Dysthymia is more than "the blues". It is also known as "persistent depressive disorder". At some point every day becomes a gray blank slate. And that seems normal. Sufferers can experience symptoms for many years before it is diagnosed, if at all. As a result, people believe that depression is a part of their character, so they may not even discuss their symptoms with anyone. "I'll always be a Debbie Downer" or like Eeyore, always looking for something positive but already sure it won't be found. Living with Dysthymia, or with a dysthymic partner or relative, can be overwhelming. But there is hope: talk therapy, self care and early diagnosis can go a long way to offsetting the symptoms and avoid major depression episodes. Join Kevin O'Donoghue and Niseema Dyan Diemer as they explore Dysthymia, and provide tools to work through the gray and into the light.
Dysthymia is more than "the blues". It is also known as "persistent depressive disorder". At some point every day becomes a gray blank slate. And that seems normal. Sufferers can experience symptoms for many years before it is diagnosed, if at all. As a result, people believe that depression is a part of their character, so they may not even discuss their symptoms with anyone. "I'll always be a Debbie Downer" or like Eeyore, always looking for something positive but already sure it won't be found.
Living with Dysthymia, or with a dysthymic partner or relative, can be overwhelming. But there is hope: talk therapy, self care and early diagnosis can go a long way to offsetting the symptoms and avoid major depression episodes.
Join Kevin O'Donoghue and Niseema Dyan Diemer as they explore Dysthymia, and provide tools to work through the gray and into the light.
For more information or support contact Kevin or Niseema at info@thepositivemindcenter.com, or call 212-757-4488.
These are challenging times and we hope this episode served to validate and ease your anxiety about what you may be experiencing.
Please feel free to also suggest show ideas to the above email.
Thank you for listening,
Kevin and Niseema
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https://www.kevinlmhc.com
www.niseema.com
www.thepositivemindcenter.com
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26s
Kevin O'Donoghue and Niseema Dyan Diemer
Hi everybody. This is Kevin Donahue, licensed mental health counselor, and I'm Niseema Dyan Diemer, licensed massage therapist and trauma specialist. And this is The Positive Mind where we bring you some ideas, concepts, and guests to help you lead a more positively minded life. And Niseema spring has sprung, driving down the highway here in New York, seeing how the trees have just bloomed, blossomed spring, spring has sprung. And how is that doing for your mental health? Are you noticing a change in your mental health? Are you feeling what's called inspired? You know, when you don't feel inspired when you have nothing to make you or feel inspired in your life you might have what we called last week.
1m 11s
Kevin O'Donoghue
Alexithymia that's right. I told you about this word alexithymia Lex, meaning words, not having the words to describe your feelings, how you're feeling. It's a kind of general state of being blah, and just feeling one or the other, the black or white, you know, gray. No, just not having any color in how you're feel, but this week we're going to talk about another word. Dystymia not alexithymia but this time, year, and it is what happens when you are depressed let's say for a long period of time, not just three weeks or one week or two weeks or three months, but actually for year on, year on, year on year.
1m 57s
Kevin O'Donoghue
And you know, there are some people like that. Do you know anybody like that? Do you know any people in your life that suffer from this you know, dysfunctional emotions? Do you know anybody like that? Have you felt that way? Are you afraid? Did Covid bring out the fear in you of maybe developing dysthymia? I've been depressed, you might say since this whole thing started, or maybe a week or two weeks or a month into this whole thing starting. So it's important to know this is not unusual. Dysthymia effects at least 7% of the population at one point or another in their life, 7% walking around, feeling depressed for not just a month or a couple of weeks, but actually for at least two years.
2m 51s
Kevin O'Donoghue
First for children and adolescents it's one year, but for two or more years, and you know, before we replay this show, we did about a year ago when the virus hit us and it was very topical and we ran last week show because it was very topical. And a lot of people listened to that show. And we want to run this show, which was actually even listened to more than last week show. You might start to recognize depression with irritability. A lot of people think depression is just being sad and that's it. And if you're not sad, well, then I can't be depressed and that's not it at all.
3m 31s
Kevin O'Donoghue
It can show up as an irritability. Are you more irritable than lately? It can show up as low energy. I have no energy anymore. You can just show up is what we call Dysthymia. Like I can't move well, I'm moving very slowly. It can be in a change of eating habits. It can be a lack of hope. You know, to me, that's the one of the bigger signs. So all of these things can show up as signs of depression. And if they last for a longer period of time, it could show up as this time. Yes. So we're here to run the show for you again on this time here, and we hope you enjoy it. You're listening to The Positive Mind. So we want to talk today about a condition and maybe first we should just describe some of the symptoms.
4m 17s
Kevin O'Donoghue
So irritability would be one of them, Niseema,` sleep interruption or let's go with concentration. How is your concentration? Do you notice when you're not being, you're not concentrating and you're not able to concentrate when you're reading something and nothing is really going in. Have you had that experience? This is a symptom for something we're talking about. I have, you know, I could I read that whole article. I can't tell you what it's about. Right? You know, so that's an, an impairment of your concentration. And then of course we did a show, not too long ago, podcasts here on sleep, right?
