Subtle sadness: Why dysthymia can be often overlooked and really shouldn't be

This week marks Mental Health Week, a national attempt to raise awareness, erase stigmas and remind those struggling with such issues that they are not alone. It's estimated that 1 in 5 Canadians will experience mental health issues this year and that, by age 40, half of the country's population will have or have had a mental illness. While there is ever-growing public support for major issues such as depression, schizophrenia and bipolar disorders, the spectrum of mental health is so varied and complex that some forms of mental illness may go undetected or be trivialized, though the consequences may be severe.

Case in point: dysthymia, also known as persistent depressive disorder (PDD), since it presents as an individual exhibiting two or more symptoms consistently for an extended period of time (at least two years). These symptoms include low self-esteem, worry, guilt, lack of interest, inability to make decisions or focus, changes in sleeping and eating habits (either too much or too little), social withdrawal, hopelessness and suicidal thoughts. The duration of these symptoms can last, on average, five years and, although it can interfere with with work and family life, individuals can remain relatively functional compared to those with major depression. As such, dysthymia can often be overlooked, and people suffering from it can feel they're "not sick enough" to require attention or treatment.

StatsCan estimates that dysthymia will affect between 3-6% of Canadian adults over the age of 18. Women are 2 to 3 times more likely than men to suffer from it and, while dysthymia can begin during childhood and teen years, the most common occurrences are seen in those around 21 years of age.

While the exact causes of dysthymia are not yet known, researchers are making links to the similar biological causes of depression. Dysthymia more commonly occurs in those whose first-degree biological relatives (parents and siblings) have had major depression than those whose relatives have not. Recommended treatment is similar to treating depression as well; antidepressants and/or therapy are often prescribed over the long-term duration of the illness. Those affected most often demonstrate the symptoms most noticeably through their interpersonal relationships, though it can be difficult for even those with the illness to realize they have it.

What's so wrong with just "grinning and bearing it"? Even beyond the initial suffering dysthymia brings, it can leave individuals open to even more serious mental health issues. It's estimated that 75% of those diagnosed with dysthymia will have a major depressive episode within five years of being diagnosed with their initial illness. Plus, a condition known as double depression could occur, in which the depressive episodes are layered on top of the existing dysthymia.

It's easy to see how long-standing symptoms of dysthymia could be brushed off as personality traits rather than a deeper problem. Think of what we define as "teen angst" or moods that could be the result of hormonal changes being overlooked, yet StatsCan projected that those aged 15-24 had the highest rate of mental illnesses than any other age group, 7% of which had depression within the past year.

If you notice certain symptoms or changes in behaviour (especially related to loss of enjoyment, different habits, withdrawals and concerning attitudes), know that you can find mental health services and there are plenty of ways to spread the word to others that may need it too.