had to be.

As I sit here writing this, the term mild to moderate depression mocks me. I won't even begin to estimate how many years I've lost to a disorder predicated by the modifiers mild to moderate. The least they could have done was assign the name of a Shakespeare character - Hamlet's disease, Lear's disease, anything, really. Just so long as it doesn't imply I was cut down in the prime of my youth by some invisible stupid nerf bat pounding against the inside of my brain."