Thursday, May 24, 2012

Swing at that ball: Coping with chronic depression

I was 20 years old, walking across my college campus, in front of one of the main buildings. I don’t remember where I was going and or where I was coming from. What I do remember is thinking, I don’t look forward to what the day might bring anymore.
I no longer thought of the day as open to anything good or surprising. It was open to only the same thing, the numbness and sadness I felt everyday.
That is my personal definition of dysthymia.
My therapist has diagnosed me with dysthymia, or chronic depression.
From what I’ve learned in therapy, chronic depression is not an unending bout of deep depression that leaves me unable to function.
Rather, it is a consistent and constant low mood. I may drop into deep depression, but when it improves, it will improve only so much. My mood doesn’t lift above that low level.
My therapist said one of the hallmarks of chronic depression is a sense of hopelessness and of helplessness. People with this disorder tend to believe that no matter what they do, it won’t make a difference. They may stop even trying.
Hopelessness is what I felt that day on campus. No more hope that the day might bring something good.
Another characteristic of people with chronic depression is that they sometimes can’t even pinpoint what they want, because it has never been about what they want. They’ve never seriously considered it, because, again, what good would it do?

My interpretation of chronic depression.
According to the National Institute of Mental Health’s website, dysthymia is defined as “depressive symptoms that last a long time (2 years or longer) but are less severe than those of major depression.”
I like to look at a list of the main signs of depression every now and then and remind myself that it is a disorder with symptoms, not just a word we throw around to describe a bad day.
The NIMH website provides the following information about the symptoms of depression.

Different people have different symptoms. Some symptoms of depression include:
*Feeling sad or "empty"
*Feeling hopeless, irritable, anxious, or guilty
*Loss of interest in favorite activities
*Feeling very tired
*Not being able to concentrate or remember details
*Not being able to sleep, or sleeping too much
*Overeating, or not wanting to eat at all
*Thoughts of suicide, suicide attempts
*Aches or pains, headaches, cramps, or digestive problems.

How has having chronic depression affected my life? I think about that often. And I wonder what my life would have been like if I didn’t have OCD either.
Being depressed and having OCD have affected my life in some concrete ways.
For example, I never finished my doctorate. I was so close. I was ABD, which stands for all-but-dissertation. But I never finished—I never really started writing—my dissertation.
I also never aimed high in my career. I stifled what I really wanted to be—a writer—and did what was safe. I spent years working as a public servant, first at the state employment agency and then as a health educator for the health department. They were rewarding jobs in their own way, and I enjoyed much of the work, but it wasn’t where I wanted to be.
And my interpersonal interactions are affected by chronic depression. I tend not to ask enough questions of others. I make a lot of assumptions. I stuff a lot of anger instead of expressing how I feel because I fear conflict.
The thought and behavior patterns that perpetuate chronic depression run deep, but we can learn new ways of thinking and behaving.
I want to get out of this cycle of chronic depression, deep depression, back to chronic depression. I am afraid that I never will.
But with the CBASP therapy (Cognitive Behavioral Analysis System of Psychotherapy), and what I’m doing on my own with study and practice, I am trying.
My therapist loves the analogy of the baseball player who is afraid he won’t hit the ball. He’s so afraid of not hitting the ball that he won’t even try. So he’s guaranteed never to hit the ball.
But if he goes up to bat, and practices good form, and makes an effort, he might hit the ball. Even if he doesn’t, he tried.
I’m up at bat, and I’m practicing good form. I’m doing the therapy assignment each week, and my therapist and I work hard during each session. I read, I listen, I think, I write. I practice what I’m learning.
And I am getting better. I am feeling more positive. I have more energy. I’m stopping the negative thinking more quickly.
I still have doubts. I still get anxious when I think about the possibility of not getting a lot better. I worry about not trying hard enough, or not doing the right things, or missing something vital my therapist tells me, or not understanding the therapy.
At least part of that doubt comes from my obsessive-compulsive disorder. I want to ensure there is no miscommunication. I want to make sure I’m not doing something wrong. I’m obsessing over it.
But despite my fears, I am doing my best. I will arise above that low level.
And I will look forward to each day.

Is there something you are up at bat for? How do you practice good form and swing at the ball?


