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MerryMary


Member

Posted Mon Apr 30th, 2007 9:06pm Post subject: Dysthemic Disorder
Not bi-polar, but live with (early onset/ pre-teen) dysthemic disorder. Think nearly constant, low-grade depression. Like most of these things, it is chronic, but not necessarily progressive, at least in my experience.

Ah, but we with this are clever. We "present" as cheerful, calm & contented. That is, until the dip sinks and we withdraw for days on end, preferring the cocoon of a warm duvet. Usually the dip rises to baseline after a few days, and no one is the wiser. These episodes can cycle through me several times per year.

I have found that every few years, the dip persists and other behaviors manifest. When I begin to hurl crockery about, I cannot continue the denial that things are not quite right. By the way, how many people reading this understand that anger and it's expression can be a sign of depression? It is not always about tears and hiding out.

In my case, I call my dear GP and ask him to phone in the medication, and after about a month, I begin to feel relief. I know that I will require the meds for many months in order to reboot my hard drive. Often I will seek some CBT or just re-up with my spiritual director until the meds kick-in.

FInding the best medication often requires the creativity of Oz and the magic of Gandolf. Finding which works for one's particular chemistry is not much fun. The problem is, as many know, finding an SSRI which 1) does not make you fat and 2) does not quash your libido. God help us!

I feel extremely fortunate, in that I do have something which makes a significant difference for me. Wellbutrin is my magic potion. Some cannot take it because it can actually inspire mania. For me, it does create a bit of a buzz, so I lose the coffee and take my tablet in the morning. An added bonus is that, 1) it does not make me fat ( quite to the contrary, it allows me to stop self-medicating with food) and, 2) sex becomes much more delicious and frequent.

Show-and-tell time anyone?

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Aoibheann


Member

Posted Mon Apr 30th, 2007 9:11pm Post subject: Dysthemic Disorder
1) it does not make me fat ( quite to the contrary, it allows me to stop self-medicating with food) and, 2) sex becomes much more delicious and frequent.

Cocaine does the same..........



About the thing about the anger thing.... i just found this out recently.... never realized! Mad isnt it............

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Fourth Feline


Member

Posted Mon Apr 30th, 2007 9:20pm Post subject: Dysthemic Disorder
Hello MerryMary,

Whilst I do not have dysthemic disorder, but Bi-Polar II, I can still associate with what you describe on two clear levels.

1) My depression occasionaly manifests as 'agitation' or "agitated depression", - so I can associate with the outcome being more anger than withdrawal sometimes.
At those times I have to look out for the warning signs and remember to be reasonable with situations/people. In theory my Consultant says that agitation goes with mania, but not so with me, it goes with feelings of vulnerability, like being a cornered animal.

I also experience long ( sometimes 8-9 month) depressions, and now the slight highs of BP II have been medicated out, I rarely get to or over the 'middle line' - so I feel your own description of dysthemic disorder, sounds very familiar.

I am not officially in your 'group' but it just shows how much these things can overlap.

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MerryMary


Member

Posted Mon Apr 30th, 2007 9:39pm Post subject: Dysthemic Disorder
Yes, yes. It is that primal "fight or flight" which has not Darwined out of us.

It is useful to have a system of some type where one tracks the ride. You offered a good example of maintaining an awareness of behavoirs or signs which are indicative of another episode.

I officially welcome you as ex-officio to our little party by viture of modern medicine!

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Anonymous


Unregistered

Posted Mon Apr 30th, 2007 11:36pm Post subject: Dysthemic Disorder
Fourth Feline -

In theory my Consultant says that agitation goes with mania, but not so with me, it goes with feelings of vulnerability, like being a cornered animal

- behavioural outcome of anxiety, which is frequently the sister of depression.

Dysthemia does not show up on standard Depression Inventories, becuase there is no perception of change recorded in the inventory responses - a tricky one. This overlapping is perhaps why there is a lot of uncertainty reported bypeople on the forum about what is actually wrong - what i take fom this is that it is not necessarily the condition/disorder/illness that seems most 'desirable' to have, if one is forced to accept that one has something going on.

Interesting that both of you refer to awareness of behaviours acting as indicators to initiate containment/modifying responses. Also the combination of meds and cognitive therapies in MerryMary's post.


Chris

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MerryMary


Member

Posted Tue May 1st, 2007 1:21am Post subject: Dysthemic Disorder
- behavioural outcome of anxiety, which is frequently the sister of depression.

