But I Don’t Feel Depressed!

Posted by on Jun 4, 2014 in Depression, Dysthymic Depression, Mental Health, Therapy | 0 comments

Friends or relatives often give advice to someone that they should go to counseling for Depression, but sometimes that person doesn’t believe that they are depressed.  At times a person has lived with depressive symptoms for so long, that how they feel just seems normal.  This is especially true with a form of Depression called Dysthymic Disorder – which is sometimes referred to as a “Low Grade” depression.  While in some ways the symptoms of this kind of depression are less severe and dramatic, this Dysthymic depression can gradually have a debilitating impact on a person’s quality of life and a negative effect on their relationships.

The person experiencing this type of depression is often able to function, get through their day, but everyday life is more of a difficulty.  They may feel like they are functioning at a high level, but other people around them report that they are not fun to be around.  The person with Dysthymic depression may be seen as negative, grumpy, moody, or detached and aloof.   This type of depression by its very definition lasts for years, and is often life-long.  It often starts in childhood or adolescence, and many clients tell me “I’ve always felt this way, I just thought it was normal.”   What does this low-grade depression feel like?  Usually people describe it like this:

“Day to day tasks feel like a struggle.”

“Everything is always a problem.”

“I have a hard time making decisions.”

“I get irritable or annoyed by a lot of little things.”

“I’ve never slept very well.”

“Everybody else has it easier than I do.”

“I’m not really very good at anything.”

“Nothing is ever going to change.”

“I’m good at pretending everything is fine, nobody knows.”

Friends or family members might frequently note that this person needs to lighten up or enjoy themselves more.   They may need encouragement to go out with friends.  Spouses often give feedback stating that their significant other is always the negative one, or always frustrated and irritable.   They might do well at work, but they assume they are not thought of well by their boss. They might believe there is no hope for promotion.  They might avoid old friends or become increasingly isolated assuming others don’t want to be around them.  If you ask this person about the future, they will probably tell you that things won’t get better, but “that’s just how life is”.  The glass is half empty; however, they may say they are just a realist. Their motivation is to get through the day.   There are no long lasting happy times, but also no severe down turns. In general, life is blah, mundane.

People with Dysthymic Disorder may be successful – but often not as successful as they could be.  They get through school, go to work, have marriages and kids – there are often no “red flags” or warning signs.  A person with Dysthymic Depression will not be found lying on the couch all day, or crying themselves to sleep every night. If they are suicidal, it might be a “passing thought” that they’ve had for years that they’ve never talked about. There may exist a “who cares” mentality. While others might worry about getting cancer, the person with Dysthymic Depression might think “well, so that would be the end, I’d be OK with that.”   There is often an attempt to self medicate.  A person with Dysthymic Depression may be more likely to get substance abuse treatment than mental health counseling, because it is the substance abuse or dependence that begins to cause major life problems.

Dysthymic Disorder Symptom Checklist:

Chronic, depressed mood for most of the day, for more days than not, for at least 2 years. (In children and adolescents, the mood can be irritable and duration must be for at least 1 year.)

The person goes no more than 2 months without experiencing two or more of the following symptoms:

  • Poor appetite or overeating
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness


While medication can help improve symptoms, therapy can help people make long lasting changes to negative thinking patterns and behaviors. Without treatment, this type of depression (as with all depression) can become debilitating and possibly life threatening.  While usually chronic, Dysthymic Depression is highly treatable.  When thinking and behavior patterns change, people begin to see that life can be enjoyable and fulfilling. Relationships can improve and life does not need to be a constant struggle.  If you believe that you or a loved one may have Dysthymic Depression, mental health therapy can be extremely helpful.

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