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Dysthymia: You Have The Right To Be Happy!

Lauren, 28, struggles remember a time when she didn't feel stressed, anxious or exhausted. Well, actually she can, but she was eight years old and running through sprinklers in the backyard so it doesn't really count. For the most part, she trudged through school, university and work feeling like she had a huge weight on her shoulders.

"It was as if I had a bubble of fuzz around me that made everything I tried to do 10 times harder and less enjoyable," Lauren remembers. "I would get through the day without major dramas, but I was always tired and emotional. I'd think about going to the gym but decide I couldn't be bothered. Then [I'd] get annoyed at myself for being unfit!

Even going to a bar with friends required a huge effort; I hated having to get ready and find my way there. Then I'd stand around feeling so self-conscious that, in the end, I just stopped going. I was sad and irritable 24/7 and I thought it was normal." Can you relate? You're not alone.

A nationwide mental health survey found that cases of anxiety and depression are higher in Singapore than other Asian countries, such as China and Japan. More than five percent of Singaporeans suffer from depression. What's more startling? Dysthymia, or low-level depression, is most common in young women.

Dysthymia is diagnosed when someone has been in a state of continuous angst or despair for longer than two years. Sufferers experience tiredness, moodiness, under- or overeating, boredom, muscle aches and low self-esteem. Don't be fooled by the "low-level" tag, dysthymia can be a real serious condition.

"The ugly thing about dysthymfa is that it's chronic," says Dr Bob Murray, co-author of Creating Optimism (A Proven Seven-Step Program For Overcoming Depression) . "If left untreated, it can last for years with little to no relief. You may not get the extreme highs and lows common to major depression instead, you're always down."

Depression is thought to be caused by a combination of genes, personality and life experiences. Most sufferers can't pinpoint a specific time when the blanket of gloom fell over them; it just develops from persistent stress and worry. It can, however, be triggered by traumatic childhood events and stressful experiences, like breaking up with your boyfriend or losing your job, both of which can exacerbate the problem.

Ashley, 33, believes her battle with dysthymia was sparked by the loss of her fiance in 1994. "I think the problem started with Ryan's death, but weight issues and stress at work made it worse," she says. "It really affected my relationships. My best friend even told me she didn't want me as one of her bridesmaids in case I spoilt the wedding.

Since being diagnosed, I've done loads of research and found lots of ways to help myself. My mum has been really great too. When the going gets tough, you realise who your friends are." Christine, 19, suffered from depression in her last year of high school.

"My boyfriend and I were rock solid and talked about finding a place together and getting married," she says. "Then I found out I was pregnant. We both knew we couldn't keep the baby it hurt me so much to let it go. It was all I could think about for weeks afterwards.

I gradually slipped into a depression. Somehow, with the support of my family and some wonderful teachers, I got through that year with fairly good points. Not getting help earlier is my biggest regret. I still have good and bad days, but I'm much better than I used to be."

Beating The Blues

The good news is that low-level depression is very curable. However, it's important to attack it head-on, because the longer you leave it, the worse it gets. "Depression is a bit like cancer - if you leave it alone, it really takes hold," says Melbourne psychiatrist Dr David Horgan. "There's also a good chance that if you don't treat it properly the first time, it'll come back around."

So how do you know if you're at risk? Feeling tired and miserable are key symptoms, but the main thing to look out for is any change in behavior. Have you stopped going out? Has your health taken a dive? Do you feel any different? If just getting out of bed in the morning is an effort, it's time to make some changes. Start by saying yes to everything.

Accept all invitations and get into the habit of calling a friend once a day. Remember, the best defence against depression is making time to enjoy life. Make a date two nights a week to have dinner with someone. Go tenpin bowling on the weekend, take a 20-minute walk after work, cook a barbeque lunch in the backyard, visit the markets - just getting outside and being active will lift your mood instantly.

More strategies: Eat healthy food, look after yourself and work on boosting your self-esteem. "Don't let anyone put you down," advises Dr Murray. "And we're usually our own worst enemy. So ask your pals to pick you up on any negative self-talk." Other must-avoids:  alcohol and drugs - you don't want even more factors screwing up your chemical balance.

Did you know that marijuana doubles the risk of getting majorly depressed? Also, come-downs after use of ecstasy and amphetamines will only sink your energies further. Make these blues-beating changes for longer than eight months and they'll become part of your lifestyle. If you don't see your condition improving, visit your GP for further advice.

You could also find it helpful to visit a therapist who can listen to your troubles, offer you comforting words, and help you sort through all the emotions you're having. No one should go through life constantly unhappy. Put on those fighting gloves on and give beating the condition your best shot.

Lend A Hand

If your friend is battling dysthymia, the best thing you can do is to understand that depression is an illness she can't always control. With your support, she can overcome it.

Here's How You Can Help

Do Let Her Know It's Ok That She Has Depression

She doesn't want to be treated any differently just because of her illness. If the people around her are comfortable, it makes talking about the situation easier when she's ready.

Do Encourage Her Gently

Be it visiting a doctor or watching a movie, you can't push her into something she's unwilling to try. Show support when she mentions an activity and let her know you'd be more than happy to accompany her.

Do Congratulation Her On Taking Little Steps

Lack of motivation and lethargy are part of dysthymia so if she starts doing even the smallest thing, such as agreeing to have coffee with your usual bunch of friends, say something like, "Everyone's excited to see you again!"

Do Have Faith In Her Ability To Get Better

Though she may feel that her condition's hopeless, your steady optimism (try suggesting a beach holiday together when she recovers) could be the dose of sanguinity she needs.

Don't Tell Her To Snap Out Of It Or Cheer up

It's not a matter of her having an ordinary bad day or throwing a tantrum. Depression is a medical condition, wherein chemical imbalance is affecting her emotions.

Don't Feel Bad That You Can't Do Anything

Just as her dysthymia is not her fault, neither is it yours. She'll feel worse when she sees that she's dragging everybody down.

Don't Keep Asking When She's Going To Get Better Or How Her Treatment Is Coming Along

Recovery from depression requires time and the length differs for each person. Adding more pressure could only delay the process. Just continue offering your support until she can pull herself up on her own.

How Is Dysthymia Different From Other Types Of Depression

Major depression is severe and brief in duration, lasting several weeks or months. Symptoms include a sharp drop in mood and it might be accompanied by poor sleep, loss of appetite, weight loss, hopelessness or suicidal ideas. In contrast, dysthymia is milder on a day-to-day basis and it lasts for years, even decades. But it should not be slighted: dysthymia is a severe disorder, leading to higher rates of suicides than major depression.


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