  1. I like the baseball player analogy - it's a good one!

    1. My therapist uses it a lot. I'm not a baseball player, but it is an analogy that works for me.

  2. Tina,
    I was diagnosed with dysthymia as well and it takes a lot of self-talk at times to convince myself not to go down that depressive path and to look at the positives. It's a very interesting thought process...I know when I am in the midst of it and finding it necessary to get to the other side so I don't spiral down. Can you go back and finish your Doctorate? Do you have that desire? when I don't go to bat, it's because I'm afraid of failure...

    1. Tracy, I am learning how much self-talk and self-awareness it will continue to take to deal with the dysthymia. It is interesting when I realize what thinking pattern I'm in even when I'm in the midst of it.

      It's long past time for me to be able to finish the doctorate, because I started the program in 1987. I think I had 8 years to finish it. I wouldn't get a doctorate today. I don't want to teach and the things I want to do wouldn't require it. I would more likely work on a another master's in another subject.

      Fear of failure keeps me from going to bat, too. I think the sense of hopelessness feeds into that fear.

  3. I like how your posts always seem to be looking forward to better days and times and seem to highlight that you are always doing your best. I find that very inspiring my friend.

    1. Thank you, Keith. I do have optimism, sometimes to my great surprise!

  4. Tina,

    This is such an informative post.

    I suffer more anxiety than depression but my brushes with depression are awful! I would hate to have to deal with it every day.

    I really admire you for your positive attitude, introspection and hope.


    1. Thank you, Elizabeth, and hugs back to you! I am so glad that you are starting to feel better.

  5. I have had chronic depression from about when I was 9 or 10. For the most part, I was still out and about with a constant cloud over me.

    I consider my depression my shadow. It lurks in the background, ready to pounce. Sometimes it is more visible but it is always the shadow in the corner.

    1. Jen, That's a vivid picture to me, of the shadow in the corner, always there. I see my depression as a gray, sometimes black, haze that falls over me.

  6. Tina, I'm so sorry about the depression. I know how awful and never-ending it can be. I'm proud of you for fighting anyway. Your therapist is so right. If you never swing, you are guaranteed to never hit the ball. You should really feel good about everything you are doing. It is really hard to do those things while in depression, but you are swinging every step of the way. I really believe you will enjoy the benefits of your hard work soon.

    The way I keep swinging is to stay involved with OCD stuff as much as I can. I have to keep it at the front of my mind, or else it would be too easy to slowly slide back into compulsions. I do this by blogging, reading blogs, attending support group, reading lots of stuff about OCD, going to conferences, etc. One of the things I should be doing, but have not been doing very much, is trying new ERPs. Oh, I've done little ones here and there since my therapy ended, but I really need to become more purposeful about it. Thanks for this post, it's making me think about some things I need to do!

    1. Sunny, Thank you for your encouragement, which you so often give!

      You are doing many fine things to keep up with what's going on the OCD world, helping others and working on your own stuff. I understand wanting to be more purposeful with the ERPs. It is so easy to drift away and get caught back up in compulsions.

  7. Tina, this post is a home run! I'm so appreciative of your honesty and hard work. By sharing your journey you are not only helping many people, but inspiring them to step up to the plate too. I am sending positive vibes your way for your continued progress.

  8. This blog is your dissertation! You certainly earned it!

  9. What I like about your writing is that you really bring us into your world. While I can't relate to depression (I have anxiety), I had the sense for a moment that I was walking in your shoes. I'm so glad that you're sharing with all of us!

    1. Nadine, Thank you for your kind words! I'm glad my words had that effect--it's what I'm trying to do!

  10. You wanted to be a writer, Tina? Well, You ARE a writer! And your writing helps more people than you probably realize. Thanks for sharing your journey with us......and I'm so glad you keep coming up to bat!

    1. Janet, Your words are so encouraging--more than you know! Thank you for your part in my journey!

  11. My therapist told me once: forget the diagnosis of having a chronic depression and just think of it as part of being who you are.
    I hated that. why should it just be part of who I am and I asked her to explain. She said you will never get better, you will never feel better,. You are like that just like another person would be funny or entertaining. You are depressed. It might be true that I will always be depressed, but itgets better when you adapt and learn to cope with it by doing what you know helps you feel better

    1. Nikky, I have hope that I will feel better--I'm actually starting to. So I know you can feel better too. You're right--we may have depression, but we can do things to feel better and be better.


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