Hi hhmc, welcome
Diagnosis- different for everyone, its often by interview. In my case one visit to a psychiatrist (after 7 years of misdiagnosis by another one) he focussed on several things, first the depression then the bipolar and finally the life long melancholy low mood.
What do you do when you are melancholy?" = "write sad poetry, remain alone, seek out homeless and give them food, stay away from as.hole.s" and so on. Then he asked me several times about my childhood in particular if there were any traumatic events. I kept saying no, my wife kept nodding her head indicating there was an event. Eventually I recalled at 13yo my then older brother (dec 1979) had a fit in our above ground backyard pool. I lifted him over the edge and he came to by this time my parents gave him jam (diabetic) and he was ok. However I stopped talking for 3 months- not a word. Then I commenced talkin again.
This as the event he was seeking. He then diagnosed me on the spot as having dysthymia. However as I have 2 other issues - the depression and bipolar (and anxiety which I conquered by 2011) some symptoms could be from the other issues - intermixed if you like. ADHD for example was an early diagnosis but was not so...mania it was. It gets complex.
Medication for my situation is mood stabilisers and a small amount of antidepressants. In fact recently I missed my AD's and for the whole day was sad and emotional. I'm convinced totally the diagnosis is correct. This diagnosis and the tweeking of my meds to get it as right as I can get, has changed my life. Over the years I've raised and lowered both meds then settled again on a certain amount. I've learned that if I feel I need to raise it or lower it best to wait 2 weeks or so because sure as houses the little wave of symptoms comes then goes.
Hope this has helped.
Finally, the absence of chronic sadness has allowed me to seek out what happiness can be like. I've studied happy joyful people seemingly without a worry in the world rather than my serious persona all the time. I cannot write poetry now unless I feel a little melancholy so that has dropped off. But that's ok. It's a good trade.
What is certain is that good management of my illness has been my lifeline. In many ways I feel lucky to be here. My dysthymia took me a few times towards my end. It seemed a million tears were dropped. Had I not had a general positive never give up attitude life would not be what it is now, a happy man.
Tony WK
