Persistent depressive disorder (dysthymia)

[Leafmaple]

Am 70.  When I was 20, I saw a psychiatrist at the university health service because of extreme shyness, particularly with girls.  He was so awful I never went back after the first time.  I had an academic career, successful, publications, awards, etc., but feel a failure.  I could be entertaining, spontaneous, informative, etc. talking to a hundred people, but in an ordinary social situation where I am not a lecturer, I freeze, can't talk, or when I do, it comes out so awkwardly that it falls flat.  It is as though I were two different people.  I only identify with the loser "me", not the successful "me".  I was good looking as a young man, looks never a problem.  Spent 3+ years with a psychiatrist in the 1990s (dysthymia was his diagnosis), learned a lot about why I react in certain ways, but could not change and ended up feeling even more of a failure.  I have almost no friends, avoid social situations whenever possible.  Am married with 4 adult children (great relationship with children), but no help.  No time to talk about marriage/sex, but also a problem all my life.   I have little faith in therapy, but I would like not to feel so lonely and useless (not suicidal, though).  I have notes the psychiatrist gave me, but they just confirm my inability to modify my behaviour patterns.  For example, I realize, as he said, that my self-image is largely the result of my conditioning by my mother, but it still seems, or rather feels like the "real me", even though I know that is its origin, so I still behave the same way.    I have read about CBT, but from what I read, it seems to me that you have to tell your self lies, deny what you know, or at least feel, to be true, and I couldn't do that.  I don't really have a good question, except that I would like to know if anyone knows if it is possible to find some kind of "cure" at my age, so that what time I have left (am fit and healthy, attend a gym) is not as miserable as these 70 years have been.

[white knight]

Hi leafmaple,  welcome to BB.

Not many people post about dysthymia. I have it among other ills like bipolar type 2 anxiety and depression.  I'm 58.

I was finally diagnosed in 2003 so I was 47.  47 years of hell as no one could figure it out, my behaviour that is.

I too was incredibly shy as a boy and had a very domineering mother, a beaut dad but he reacted to mothers whistle. I now truly believe my mother has borderline personality disorder as described by the 4 personalities in Christine Lawson's book "the borderline mother". Google - lawson waif witch hermit queen     that will get some good reading that MIGHT be relevant to you.

So I was diagnosed by a great psych with a second psych in attendance. What happened in that room in 2003 was very revealing. He questioned me a lot and he knew I was really sensitive and wrote sad poetry. I was a sad sack but when I had elevated mood I was the clown of the party. Two extremes. So his questions went on and on. He wanted to know what traumatic experiences I had as a child. I had to think hard about it.

Finally I told him I couldnt think of any traumatic experience except when I stopped talking for 3 months. His eyes opened wide and he asked me what happened. I told him my older brother, a type 1 diabetic from birth was unstable on his insulin and we were swimming in the back yard. He had a fit in the water and I managed to get him over the edge so he fell to the ground. He staggered up to the back door where our parents gave him jam etc to help him.

The psych knew it was that episode that brought about my dysthymia- the spark!.  My medication for this is a very low dose of anti depressant. It certainly stablised me over time. But for 35 years I was always teary eyed, a feeling of hopelessness, deep sad thoughts, lack of feeling like having fun. But remember, I have those other illnesses as well so the boundaries of each illness are very blurred. Some symptoms could be from them. Like moodiness, anger, inability to fit into a group,  many jobs over my lifetime (now retired), many cars eg compulsive behaviour. And I might have had ADHD.

I've tried cognitive therapy and I felt it was a waste of time. For me my best moves were to withdraw a little from my vast friendships- less bullies,- for protection.  My partner also has depression so we help each other with mutual understanding- a gift it be. Change of environment helped me a lot. Ridding myself from toxic people was reassuring.   Hope this helps

[Leafmaple]

Hi White Knight.  Thanks for taking the time to reply.  I appreciate that.  I had a look at what it says on line about the book you recommend, and it does look interesting. The only one of the four types my mother resembled is the hermit mother,; while she shared a lot of the characteristics described,  it is not an exact fit.  I certainly have all the effects listed though.  I will follow it up, but I have trouble seeing how a book, by itself, could help me.  You have obviously had a tortured and painful time.  My problem in relating to everything you have experienced is one you mention, that it is hard to separate what is the result of what condition.  As far as I know, I just have this one problem, although it has destroyed most of my life by itself.  I don't remember any trauma as far back as my conscious memory goes , but I don't ever remember feeling much different.  I have had some good times, but not many.  I think my problems are a combination of genetics and parents who were obsessed with controlling me "for my own good".  I was born overseas and have one friend  there, my best friend.  I really have no others, although I know a few people here, not many, but they are in no way friends.  Social gatherings, functions are torture for me, so I avoid them as much as possible.  I have no interest in social media for myself.  

