Q. I don't really feel depressed. I just never get excited about anything. I see other people having a good time, but I never feel happy or have fun. I go to work, participate with friends, and have a good family. I don't talk to anyone about this. What is wrong with me?
Q. I don’t really feel depressed. I just never get excited about anything. I see other people having a good time, but I never feel happy or have fun. I go to work, participate with friends, and have a good family. I don’t talk to anyone about this. What is wrong with me?
A. You may be suffering from a condition called dysthymia which is a chronic, low-level depression. Approximately 6 percent of adults have this disorder, but it is often not diagnosed because many people, such as yourself, suffer quietly. Dysthymia symptoms can wax and wane over the years, but most individuals rarely feel happy or report having fun.
For an official diagnosis of dysthymia, you must have experienced a sad or despondent mood on most days for at least 2 years. Additionally, two or more of the following symptoms must be present: feeling hopeless, difficulty maintaining a sleep schedule, lack of energy, over or under eating, poor concentration, and low self-esteem. Because these symptoms are less severe in someone with dysthymia, they often go unnoticed. Others may just see you as withdrawn, moody, or even difficult.
People with dysthymia often have a negative life attitude. Not only do they take a discouraging view of themselves, they often take a negative view of other people and life situations. When one has a dysfunctional outlook, problems become difficult to solve and seem to be insurmountable. While most people can looks at the pros and cons of situations, dysthymic people seem to see only the cons.
Because dysthymia can turn into a major depressive episode called “double depression,” I would suggest that you meet with your physician about the possibility of beginning an anti-depressant medication. You should also meet with a counselor or psychotherapist, at least on a temporary basis. If you are unable to do either, there are effective self-help books on techniques to manage depression. You should not have to go through life without enjoying the happy moments.
Q. My wife has serious depression. Although she is being treated, I am always afraid that she will attempt suicide. What are the warning signs?
A. Since your wife is being treated for her depression this lowers her risk for suicide; however, there are definite warning signs of which you should be aware. If you notice her symptoms are worsening, be certain that you inform her psychiatrist or physician immediately. A behavior that often precedes a suicide attempt is giving away belongings that one still uses or values, such as clothes or family heirlooms. Other behavioral warning signs are withdrawing from close friends and an unwillingness to participate in social life.
During a time of anxiety, your wife may be at a higher risk for suicide. These anxieties may be major, such as deaths in the family, or they may be an accumulation of daily hassles. Remember that people who are severely depressed have fewer coping mechanism. If she shows great calm after a period of stress, it is often cause for concern. Some people who are usually agitated, get extremely calm when they have made a suicide plan.
The most obvious sign of suicidal ideation is talking about suicide. Statements, such as “you’d be better off without me,” should always be taken seriously in anyone, but especially in someone with a history of severe depression. If she is threatening to harm herself or engages in self-injury, it is time to take immediate action. Forcing her to go to the emergency room or calling the doctor against her will is much better than facing the possibility that she commits suicide and you did nothing.
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Nancy Ryburn holds a doctorate degree in psychology. She teaches psychology at Southeast Arkansas College and maintains a limited private practice in Pine Bluff. If you have questions pertaining to mental health, e-mail them to firstname.lastname@example.org. The questions will not be answered personally, but could appear in a future column. There will be no identifying information and all e-mails remain confidential.