• Anonymous
      September 10, 2009 at 4:08 pm

      It sounds like a city in Greece. Have you ever been to Dysthymia? It is such a fun place to visit- I take all of my vacations there!

      No, it’s not a city, but I do seem to reside there. One might say it is a state of mind, but there is more to it than that. Depression is such a generic term the medical community must carve it up, to get a handle on what it is to be depressed so they can charge insurance companies when they treat the disorder. There are so many ways to look at depression, but no matter what flavor you have… it is no fun being depressed during an economic depression.

      It seems I suffer from Dysthymia, my spectrum of the rainbow. The Wikipedia folk have a fine write-up over there and it is as good place as anywhere to get started. It is considered “a chronic depression, but with less severity than major depressive disorder. This disorder tends to be a chronic, long-lasting illness.”

      “Dysthymia is a type of low-grade depression. Harvard Health Publications states that, “the Greek word dysthymia means ‘bad state of mind’ or ‘ill humor’. As one of the two chief forms of clinical depression, it usually has fewer or less serious symptoms than major depression but lasts longer.” Harvard Health Publications says, “at least three-quarters of patients with dysthymia also have a chronic physical illness or another psychiatric disorder such as one of the anxiety disorders, drug addiction, or alcoholism”.

      “The Primary Care Journal says that dysthymia “affects approximately 3% of the population and is associated with significant functional impairment”. Harvard health Publications says: “The rate of depression in the families of people with dysthymia is as high as 50% for the early-onset form of the disorder.” “Most people with dysthymia can’t tell for sure when they first became depressed.”

      Here are a few of the key symptoms that might offer clarity, with my comments in parenthesis:

      [B]Feelings of hopelessness[/B] (not sure if I can continue writing this thread).

      [B]Insomnia or hypersomnia[/B] (Sleep apnea since I was a young adult- I am now fifty years young).

      [B]Poor concentration or difficulty making decisions[/B] (I guess I should include this symptom, but I am not sure where to place it in this list) (I guess I should include this symptom, but I am not sure where to place it in this list)

      [B]Low energy or fatigue[/B] (/me takes nap before writing next line)

      [B]Low self-esteem[/B] (I am a good person no matter what I think others see in me)

      [B]Poor appetite or overeating[/B] ( OK, late night cookies have not been kind)

      [B]Decreased concentration and decisiveness[/B] ( I’m not sure what to say here, other than that I have a tough time with complex tasks like writing… hmmm,, what next…)

      [B]During a majority of days for 2 years or more, the patient reports depressed mood or appears depressed to others for most of the day[/B] ( try twelve years… two year sufferers are rookies!)

      [B]The patient has not had any Manic, Hypomanic or Mixed Episodes.[/B] ( I plan to be a hippomaniac in the future)

      [B]In contrast to major depression, these symptoms may not always result in clinically significant distress or impairment in social, occupational, academic, or other major areas of functioning (APA, 2000).[/B] (They haven’t taken me to the big house yet because I am always one step ahead of them!)

      [B]People suffering from dysthymia are usually well capable of coping with their everyday lives,usually by following particular routines that provide certainty.[/B] ( I am certain of my chronic routine of feeling depressed, if that counts. Besides, this seems like more of a statement than a symptom).

      There you have it. If you have these symptoms welcome to life in Dysthymia, where a vacation means sleep, for it is the only way to get out of town. That is, other than the once in a while distraction that feels like depression took a holiday. Otherwise, part of me wishes I just had a major depression, so I could have at it and be done with it. My, don’t I sound dysthymic! LOL

      I’d imagine the reader must think me strange to tout on about depression, but I have a reason and purpose- when I can cut through that fog of indecisiveness and muddled concentration. You see, I present a difficult case and think my mental health providers experience difficulty with the reality of my clinical profile because I was afflicted with GBS twelve years ago.

      When I talk with my psychiatrist and therapist about chronic fatigue I can tell by their comments that they attribute it to feeling depressed. It is frustrating in that a behavioral treatment for fatigue related to depression is exercise and increased socialization. They say, “Get some exercise and the fatigue will go away… it is your metabolism” or “Perhaps it is a feeling you use in the form of defensive isolation… go to a party and have some fun!” I try and educate them somewhat about GBS and fatigue, but it is a tough thing to understand. Heck, my family does not understand the residual of fatigue, so I can’t expect mental health pros to get it.

