Wednesday, February 10, 2010

Chronic Depressive Disorder

It seems I won't have Dysthymia in May 2013 when the new DSM-V is released. In their everlasting effort to pathologize almost everyone in this country, the APA is drafting a new DSM, and facing a lot of criticism from outside the APA and within the APA about the changes and the additions to the DSM, pretty much putting a blanket disorder classification over seemingly normal human thoughts, feeling, expressions or behavior.

But that aside, the APA is proposing to change Dysthymia to Chronic Depressive Disorder. They simplify some of the criteria, but mostly the basic diagnosis is unchanged. So why change the name? Beats me, but mostly it seems they're lumping moderate chronic depression with low chromic depression into one catagory.

In the past it's been the distinction which separates Dysthymia from other and more significant, moderate and even major, depression. I think this worked as many people suffer from longterm, some like me, lifelong, low chronic depression, with occasional period of moderate to severe depression, and only short periods of some level of low level satisfaction or comfort from depression.

I think this distinction is important because it identifies people who have longterm or lifelong low depression and can function reasonably well just outside the criteria for people with moderate to major depression. We don't find life so overwhelming most of the time the depression interfers with getting through life, just for enjoying, or not enjoying, life.

And that's not being addressed in the proposed standards. I don't want to be labelled depressed and with people who are seriously depressed. I won't argue my Dysthymia is persistent and consistent, but it's liveable without intervention (therapy) or without drugs.

Some do need one or both, but I've manged well enough without either except on rare occasions during my life. But the last thing I need or want is another label of some disorder which can easily be misunderstood or misinterpreted to be worse than it really is. I'm lucky my Dysthymia is relatively easily managed, and I've function well in my life and work.

But it's not something I want people to see me as sick because they don't know or understand because some label says I have a disorder. Dysthymia is explainable. Chronic Depressive Disorder isn't. That's not right or fair.


  1. While I have plenty of problems with proposed changes in DSM-V, I have to disagree with you on this. Dysthymia is certainly different from very severe depressions, but I have yet to meet a psychiatrist who could tell me where "severe dysthymia" ends and "mild major depression" begins. They don't know either! And while I'm glad that "dysthymia" hasn't ruined your life, it has robbed me of pretty much everything. I have had a couple of "major depressions", and I could cope far better with limited (and generally treatable) episodes of that than trying to cope with the endless misery, lethargy, pessimism, and hopelessness that is dysthymia--which never ends.

  2. I have dysthymia and have a bright outlook on life and am NOT depressed. Therefore, I am VERY upset about the change, too.

  3. If you have a bright outlook on life, and no depressive symptoms you are either being treated or you by definition do not have dysthymia.