Dysthymia: According to the DSM’s definition of dysthymia, it is a serious state of chronic depression, which persists for at least 2 years; it is less acute and severe than major depressive disorder. As dysthymia is a chronic disorder, sufferers may experience symptoms for many years before it is diagnosed, if diagnosis occurs at all. As a result, they may believe that depression is a part of their character, so they may not even discuss their symptoms with doctors, family members, or friends (Wikipedia).
Translation: In the process of breaking down, ma wakes up and listens to the sound of birds and crickets, the sound of a diagnosis that possibly explains the exegesis of her existence, the ball chained to her chain. The pitbull to her pitfalls. I always thought it was just part of my character, ma said. I know, I said. But, I always thought you were nuts. This makes sense, ma said. Even the sound make sense to me–dys-thy-mia. Like dys-topia, I said. Like dys-function and dys-plasia, she said. Like that always made sense to me, I said. I was always a woman on the verge of greatness and apocalypse, she said. A thousand miles below the seabed, I felt this in me. Maybe that’s why you always go after the wrong men, I said. And the wrong women, ma said. Amen, we said. And raised our hands.
Diagnosis: The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, characterizes dysthymic disorder. The essential symptom involves the individual feeling depressed for the majority of days and parts of the day for at least two years. Low energy, disturbances in sleep or in appetite, and low self-esteem typically contribute to the clinical picture as well. Sufferers have often experienced dysthymia for many years before it is diagnosed. People around them come to believe that the sufferer is ‘just a moody person’.
Translation: Like old friends who can’t discern what stands in front of them because their memory of ‘who’ was was always who she was.
Note the following diagnostic criteria:During a majority of days for two years or more, the adult patient reports depressed mood or appears depressed to others for most of the day.When depressed, the patient has two or more of:
1. Decreased or increased appetite: ma eats like a cow and stars (or starves) herself like veal depending on the day of the month.
2. Decreased or increased sleep (insomnia or hypersomnia): Ma can’t sleep more than 6 hours, which is no big deal, but there are days when she only sleeps 3 hours. She never has days when she can sleep more than 7 hours or nap like she used to when she was a boy.
3. Fatigue or low energy: ever since ma was littler, she always thought she had chronic fatigue disorder as a result of insomnia or weak bones or brain damage.
4. Reduced self-esteem:ma hates steamed vegetables.
5. Decreased concentration or problems making decisions: ma is still in transition languishing between man and woman, complete and incomplete.
6. Feels hopeless or pessimistic: she hopes less and pesses me off a lot.
7. During this two-year period, the above symptoms are never absent longer than two consecutive months: true.
8. During the first two years of this syndrome, the patient has not had a major depressive episode: Ma can’t remember cause she is always depressed so I guess the answer is yes but she may be just melodramatic and gloomy in her go go boots and Bon Ton top.
9. The patient has not had any manic, hypomanic, or mixed episodes: ma is impatient and not really sure if she’s a hippo.
10. The patient has never fulfilled criteria for cyclothymic disorder: ma is a cyclone.
11. The depression does not exist only as part of a chronic psychosis (such as schizophrenia or delusional disorder): sometimes ma thinks she is a woman bisected by the energy of a man. Sometimes ma thinks she is a man bisected by the energy of a woman. The rest of the time ma rests next to me in a constant state of disarray like a wet cat ball.
12. The symptoms are often not directly caused by a medical illness or by substances, including drug abuse, or other medications: the only thing ma abuses is her body through the possibility of sex as the knots of fibers that keep her little body together.
13. The symptoms may cause significant problems or distress in social, work, academic, or other major areas of life functioning: ma engages in relationships with men suffering from major psychological disorders who choose not to help themselves so that she can help them and receive uptake from her charitable giving. She uses them to cover up her own major psychological disorder just like paint on a canvas is used to cover up the emptiness. Ma always thought this was her character, the role she’s played her entire life, an actor and an actress teetering between her self and her anti self on a shelf hollowed out by termites.
14. (Added by ma.) The symptoms may cause significant distress in the universe. In other words, ma thinks there’s only one verse and that’s the verse she ignores looping inside of her head because it’s the loop she was born with and sleeps with every night in bed. Next to my head.
- How Gender Stereotypes Warp Our View of Depression (healthland.time.com)
- The Importance of Regular Mental Health Checkups (nytimes.com)