      Sometimes I fool myself into thinking I am not fatigued, just a lazy person. Perhaps my fatigue is part of my depression, that if I can receive the correct treatment for my mental disorder my body will feel better. I could then become more social and do the things I want to do, things I did prior to GBS. Am I suffering from chronic fatigue or am I just some fool who thinks he is tired all of the time? Perhaps this residual is merely in my head? Rats, there goes that mental confusion again!

      Most recently, my psychiatrist suggested I try Methylin, an off brand of Ritalin, for my fatigue. It did not help at all. In fact, I felt like I drank 100 cups of coffee and I had tremors in my fingers, from which I found it impossible to write. Yikes. My guess is that it probably helps some depressed people gain the energy required to tackle the day, but not me. (I do take Wellbutrin, which seems to help ease my depression- more so than the SSRI antidepressants).

      What percent of the GBS Residual Fan Club suffer from Dysthymia? Are you in treatment? If so, what medications and form of psychotherapy helps? Any magic cures for chronic fatigue? Does it matter from the perspective of mental health treatment if fatigue comes from depression or POST GBS residuals?

    • Anonymous
      September 10, 2009 at 8:37 pm

      Hi Rocker: I read both your posts with interest and amusement. I just have two comments. First, there is a tremendous amount of interest and some research beginning in earnest about GBS that might be brought onto the site. For example, this summary of a project done this year:
      Objective Guillain- Barré syndrome (GBS) and poliomyelitis may cause life-long health problems. We studied fatigue, pain and muscular weakness in both conditions to define possible interactions between these symptoms and their influence on residual disability and daily functioning.
      Methods We studied 50 patients with previous GBS, 89 patients with a history of poliomyelitis and a reference group of 81 people with similar sex and age and no history of poliomyelitis or GBS using the Fatigue Severity Scale, self-reported pain and muscular weakness Disability Rating Index, and Positive and Negative Affect Schedule (PANAS-X). We assessed the quality of life using the SF-36 Health Survey.
      Results The mean score on the Fatigue Severity Scale was significantly higher in the GBS and poliomyelitis patients than in the reference group. This was true also in the subgroups of mild disease, i. e., nonparalytic polio and initial Hughes score less than 3 in the GBS group. Thirty-four percent of GBS patients and 63 % of poliomyelitis patients reported pain; 13 % of GBS and 36 % of poliomyelitis patients reported residual muscle weakness. Fatigue, pain, and muscle weakness interacted in both diseases. Perceived health problems influenced all aspects of the quality of life except mental health in both diseases.
      Conclusions Fatigue, pain, and muscle weakness are common sequelae after GBS and poliomyelitis. The symptoms interact with each other and contribute to long-term disability.

      Nothing we don’t already know, but you can tell your critical voice that says you are just lazy that in fact we are disabled, to one degree or another, by residuals that research is finally beginning to validate. There is research you can show your shrink or doctor if they don’t get it.
      About depression and fatigue, they can overlap in terms of their symtoms. You can mistake fatigue for depression and depression can look like fatigue, but their causes are very different. A good therapist working with fatigue would not help you get over it, but learn to live with it. You can’t make fatigue go away by doing things, even though sometimes doing things makes you feel better.
      I am searching for more research being done and will report on it from time to time. I know I don’t post as much because there are many others who can educate newbies just as well as I can or better.

    • Anonymous
      September 11, 2009 at 2:15 pm

      Hey there, Jeff. Thanks for the reply. I appreciate the feedback.

      Interesting study, which validates the premise that I am not just lazy. :confused:

      Please keep me posted on other findings as you search. I posted a thread some time ago with a list of research papers concerning fatigue and depression, but it got swept under the carpet; there might be something there you might find useful. Let me do a little digging here to see if I can find it….

      OK, I’M back 🙂 Here is the link:


    • Anonymous
      September 11, 2009 at 11:30 pm

      Rocker, You have a Way with words and meanings!!!!:D I think I smiled at a few of those !!! just too lazy to laugh out loud!!;) I was told I was mdd because I laugh and smile and joke about my health issues!! soo keep this post underwraps !! Hugs!!:D

    • September 12, 2009 at 8:17 pm

      based on the descriptions, we ALL suffer from this to some degree. Sheesh, nice to find another definition for our daily struggles. I like your replies, made me smile. Maybe we should each add our own. Not to make a joke out of something serious, but to find the bright side in all of it.

    • Anonymous
      February 24, 2010 at 10:22 am

      I would like to thank “Rocker” and Jeff for their facts and humor as thats how I look at life. This “site” has helped me tremdously over the past few days in dealing with on going residuals. Thank You, Thank You, Thank You!!

    • Anonymous
      February 24, 2010 at 5:59 pm

      I too have been dx with that as well.