Thank you for trying to help.  I will look further into the book.  But the situation looks hopeless to me.

[Neil_1]

G’day LeafMaple  (interesting choice of name by the way – in two and a half weeks, me and my fam are travelling over to where the leaf of a maple tree is on their national flag)

Ahhh, now, could that be where you actually hail from??

Also welcome to Beyond Blue and thanx for coming here and posting.

Doesn’t it suck when you go to something for the very first time and you encounter a bad experience from it.  It tends to put you off for trying to go to that particular thing a second time.  I’m not saying that if you snared a good pysch at that first visit when you were 20 would have made things right – but potentially it could have set you on a better path/journey forward.  Potentially?

Your description of how you were in a professional mindset and yet, you changed massively when in private resonates with me big time and also I’ve heard/read where so many popular actors/actresses, sports people are like this also.  Two different people – yes, I’ve told my psych that particular line for years.   The other thing that I’ve used and many on here have expressed the same is the ‘wearing of a mask’.  So you shield how you really are from the public and once you’re in the privacy and sanctuary of your own home, you can lower the mask to reveal your true self.

And you know, the mask wearing can be very dominating and extremely taxing on the person – you can feel exhausted from being “up” all day and once you get home, you slump down big time.

Aged 70 and fit and healthy and a gym goer … man, that’s what I’m aiming to be as well – currently I sit on the number of 49.  But with the way my body has packed it in over the last couple of months, I’m beginning to wonder if it’s just a pipe dream for me.   So you’ve got the bases covered of doing the fitness thing to assist with the depressive symptoms.

May I ask if you’ve got a current GP or pysch that you see?   Or are you on any anti-depressants at all?

That’s also a damn fine question – is there a cure for someone of your age?   I really don’t know cause I then return serve with … is there a cure for folk who are of any age?  Potentially young ones have a very high chance of overcoming certain symptoms – but again, it would be a case-by-case basis – dependent on what the key issues were.

I want to write more to you and will on another post, cause I think my word counter is near its limit.

Kind regards

Neil

[Leafmaple]

Hi Neil.  Thanks for replying.  I appreciate your thoughtful and friendly answer.  I hope you enjoy my home country.  It is still home to me even though I have lived here longer than I lived in Canada (no complaints, whinges about Oz, it is just not home).  What part are you going to and why?  

Sorry I am late answering I didn't think I would get more replies, so haven't been back for a day or two.  Having had a reasonably good psych the second time around, I have thought many times about the "what if...?" concerning the first one.  The latter was unfriendly, unsmiling, and seemed to think I might be there to get out of assignments.  Of course, I am retired now, but the "professional" life and the private life comments you make are very close to spot on, so it is nice to know that someone else who has lived with that.  When you live with it, you tend to get very egocentric about it; even though you know it isn't true, you (or at least I), tend to wallow in self-pity thinking you are the only one.  I did my job for many years at the same institution, but the day to day job was not a problem for me.  I was a different person, confident to a certain extent anyway, spontaneous and relaxed giving a lecture, for example. Only had trouble in a new situation.  But outside I was hopeless.  Now that I am retired, I avoid social situations as much as possible.  I actually never went to receive an award just after my retirement, because it would have meant attending a conference dinner with strangers I would not be able to talk to.  When social things are unavoidable, I don't handle them well.  I desperately want to sometimes, because I am quite lonely, but the torture in the situation makes me prefer the loneliness.  I presume you are describing yourself when you talk about the letdown in coming home after work; I can really understand how that must be for you, because there are situations where I have to wear a mask, and you are dead right---it is so draining, and almost nothing creates loneliness better.  Does your family understand?  There is an old but interesting play I read years ago about that very thing, The Great God Brown, by, I think, Eugene O'Neil.

Am running out of words. No psych now, GP only for physical problems, no anti-depressants.  Would enjoy chatting with you more, feel it have been self-centered here, but would like to ask you more questions about your own situation too.

Thanks

Leafmaple

Dennis

[JillCameTumbling]

Hi Everyone

this is my first post here despite having come to the website multiple times in search of hopeful or at least empathetic stories. 

I just wanted to say to LeafMaple that I know a little where you are coming from with regard to CBT-  having studied at university for a while and my psych describing me as "highly cortical" I never thought it could truly help me. It also felt to me like telling yourself lies, and that how could I believe these substitutions in thought? Let alone challenge the things I knew already were not helpful to me?? And indeed each time I found myself questioning CBT I felt more of a failure. 

i don't have a lot of time to write this post but I wanted to share a little ray of possibility. I have tried CBT in one-on-one therapy before and found it no good. About 10 years later of recurring/chronic depression I did a 2week intensive group CBT therapy and I feel it has helped immensely. It's only been 3 weeks since I finished it but I feel more hopeful about my future than I have for about 10/11 years. 

