Persistent Depressive Disorder (Dysthymia)

Management and Resources

At home

When an individual has dysthymia, it is difficult to make changes to behavior. In fact, getting out of bed might feel daunting. Even so, small tweaks in a daily routine can accelerate recovery. Behavioral changes, when added to medications and therapy, can be a powerful combination. The following ideas for positive behavioral changes are are offered as examples:

Resolving to accomplish one thing each day

These should be simple actions: For example, to get up and get dressed. To get outside and take a walk around the block one time is even better. The goal simply needs to be doable; something that can be achieved within a day, not something more elusive like training for a half marathon or acing an assignment. When a person completes the chosen activity, they can tell themselves they did well, and work to silence any negative thoughts that say otherwise.

Doing one kind thing for someone else

This can be as small as a text message to say “I’m thinking of you,” or kind words over phone or email to a family member or friend. Some people feel better when they volunteer occasionally in their community. This helps focus thoughts away from oneself and, at the same time, help others in need.

Resolving to express gratitude for one thing at the end of the day

If the weather is bad, such as a snowstorm or a torrential downpour, it can help to try and find something about it that can be appreciated. For example, one may find the scene beautiful or be glad that it was not necessary to drive in the weather. Finding gratitude, and specifically, writing down those thoughts promotes feelings of wellbeing. Ideally this would be part of an end-of-the-day routine.

Diet & exercise

While many are aware of the vast, proven benefits of diet and exercise, taking these steps can be particularly difficult while depressed. However, one's body needs movement, sunshine, and non-processed foods (especially vegetables). An individual should start small. Eating one vegetable or fruit per day; Walking one lap around the block. Tiny changes, over time, can make a real difference.

At work

Dysthymia tends to affect all parts of one’s life, including life at work. It can lead to tardiness, missing details, and lower productivity. In some cases, work scenarios can contribute to one’s depression. Unsupportive work cultures or demanding environments can contribute to burnout and amplify the symptoms of depression. When depressed, it is important to remember that getting treatment might make work feel more manageable. In the meantime, here are some examples of ways to move forward:

Employee assistance programs

Many organizations have started to offer an employee assistance program or partner with an organization that offers mental health services. Individuals should check with human resources at their workplace to see whether such resources exist and whether the individual is eligible.

Giving oneself grace while dysthymic

Simply keeping in mind that one might need to take a break every so often, or perhaps a day off in order to maintain spirits. While taking breaks can seem disruptive, this strategy may be effective in protecting wellbeing and providing perspective.

Consider sharing in the right circumstances

One should never feel that they must tell anyone at work about having depression, and at the same time, it does not need to be a secret. The amount an individual shares is their own choice, though some people find it useful to share that they are having a rough patch with a colleague or supervisor. Well trained managers understand that individuals experiencing depression might need a modification in their work responsibilities for a period of time.

Getting support

Having a friend, preferably at work, can lend many benefits. Getting the support of friends, family, and even online support groups can be a powerful way to listen to others and share one's stories in a confidential and dignified way.

If in an unsupportive work environment, where continued productivity is inconsistent with protecting one's mental health, one may need to think about whether a job change in the future is right for them. As a general rule, individuals should not make life-changing decisions while depressed. This applies to work and personal relationships. For this reason, it is ideal for individuals to discuss work modifications with an employer while also getting treatment. As an individual improves it is more likely that a judgment about work is solid.

At school

Dysthymia also affects school performance for adults. Dysthymia can lead to tardiness, missing details, and absences at times. When depressed, it is important to remember that getting treatment might make one's school scenario feel more manageable. In the meantime, here some examples of ways to move forward:

Counselling services

School administration typically offers student counseling services. Given the abundance of stress related to exams and school performance, it is common for students to feel overwhelmed, depressed, and in need of support. Individuals can reach out to a dean of student services for information.

Giving oneself compassion

For some with depression, simply keeping in mind that they might need to take a break every so often is helpful. Or, reminding oneself that everyone makes mistakes, and goes through rough patches at some point or another. Remembering that productivity requires one to feel energized, and breaks and moments of self-forgiveness are necessary for everyone.

Getting support

Having a friend, preferably at school, can lend many benefits. Consider finding study groups, free tutoring offered though the college, or college groups that offer meetings or activities on campus or virtually.

In relationships

Dysthymia can have an impact on a person’s relationships in many ways. When a loved one or friend does not have depression, it can be difficult for that person to understand what the dysthymic person is going through. Others may expect the person with depression to “snap out of it,” which can add to feelings of loneliness or sadness. A person with depression may be worried they are burdening others with their emotions or behaviors, but this may not be the case. Oftentimes, being open during these struggles can fortify key relationships.

Dysthymia can impair self-esteem, which can lead to frequently needing reassurance or outside validation during episodes of depression. A person with depression benefits from receiving consistent compassion and patience, which helps them build a better support system.

Depression can impact dating and romantic relationships. If someone is depressed, they may be less likely to want to plan activities together or socialize with others. It is important to recognize that withdrawal or isolating oneself is a common symptom of depression and to remember that this lack of interest is usually temporary and likely to improve with treatment.

Couples counseling can be a fantastic tool when one or more partners struggles with depression. It can help both parties empathize with the other, and to find ways to best support one another.

Medications and sex drive

For some people, having dysthymia, and taking antidepressants can impact their sex lives. However, if an individual experiences low libido, erectile dysfunction, etc... there is hope. The first step to addressing this issue is for a person to acknowledge the problem. At the same time, sharing this sensitive information with a partner or provider is not always easy. A couple of steps one might try include:

Trying a new routine with one’s partner such as exercising before sex, or incorporating new types of stimulation into the routine.
It is possible that when depression improves, libido will also improve: Research has shown that depression can cause these effects with or without taking an antidepressant.
A provider may adjust an individual’s dose of medication to find a level which balances effectiveness with libido.
Some of the commonly known medications for erectile dysfunction (Viagra, Cialis, etc..) can be helpful to antidepressant induced sexual dysfunction in men.
If the examples above do not work in a particular instance, a different type of medication that has fewer sexual side effects might be the next step.