Dysthemia does not show up on standard Depression Inventories, becuase there is no perception of change recorded in the inventory responses - a tricky one. This overlapping is perhaps why there is a lot of uncertainty reported bypeople on the forum about what is actually wrong - what i take fom this is that it is not necessarily the condition/disorder/illness that seems most 'desirable' to have, if one is forced to accept that one has something going on.
:-|[/quote]



I agree with your comment about those evil twins, depression and anxiety. It can be a vicious circle wherein each feeds the other. It can also call forth a "chicken or egg" paradox. Is one the genisis of the other? In my case, increased levels or stress and anxiety contribute greatly to my condition. Taking measure of those two, and redirecting my thinking can mitigate an episode.

It is hard to dx. The DSM-IV ( by the American Psychiatric Assn) does describe the disorder. It is important to rule out episodes of Major Depressive Disorder, any of the manic disorders, and substance abuse which apparently can trigger non-dysthemic depression.

As to your comment regarding labeling of conditions, I also agree. We so love to, need to, give a name for what it is that affects us. Clearly this is an inexact science, and we do our best to remain informed and connected.

My work demands that I be "up". I understand a bit of the mania aspect of BP because performing releases all those wonderful endorphins and things which enable one to be spot on, reacting quickly to the unexpected and energizing oneself and the audience. Once the high of the performance wears off, it is common for all performers to feel a let-down. The distinction is this: at which point does this condition morph into pathology versus the normal ebb and flow of performing

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Anonymous


Unregistered

Posted Tue May 1st, 2007 1:50am Post subject: Dysthemic Disorder
You write:

The distinction is this: at which point does this condition morph into pathology versus the normal ebb and flow of performing.


Quite... where i'm at with this is that it depends on context and setting...

Where it might be expected to feel wiped-out-low after a show, [poetry!!] at another time it might be quite dissonant to feel that. i have a feeling that quite a few people can get hung up on how they 'should 'be to be this thing or that thing, (short, mid or long-term)

This was being discussed last night [what is normal?] and i put up this psychology interpretation, and for me it really works.

Just picture... Mr Fry (as in the tv programme0 didn't have a problem(guilt) about having a zillion macbooks, and wasn't upset by any feelings, and performing was rosy an allhis mates were unaffected by anything and nothing was wrong with anyone about any of it, and SF just got on with being a brilliantly funny man and observer of the human condition... then why should a diagnosis of Bipolar matter in any way?? I t wouldn't really, would it. But his life is affected one way or another to the degree that he feels there is a merit in making the tv program, and i thank him for doing that, so something is happening... it fits the definition below, synthesised by two psychologists -

A contemporary definition of abnormal psychological health is:

"Abnormality is any behaviour or emotional state that causes an individual great suffering or wrong, that is self-defeating or self-destructive, or that is maladaptive and disrupt's a person's relationships or larger community."

Wade and Tavris 1993.


Diagnoses are helpful if they help.

I've got two but i am agemini!

Lost the plot a bit here but hope this is interesting.

Chris

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MerryMary


Member

Posted Tue May 1st, 2007 2:32am Post subject: Dysthemic Disorder
Very interesting, indeed. I am enjoying our conversation. A gemini friend of mine has a joke about asking himself, "So, which one am I today?"

Your quote nails the thing beautifully.

As to S.F. and the SLOTMD, I just watched via YouTube (thankyoujesus for this amazing technology) the programme last night. This is what prompted me to start a new thread. You so accurately describe his affect. I found myself pulled into his experience, and thinking, similarly, that he was all jolly fine, and had a kind of amusement about the mania. He likes the high, and it feeds him.

I think the big issue for BP may well be the depressions and associated risks. If one has good people in one's life, with whom one can be honest, as Stephen clearly is with his sister Jo, and I assume M/M Laurie, who can keep a loving eye on you and square you away when they see the ship listing, then carry on. Not needing to "push the button" is such an individual and situational
circumstance.

Still, I feel terribly for those whose lives are in such disarray as to require lithium and so on to approach normalcy. I do have an auntie sort of friend, an lovely lady who just turned sixty-five. She has had to be on lithium for the past twenty-five years. For her, it has literally saved her life.

I feel lucky that I am only stuck with a kind of whiney, easily treated condition. I just get on with it, and listen to Jackson Browne and tragic operas. I felt such empathy watching the show and was deeply touched. Mr. Fry is such a dear man. I really adore him.

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Anonymous


Unregistered

Posted Tue May 1st, 2007 3:06am Post subject: Dysthemic Disorder
For Everyman

This is an interesting conversation and I hope it proceeds over the time.

I regret its 0200 here in UK and I have to call it a day.

Psychology, people, the world indeed, is such an interesting place, and I believe we live in a golden age [well those 20% percent of the six billion who can be said to be relatively free of poverty and war, to be fair], but a golden age in which we have ipods et al but have not yet been climatised to dust in a bio-un-diverse environment.

Let's change the world - ooh, suddenly gone all sad....

San Francisco - City of Dreams and Jefferson Airplane.