If you would like to ask me about it please do. as a possibility, it can't hurt, right?

[Leafmaple]

Hi Jill.  Thank you for taking the time to answer and share with me.  I would love to know more about your experiences with CBT.  In particular, I would like to know what you think the difference was between the one on one therapy and the group therapy.  I would be grateful if you could tell me how the group worked, because I don't usually function well in social situations, and even though a therapy group is not the same, it is similar in a few ways.  

[JillCameTumbling]

Hi Leafmaple

My apologies for the delay in responding - work and so on got in the way. Also thanks internet crashing and forgetting my password!

I found group CBT quite different

1) not all the focus is on you 100% of the time like it is in individual therapy, so in some ways that helps with the anxiety - you can take a break and listen to others

2) the perspective of others; trying to understand their point of view and the group discussing examples can give a different way to see problems or obstacles that is not just from the lead therapist. Also if you can see from the outside how to perhaps break down someone else's problem, it starts to become a bit easier to consider the possibility that you can do it for your own.

3) There's many components to the program. It's not just challenging thoughts. It's life skills like relaxation, learning about yourself and what core beliefs might shape the way you act and think, taking a look at how you communicate with others, identifying trigger situations for anxiety or low mood, and many other things besides.

Of course it's a bit awkward to start, but 99% chance everyone in the group feels the same. It's not easy to break that barrier down you've been building up for so long, but gee it's a relief when you do.

Like other therapy, it does take a bit of work, but there's no rush. Everyone is different. Some people find different components easier or harder.

As you mentioned being from an academic background, it might also comfort you to know CBT has been extensively researched over the past 3-4 decades. There is strong evidence it can help people.

It is a journey, but so is each day.

Best wishes, J.

[BeeGee]

Dear Dennis

I completely relate to what you are saying about social situations being completely draining.  I too am dysthymic (30+ years, just diagnosed) and although I don't mind spending time with groups of people I know well (not too large groups though) I find having to mix with a bunch of strangers horrifying and will avoid it almost at any cost.

I'm sure you've probably already thought through this yourself, but one of the things I want to focus on in my treatment is distinguishing my natural inclinations as a pretty strong introvert from my avoidance tendencies arising from my illness.  I know I am never going to be "the life of the party" - as an introvert I prefer to be with one or two close people, or alone.  But I hope to get to a point where the thought of going to some function where there are piles of strangers doesn't make me want to run away and do something, anything, else.  Reading between the lines I'm thinking you might be an introvert too - would I be right?  I wonder if this might be an issue for you too?  Perhaps this is something group therapy sessions might be good at dealing with as Jill has discussed.

All the best Dennis - I hope you have some success finding a good CBT group.

[Leafmaple]

Hi Jill.  Thanks for your description of the group CBT., and for sharing your experiences.  I noticed in your first message that you said your psych told you that you were "highly cortical".  If by that he/she meant you intellectualize, that is something we have in common.  I have published articles on existentialist themes in modern literature, and my psych said I had analyzed my own problem and pointed out the answer in them.  Those weren't his exact words but that was his meaning.  Intellectualizing is a way for me of preventing action, spontaneity, because spontaneity brought punishment as a child growing up.  

Anyway, I am not sure, but I think I would have huge trouble with group therapy.  The idea of telling others why I think I am pathetic---well, I just don't think I could do it.  One of my major problems is not being able to deal with someone I don't know extremely well.  I can just barely  handle one on one, but a group is beyond me.  

I guess for me , if life is a journey, I am just tired of it because it is a journey that always goes where I don't want to be, and I don't want to travel anymore.  And by that I don't mean suicide, would never do that.  I just mean that I withdrew from the journey as much as possible a long time ago, because it hurt less that way.  But there is a line in an old song of the Eagles: "I guess every form of refuge has its price".  Mine has been very expensive.

I'm going to try an online CBT thing offered by Macquarie uni, not sure why because I don't have faith in the treatment.  I know there has been a lot of research on it, and I can see how it could work for things like phobias, but not for other things.  Have no idea where to find a group thing, but think that would be something I couldn't handle.

However, I am very grateful to you for taking the time to explain your experience, and it is absolutely fabulous that the group experience has helped you so much.  I hope my negativity doesn't affect that, and wondered about responding at all, in case I did have a bad affect on you.  If you have just finished the course recently, you are perhaps still a bit fragile.  But I thought it would be even worse to appear so ungrateful and impolite as to not thank you for sharing that.  All the best, Jill.