Dysthymic disorder- read to the end

heapsreal

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A clinical diagnosis of dysthymia requires a person suffer from two or more of these symptoms for at least two years:

  • Hypersomnia or insomnia
  • Poor concentration
  • Sad and hopeless feelings
  • Fatigue
  • Low sex drive
  • Irritability
  • Suicidal ideation
  • Social isolation

Diagnosing dysthymia is often difficult because symptoms resemble physical illnesses such as fibromyalgia or chronic fatigue syndrome. In addition, dysthymia can accompany other psychological or personality disorders that overshadow the symptoms.
 
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pattismith

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Diagnosing dysthymia is often difficult because symptoms resemble physical illnesses such as fibromyalgia or chronic fatigue syndrome. In addition, dysthymia can accompany other psychological or personality disorders that overshadow the symptoms.
Glad to read that I can add more names on my disease, after conversion hysteria, neuropathic pain, ME and Fibro, now dysthymia ;)

Which additional drug am I supposed to take to cure this additional disease...:D
 

Hip

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I get depression and anhedonia alongside ME/CFS symptoms, so was considering dysthymia some years ago, as anhedonia can be present in dysthymia.

Anhedonia is the loss of enjoyment of things that were once pleasurable.

The interesting thing about dysthymia is that people who suffer from it are often unaware that they have this form of depression. They may just think that their symptoms are just their normal personality. So they often do not seek out any medical advice or treatment.

This contrasts to major depression, which people are usually aware that they have.

I posted some info on dysthymia in this post.



For me, my anhedonia is worse than my ME/CFS, in terms of the misery it causes. If I could choose between getting rid of anhedonia or getting rid of all my ME/CFS symptoms, I think I would probably choose getting rid of anhedonia first.

The trouble with anhedonia is that there are almost no effective treatments. Anhedonia is usually found as a symptom of depression (or a symptom of schizophrenia). It does not usually occur on its own (although some people say that they do have pure anhedonia on its own).

If you have depression without anhedonia, it's often treatable with antidepressants. Whereas if you have depression with anhedonia, that's often the treatment-resistant form of depression, which does not respond to antidepressants. So the presence of anhedonia makes depression much harder to treat.
 

knackers323

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A clinical diagnosis of dysthymia requires a person suffer from two or more of these symptoms for at least two years:

  • Hypersomnia or insomnia
  • Poor concentration
  • Sad and hopeless feelings
  • Fatigue
  • Low sex drive
  • Irritability
  • Suicidal ideation
  • Social isolation

Diagnosing dysthymia is often difficult because symptoms resemble physical illnesses such as fibromyalgia or chronic fatigue syndrome. In addition, dysthymia can accompany other psychological or personality disorders that overshadow the symptoms.

An effective treatment is....?
 

heapsreal

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Is the weblink to an article missing from your post?
Sorry for late reply, the article was from a medical site. I should have posted the link. If i find it i will attach to this link.

I found it interesting that they made a difference between dysthymia and cfs but understand that it can also be a comorbid issue with cfs.
 

Hip

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I found it interesting that they made a difference between dysthymia and cfs but understand that it can also be a comorbid issue with cfs.
Yeah, I wonder if occasionally someone might have dysthymia but be misdiagnosed with ME/CFS, since dysthymia can involve fatigue and poor concentration.
 

heapsreal

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Yeah, I wonder if occasionally someone might have dysthymia but be misdiagnosed with ME/CFS, since dysthymia can involve fatigue and poor concentration.
I think your right.

I also went down that road thinking possibly dysthymia. So treating dysthymia with antidepressants, what i found is i felt better about feeling like shit. So my conclusion is depression can be present in cfsme but treating depression doesnt eliminate cfsme.

Hip have you had a similar experience?
 

