Depression is one of the most common mental disorders, with approximately eight per cent of Canadian adults experiencing major depression at some point within their lifetime. But there are ways in which depression affects individuals that can vary greatly from person to person.
Depressive disorders are usually divided into two major categories, with smaller subtypes within them. Major depression is characterized by symptoms so severe that they drastically interfere with an individual’s ability to sleep, eat, work, study and generally partake in life. Symptoms can take place in a single episode, or in multiple episodes over one’s lifetime.
This is the kind of thing we think of when we think of “depression:” major, life-altering and extremely noticeable. But for some, depression doesn’t come in episodes; rather, it comfortably settles into the background for the long haul, like the drone of a 24-hour news channel that someone forgot to turn off.
This is what psychiatrists call persistent depressive disorder, or dysthymia. Those with persistent depressive disorder can be affected by many of the same symptoms as those with major depression — fatigue, loss of interest, lack of concentration, changes in appetite, feeling hopeless, and so on — but with less intensity and greater duration. Persistent depressive disorder is characterized by mild depression symptoms that continue for two years or longer.
There was never exactly a time where I would call myself “depressed.” It wasn’t a label that seemed to fit, personally or practically. My symptoms were never bad enough that I couldn’t keep up with school, hold down a job or maintain basic levels of self care. Other mental health issues like anxiety? Sure. But depression? No.
On the outside, I look like a pretty successful — albeit tired and somewhat scattered — human being. Behind the scenes, it’s a bit of a different story. Some days, I’m so tired that I can barely get out of bed — but I almost always do. I never stop eating entirely, but sometimes I forget to eat or replace meals with coffee. I’ve never had to withdraw from university or quit a job, but I do have trouble managing workloads and deadlines. I’ve never felt entirely hopeless, but I do wonder why I rarely seem to be happy with what I have.
You just get used to feeling like crap most of the time and writing it off as normal, because that’s how you always feel. High-functioning depression becomes your normal, and you find ways to live with it or work around it. Papers still get written, even if they’re not proof-read and turned in late. You still volunteer for a million things but leave feeling drained instead of fulfilled. You date people but get very good at hiding the shitty version of yourself from others.
For a long time, I figured that my shortcomings came from just being too lazy to do better. I just needed to plan more, stay up later, work harder and things would be easier. The solution to my problems was just to work harder. Duh.
When my therapist first raised the idea of persistent depressive disorder to me, I was confused. Again, I never felt like I fit within the regular definition of depression. But the more she talked about it, the more it made sense with the patterns that I’d noticed in my life and the things I’d been feeling.
Living with high-functioning depression, dysthymia, persistent depressive disorder — whatever you want to call it — brings it’s own set of unique challenges. Like any mental health issue, it never really goes away. But now I have a name for it, and that makes a difference. Abstracts are scary, but if you can name something and identify it, then you can finally start figuring out how to move forward.
And I am moving forward. Still high-functioning, still depressed, but equipped with ways to reconcile those ideas and make my life better.
Image: Kelsey Philipchuk