Conversation #3
Persistent Depressive Disorder

How are you feeling today?

A question we get asked almost every day. Sometimes people will ask you out of politeness, sometimes they will ask you sincerly. Usually it’s the first, or at least we tend to think that and therefore do not answer in all honesty. Or maybe we don’t answer honestly because we fear that we have to talk about or feelings? But what if you couldn’t really give an answer because you don’t know how you feel or you don’t know why you feel the way you do? Or what if you are not aware that what you are feeling is depressed because it has always been this way?

In our next conversation, we will talk about living with Persistent Depressive Disorder (PDD) or formerly known as dysthymia. The word dysthymia origins from the ancient greek word dusthumía, which translates roughly to ill-tempered soul. PDD describes a depressive disorder which is characterised by a persistent depressive mood, which does not meet the critierias of major depression. Additional symptoms are low self-esteem, anxiety and troubles sleeping. The symptoms can already start during childhood or adolescents and usually it takes years until those affected by it get a diagnosis. Usually the treatment consist of psychotherapy and medication.

But to gain perspective of what it really feels like to suffer from PDD, we had a conversation about it.
[Trigger warning: This conversation mentions self-harm, substance abuse and suicidal thoughts]

Conversation #3 about Persistent Depression Disorder

What would be the title of your autobiography?

I survived.

When did you realize that you struggle with something not everyone struggles with?

When I was around 14 or 15 years old.  During therapy it became clearer to me that I might have been depressed since I was 8 or 10 years old.

How does it affect your everyday life?

It affected my ability to sleep at night. Sometimes I didn’t have energy to begin my day in the morning. I was feeling anxious all the time. Plus in my teenage years I was cutting myself, drinking a lot of alcohol and consuming marihuana.

How did your family & friends react when you told them? What impact did it have on you?

Actually they were very surprised. They never realised that something was wrong with me, they just thought it was a youth thing. A call for attention, they never realised that I was self harming. I felt lonely and worthless.

What was the most valuable advice anyone has given you?

“You cannot change other people, or people’s minds, but you can change how they affect you!”

What did you discover to be a helpful coping strategy?

I read the Kibalion and I found an explanation about the world. Something like: There are ups and downs, positive and negative and that life is like a pendulum. I compared it to my moods: Sometimes I felt super good, sometimes I felt super bad. So one way to think about it was: I could go to extremes and take a swing on the pendulum or I could decide not to, but it depended on what I wanted. But what really helped me were my therapies. One with a psychologist and one with a psychiatrist who prescribed me antidepressants.

How did it feel to reach out for help? Did anything make it easier for you to do so?

Well, I was falling in love with my now husband, and thought I was going to ruin that relationship like so many others before if I didn’t work on my mental health. Additionally, one day I  realised that if I didn’t find professional help as soon as possible, I was going to kill myself sooner or later.

Could you describe in one sentence what’s it like to live with PDD?

Before treatment it was like living in the dark, where sometimes I couldn’t even breathe. Living like this for years and years was exhausting. Now I see it with a little more distance, but I’m always afraid it might come back if I don’t pay attention. So I see it almost like an addict: Today I’m fine, and tomorrow we will see.

Is there anything that still bothers you about having to live with PDD, but you made your peace with it?

I don’t know if it’s related to the dysthymia, but sometimes my neurosis is kind of too much for me. I need to have control over certain stuff. Also I can’t break my routines because it makes me very nervous and uncomfortable

What’s something you want people to know about your condition?

Depression is real, we are not looking for attention and it’s not something we can decide to have or control.

What’s a positive thing about your illness? How did it have a positive impact on the person you are today?

I try not to take everything so seriously. Always try to see the life with humor (dark humour too) and the knowing that it can be treatable if you look for profesional help. I am also very open to other people about mental health and encourage them to open up and talk about it and if posible look for a good therapist.

Thank you!

If you recognize yourself or a loved one in this conversation, please don’t hesitate to seek help by a professional. Psyonline is a website that helps you find a therapist. In acute crisis you can call the Kriseninterventionszetrum or the Psychosozioale Notdienst. 

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About Julia Unteregger

Julia is a writer and a mental health professional. In her free time she likes to hike, even though she fears heights. She also drinks a lot of coffee and plays an excessive amount of solitaire.

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