Dysthymia: What hides in plain sight

Dysthymia: What hides in plain sight

Do you know what High Functioning Depression is? Have you ever heard about it, or come across this term? If it sounds like a new age term, it’s probably because that’s exactly what it is. High Functioning Depression is not an official clinical diagnosis, but more of a popular term that has begun popping up. The official diagnosis is called Dysthymia.

Now, if you Google ‘Dysthymia’, the definition you’ll come across is “persistent mild depression”. They key word here not being ‘mild’, but ‘persistent’, because the required duration for this diagnosis is 2 years. Keep in mind that when we say ‘mild’, we are in no way downplaying the level of discomfort, but it is more of a way of saying that it very easily goes overlooked. It’s an illness that doesn’t present itself as severely or openly as any other form of depressive disorder. It just makes the daily life and daily tasks a bit more harder to deal with and it becomes a lot more difficult to manage.

The thing about Dysthymia is, that it’s a high functioning disorder, as it’s alternative name suggests, which means that the symptoms usually go unseen, unless you know what to look for. People with High Functioning Depression or Dysthymia, seem to be functioning normally in their daily lives. They go to work or school and socialize when necessary, but as soon as their social responsibilities are over they recluse themselves and withdraw from everyone. They may not feel as helpless as those with clinical depression, but their quality of life is greatly affected. They don’t feel sad so much as numb to any and all emotions. They avoid social situations as much as they possibly can without raising any red flags. They show a high level of negative self-criticism and cynicism in their daily life and feel extremely misunderstood and isolated. They have excessive pastimes, like binging TV shows or playing videogames for hours on end. They have extremely irregular sleeping and eating patterns and you will often find them being irritable at the smallest amount of stress, or indulging in unhealthy coping strategies like abusing alcohol or any kind or drug. You’ll find them tossing and turning all night long worrying about things they’ve done or said in the past, or about how they’ll hand in their assignments next week, or if they’ll have a future or not. Sometimes you’ll find them using extreme forms of dark humor or forms of sarcasm about how worthless they are or how they are not needed by the people around them. They will keep distancing themselves from any form of meaningful relationships, because they claim they don’t need them and they are happier alone.

If you look at the symptoms of High Functioning Depression, they are pretty similar to any other depressive disorder, just milder in their presentation. In fact, as mentioned before, if you don’t know what to look for, they often go unnoticed, because on the surface, it looks like the person is doing just fine. But on the inside, they feel suffocated, like whatever they do is of no use, like no matter what they do it won’t amount to anything and that the world will be a better place without them. They will always feel a bit reluctant to get help because they feel like no one will understand them, not even professionals and will be skeptical of anyone who tries.

It’s illnesses like these that need to be handled with care and patience because even though the individuals themselves know that their thoughts are irrational, as a consequence of their condition, their cognition are hampered and even the most irrational thought starts to make sense and seems valid, and that’s where the danger lies.

That’s the thing about mental illness, it plays with our cognition, or our perceptions. It dulls it or twists it to fit the distorted thoughts we have. For instance, if our friends cancel on us at the last minute we’ll feel like they don’t care about us, but that thought will be countered by our knowledge that our friends love and care about us and it’s just that something came up that they couldn’t get out of. On the other hand, a distorted cognition will have us believe that our friends truly don’t care about us at all and that they would be better off without us, no matter how much evidence we have contrary to that belief.

When our ability to think logically is taken away from us, we’re left at the mercy of our imagination, which is a dangerous thing, because when battling mental illness, our view of the world is more often than not painted in dark and vicious colors and no amount support or logic from the outside world is enough to break through those.

It’s difficult to explain and write about mental illness because no amount of words, no matter how fancy, will be able to make someone else feel what the person has gone through themselves. However, we still try, because that’s all we can do. We can try to make people understand even at the cost of facing criticism and having people tell us “it’s all in your mind”. But you see that’s the problem. How do you expect us to fix something that’s inside of our mind? Because let’s face it, our mind is the only place where we are ever truly alone. No one can look into our minds and see what we have seen or feel what we have felt. So we try and put our experiences into words, hoping that our thoughts and feelings will come across in the way we want them to, hoping to reach out to those who need us and who we need.

About the Author

Arunima Gitai
Psychologist.

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