Hip

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Hip have you had a similar experience?
I've long had comorbid depression and anhedonia alongside the ME/CFS, triggered by the same viral infection. At the moment I am using low doses of the antidepressant moclobemide. This has a much lower incidence of sexual dysfunction side effects than SSRIs and TCA antidepressants. Plus one study found moclobemide helps increase energetic feelings in ME/CFS.
 

sb4

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I've long had comorbid depression and anhedonia alongside the ME/CFS, triggered by the same viral infection. At the moment I am using low doses of the antidepressant moclobemide. This has a much lower incidence of sexual dysfunction side effects than SSRIs and TCA antidepressants. Plus one study found moclobemide helps increase energetic feelings in ME/CFS.
I'm sure you have looked into this extensively. What in the brain is associated with pleasure?

As far as I understand it, Dopamine is associated with motivating you to do pleasurable activities. Have you messed around with trying to increase it (Tyrosine, lowering serotonin, etc)?
 

Hip

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I'm sure you have looked into this extensively. What in the brain is associated with pleasure?
There's not a great deal of research into anhedonia, which might explain why there are no good treatments for it.

The dopamine perspective on anhedonia seems to be a leading one, and this paper says:
Anhedonia, or the loss of pleasure in previously rewarding stimuli, is a core symptom of major depressive disorder that may reflect an underlying dysregulation in reward processing. The mesolimbic dopamine circuit, also known as the brain’s reward circuit, is integral to processing the rewarding salience of stimuli to guide actions.
But there are lots of potential brain areas involved; Wikipedia says:
Neuroimaging studies in humans have reported that deficits in consummatory aspects of reward are associated with abnormalities in the ventral striatum and medial prefrontal cortex, while deficits in anticipatory aspects of reward are related to abnormalities in hippocampal, dorsal ACC and prefrontal regions.
The difference between consummatory reward and anticipatory reward mentioned in the above quote just refers to the two main types of pleasure/reward feeling we experience, consummatory being a pleasure we are enjoying now, and anticipatory being a pleasure we are looking forward to experiencing (the act of looking forward to something can itself bring feelings of pleasure, eg, looking forward to a holiday, or to meeting a friend).
 

Hip

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As far as I understand it, Dopamine is associated with motivating you to do pleasurable activities. Have you messed around with trying to increase it (Tyrosine, lowering serotonin, etc)?
Yes, I've tried lots of dopaminergic drugs and supplements, and while these help my depression, they don't seem to do much for the anhedonia.
 

Hip

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Has anybody experimented with J-147? (A Turmeric derivative) This thread on longecity seems to depict it favorably for depression and anhedonia as well as for aging in general.

https://www.longecity.org/forum/top...-depression-and-aging-in-general/#entry876655
Very interesting, @Sidny, J-147 is completely new to me. Apparently J-147 is a curcumin derivative, and curcumin is an anti-inflammatory and reduces microglial activation.

That to me makes sense that J-147 should work for anhedonia, as my anhedonia only appeared after I caught the virus that also triggered my ME/CFS, so I've always suspected that the anhedonia is caused by brain inflammation. And we know that new research implicates brain inflammation in several mental health conditions, including depression and schizophrenia (the two main conditions where anhedonia may appear).

Unfortunately J-147 seems a little expensive, sold here at €289 for 2 grams, and here at $100 per gram. Doses seem to be around 20 mg a day, so 1 gram = 50 days worth.

There are a few J-147 threads on Longecity.org. This seems to be the main thread.



Interesting that the thread you linked to also reckons the supplement fisetin at 200 mg twice daily is good for treatment-resistant depression (it's often the presence of anhedonia that turns treatable depression into treatment-resistant depression).

A couple of studies found fisetin effective for depression (in mice): here and here.

From that thread, fisetin's reported effect on sleep looked useful too, especially for ME/CFS patients with a circadian rhythm shift:
Over a period of maybe two weeks, I began to change from a late night person with pretty poor sleep quality, to a person that would get tired each evening at 9:30 like clockwork. I'd wake up from an awesome night of sleep at 6:30 am.

Normally I would go to sleep at about 3 am and wake at 11am, with mediocre sleep quality at best. When I began waking at 6:30 in the morning, it was such a drastic change that cognitively I felt uneasy, even if my body felt rested, and I'd try and go back to sleep without success. This early morning waking did back off a bit with continuing use, but not entirely. The amazing sleep has remained.