Dysthymia - chronic depression

[purplepie]

Hi All
I have been a member of No More Panic for some years as my initial diagnosis over 10 years ago was Anxiety states, however in recent years this has gone long side depression as it so often does and I have come to better understanding of the two combined ( and do hope that Mixed anxiety and depressive disorder M.A.D.D will be recognised by the APA and put on the DSM in future). However that is by the by! About 4 years ago I was diagnosed with dysthymia (or dysthymic disorder) - low grade chronic depression and as one of my degree modules on mental health, I have decided to focus on Dysthymia and would like to hear from people who also suffer with this regardless if you also have another mental health issue running along side of it.
I would love to hear about your experiences, how you were diagnosed, how it feels to have it, if you take any medication and if so what, have you found talking therapies helpful etc.
As I put my presentation together I may ask if it would be possible to use some of the feedback that you have given to me as I don't want it to be just based on how it affects me.
Thanks purplepie

[mezzaninedoor]

I have had many years of blips with time off for Depression, Anxiety and Stress. Recently I was diagnosed as Cyclythymic and then more recently with BiPolar type 2, basically depression with anxiety and mania .... this diagnosis now goes back to episodes in 1990.

Over the years I have tried many many therapies and interventions and can only state how much it helped or didnt help me, doesnt mean that it won't help others.

Counselling ( Listening style ) - Had this multiple times but have found that with the counsellor just listening really and guiding that it didnt provide me much in the way of outcomes

Person centric therapy ( p2p ) - Had this from July last year and I have found that the therapy is working pretty well, the challenges to fact and fantasy help me especially as I'm very hard on myself on a day 2 day basis

NLP ( neuro linguistic therapy ) - Had very limited benefits from this, it seems I'm just not very good at re-programming myself

CBT ( cognitive behaviour therapy ) - This has been better as I sort of get most of the suggested coping mechanisms and interventions interlectually but I cant always translate them into wins for me. I think its been good for me in understanding myself even if I cant work through to a good outcome

Mindfulness - I definitely find mindfulness helps with relaxation but I also find that it either helps or not much dependant on how much of a rut I'm currently stuck in

Self Help Books etc - This has been where I think sometimes we overload ourselves as we take on more and more information regards 1) our condition 2) therapies 3) self coaching that we get bogged down AND we also then blame ourselves for things not working out better. Its especially difficult when the self help books contradict each other.

dont know if that helps / makes sense ........

Tony

[purplepie]

Thank you so much for sharing your experiences, it is very interesting they types of therapy that work for some and not others. It is very much trial and error and lots of perseverance isn't it?

I would love to hear from others.

[mezzaninedoor]

I would like to hear from others as well. Its possible the title of the thread may not pull in those answers.

It is interesting as to what therapies work for what people. Peopel swear by things that then don't have the same impact for others. With my back pain I swear by the Osteo maintenance BUT a friend swears by Chiropractic which I have never got on with.

[MyNameIsTerry]

Hi All
I have been a member of No More Panic for some years as my initial diagnosis over 10 years ago was Anxiety states, however in recent years this has gone long side depression as it so often does and I have come to better understanding of the two combined ( and do hope that Mixed anxiety and depressive disorder M.A.D.D will be recognised by the APA and put on the DSM in future).

WHO have "F41.2 Mixed anxiety and depressive disorder" in the ICD-10. However, this is for use when both the anxiety & depressive elements are not severe enough to warrant a diagnosis in their own right.

F41.2 Mixed anxiety and depressive disorder This mixed category should be used when symptoms of both anxiety and depression are present, but neither set of symptoms, considered separately, is sufficiently severe to justify a diagnosis. If severe anxiety is present with a lesser degree of depression, one of the other categories for anxiety or phobic disorders should be used. When both depressive and anxiety syndromes are present and severe enough to justify individual diagnoses, both disorders should be recorded and this category should not be used; if, for practical reasons of recording, only one diagnosis can be made, depression should be given precedence. Some autonomic symptoms (tremor, palpitations, dry mouth, stomach churning, etc.) must be present, even if only intermittently; if only worry or over-concern is present, without autonomic symptoms, this category should not be used. If symptoms that fulfil the criteria for this disorder occur in close association with significant life changes or stressful life events, category F43.2, adjustment disorders, should be used.
Individuals with this mixture of comparatively mild symptoms are frequently seen in primary care, but many more cases exist among the population at large which never come to medical or psychiatric attention.
Includes: anxiety depression (mild or not persistent)
Excludes : persistent anxiety depression (dysthymia) (F34.1)

It's strange that it excludes Dysthymia which had previously held a title including anxiety yet the diagnostic criteria for it now doesn't mention anxiety at all and focusses on the recurrent depressive episodes. I guess they may have decided to change that and without looking through the ICD-9, I couldn't say about the criteria.

---------- Post added at 08:39 ---------- Previous post was at 05:29 ----------

Something that I find annoying is the fact that the NHS used the WHO ICD in patient care but psychiatrists/psychologists may also be using the DSM too. I would interested to know how this has been discussed in your studies.

The DSM-V has been criticised for going too far in trying to reduce criteria to such a level that people without mental health issues can be scooped up e.g. grief can be classed as depression in this version BUT in the ICD that would firmly fall under an Adjustment Disorder until the time lapsed and a new diagnosis made (some of the coding can also be brought forward too but only as a reference to retain specific elements of use).

I have read a fair bit of the ICD. Less so the DSM. I can see that there are differences between how a diagnosis could be made e.g. BDD is a Somatoform Disorder in the ICD-10 whereas it's an OCD Spectrum Disorder in the DSM-V. From looking on OCD charity websites in the UK, they consider BDD as an OCD spectrum issue. This tells me that the UK is being influenced by the DSM despite the NHS not using it for diagnosis of patients.

Another good example is Illness Anxiety Disorder in the DSM-V. This doesn't exist in the ICD-10, but WHO created an entire group of Somatoform Disorders to account for this. One of those maps quite closely to Illness Anxiety Disorder.

It makes me wonder how much of this is confusing the people making the diagnosis. The industry has no real minimums to join it and any therapist could be telling clients completely incorrect information about their diagnosis.