C

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MerryMary


Member

Posted Tue May 1st, 2007 3:46am Post subject: Dysthemic Disorder
Yes. Sleep's Dark and Silent Gate....
Off to bed, silly. I have to feed the flock.

You bring the flowers.

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Fourth Feline


Member

Posted Tue May 1st, 2007 8:09am Post subject: Dysthemic Disorder
Fourth Feline -

In theory my Consultant says that agitation goes with mania, but not so with me, it goes with feelings of vulnerability, like being a cornered animal

ChrisB replied:
- behavioural outcome of anxiety, which is frequently the sister of depression.



I agree Chris, although my Consultant seems to be predominantly an advocate of the biological causes / chemical cures of Bi-Polar Depression. I too have to concur with his findings , not only because of his track record, but also my own experiences.

We have however, discussed my own previous and ongoing use of cognitive modifications, but he from his position sees where self defeating 'inner dialogue' does not explain the whole of the phenomena. On that matter I can certainly agree with him, biological Bi-Polar II ( and even more so BP I ) is scary to behold, and harder to contain.

I am however, at odds with him in a genial way, over the concept of "aggitation = mania".

When clinically depressed, i find it important to avoid external stress such as loud, unwanted and repeated noise e.t.c. If therefore a bunch of kids appear right outside my window, bouncing the football and screaming for 2-3 hours, I have to negotiate with the parents for quiet. It reminds me of the psychology experiment were apes were put in a room with a loud radio, but then given a big red button that would switch it off. If they were deprived of the button, they got agitated - whereas if they were allowed the button, they could tolerate the noise much longer of their own volition.

In my case, the anxiety flows from the loss of control over a situation(s) that can have proven destructive consequences.

I find the consequences of long term stress can be quite dangerous for me, so these things are an issue. The C.B.T. therefore proves ineffectual in preventing deeper episodes, but still helps in the external wording of my 'negotiations' and 'inner' choices within any given florid episode.

Whilst I do agree with the consultant that C.B.T is better used as an adjunct therapy to medication for the big league psychiatric illnesses, rather than a 'stand alone' therapy, it still therefore proves useful in making those smaller decisions that empower one as best possible at the time.

Just out of interest Chris, my own favourite reference book for C.B.T was/is:

"The New Guide To Rational Living" By Doctors Ellis & Harper.

I first read it in the late 70s, but it is still in print and seems to eclipse a later work I read called "Feeling Good" by David.D.Burns MD.


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Anonymous


Unregistered

Posted Tue May 1st, 2007 10:33am Post subject: Dysthemic Disorder
Our tutor slavers over "Burns" but i keep telling him he's the guy out of Talking Heads, and its a different kind of talking therapy - needless to say i get a slap round the head,

Therapeutic treatment , as always, is what works for he,she,it.

Medication is an essential part of someone's regime if that is what is needed, and I am very happy to concur that the majority if not all sufferers of BP have their experience of being themselves improved or at least made tolerable and sustainable by this response.

As always FF your words stand as a beacon of light and temperate good sense in a swirling seascape of confusion and sometimes, agony.

Chris of the South-west Frontier

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Fourth Feline


Member

Posted Tue May 1st, 2007 10:57am Post subject: Dysthemic Disorder
Thank you for your kind words Chris, much appreciated as always. I have recently been asked to "Moderate" this section of the forum, so am keen to remain active in discussion, but ever 'moderate' in my approach to life and my responsibilities within this very worthwhile forum/venture.

On the subject of Ellis & Harper contrasted with the writings of Dr. Burns;
they were not at ethical odds with Doctor Burns, just that being the forefathers of current writings, E&H split the irrational thought processes into more sub groups.

My G.P. at the time felt that E&H repeated themselves too much in doing so, but that particular format helped me keep a more detailed 'shopping list'.

By the way, how did you deduce (in another thread on occupational therapy ) - that I was a Blues player ?

Good health Chris

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Anonymous


Unregistered

Posted Tue May 1st, 2007 11:21am Post subject: Dysthemic Disorder
That sounds good...

the titles i will check out - currently working out of Basics and Beyond Judith Beck, as main background text book, but certainly add others to my growing resources bibliography.


How did i sus out the blues... how do counsellors (in training) do anything?? ...by listening carefully

Must scamper [using rabbit analogies today, for a change].... mad as a hatter...

C

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MerryMary


Member

Posted Sun May 13th, 2007 10:32pm Post subject: Dysthemic Disorder
Just thinking. Dis the health system in the UK, but there is much good being done as well.
Where I live, out of pocket change to the shrink runs about $200 per hour. Health insurance usually covers 20 sessions, but the doc or therapist must come from a list they provide, and it can be hit or miss. The best doctors, as these things go, prefer to run their own business, and so we ( I ) pay. An added advantage is your privacy is legally protected.

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