5m 1s
Kevin O'Donoghue
The changing face of sleep during a quarantine
5m 5s
Niseema Dyan Diemer
And especially like the kind of maybe different sort of dreams you might be having in that sleep and that sleep has been strangely disturbed. Because again, your routine of your day may have been disturbed if you're not working, or if you're having to take care of teaching your children, when you weren't doing that before. These stressors can cause sleep disturbances.
5m 28s
Kevin O'Donoghue
Right? And we mentioned things about sleep and about dreaming. Do you remember what we said about wishes and dreams that a dream is like Freud said, a dream is a wish fulfillment, but we also discovered that dreams are awful. Something that we're trying to work out, that we're trying to solve a problem, and people are talking about their dreams. Now maybe it's because people have time to talk about the dreams, but could you write a dream journal from your three-month quarantine? I know I could. I've seen some really weird things going on, but we've done this show on dreaming and sleep and you can look that up also at thepositivemind.com.
6m 10s
Niseema Dyan Diemer
And we've also talked about a few, a couple of disorders that might be showing themselves, or you might be feeling shades of them. Alexithymia and anhedonia, which are both disorders of the ability to feel or put words to your feelings and the, the sort of not getting pleasure from life anymore. That pleasures that you had maybe in the past that you felt always kind of did the trick. Maybe they just aren't doing the trick and that we've lost the ability to engage in some of our pleasures that we relied on like sports or foods or restaurants or nightlife
6m 55s
Kevin O'Donoghue
Perfect. That's anhedonia, right? The inability to feel pleasure, which is a major, major symptom of depression, major depression. And we're not talking today about major depression, but it is a symptom that somehow pleasure is not reaching me. The food just doesn't. I don't feel or taste the tastes of the food. I'm not enjoying the typical activities that I've usually enjoyed. There's something happening to my sensing and my pleasure center. And that's called anhedonia, but alexithymia is closely related to what we'll be talking about today, which is we'll be talking today about something called Dysthymia.
7m 39s
Kevin O'Donoghue
It's a dysfunction in emotions, dysthymia. So alexithymia was Alexi means words and thymoma means emotion. So we discovered that alexithymia is an inability to put words to your emotions. And we did that about four or five weeks ago when you can find that podcast as well, but not having words, do you know somebody who just is not in touch with how they're feeling? Do you have a spouse that way is your spouse like, just tell me where to go. Well, how to show up where to be, and that's enough. And don't ask me to have any feelings about it, because even if they had feelings, they might not be able to name them.
8m 26s
Kevin O'Donoghue
Right.
8m 27s
Niseema Dyan Diemer
I think even more frustrating to have a feeling and not know how to name it, like how to distinguish this is sad. This has happened,
8m 34s
Kevin O'Donoghue
Right? So you go to a wedding and you know, you're supposed to feel a happiness. Most people feel the happiness and you know, your partner might not have any feeling about it at all or awake or a funeral. And you would expect the person to be sad and they might not even know that they're sad and they certainly could name it.
8m 54s
Niseema Dyan Diemer
There's like a place, the brain where this kind of information is relayed through. And that part of the brain might be atrophied or may not have enough capacity to be able to help this person relate and feel and be able to connect emotions and words. Right?
9m 12s
Kevin O'Donoghue
And, and one of the treatments Niseema for this alexithymia is the word again, is to increase and improve your fantasy life. Frequently. People who have alexithymia don't have any fantasies, they don't have any imagination. So one spur to improving this and getting through it is to sort of develop a sort of fantasy world, a fantasy life and talk to your partner about it. And you might be surprised one day, an emotion just might show up. So we know people like this, there are people out in the world, I call it like a colorblindness to your emotions. Everything is gray or, or, or it's one color.
9m 51s
Kevin O'Donoghue
So that's alexithymia, but let's, let's go into our show today because we want to, we suspect that a lot of people are exhibiting signs of what's called dis Damia, which again is emotional of a depression or dysfunction in emotion. And this is a syndrome, a disorder that's been around for, for years and long time. But it's different than major depression because it's, it's a low level depression that lasts for at least two years. Do you know somebody called a Debbie Downer? I just heard that name. Debbie Downer. Is there somebody in your world that has been down since high school?
10m 37s
Kevin O'Donoghue
You know, they just because frequently the onset is in adolescence. This is something we want to talk about today. Dysthymia, which is a to, you know, at least being depressed for two or more years. And the tragedy of this is that often people just don't even know they have it. They've gotten so used to managing it. And it's not crippling. It's not like major depression or bipolar disorder, which has a manic phase to it. It's, it's a Lola, it's a manageable depression, but the tragedy of it is you're not really who you could be. You're not really your normal, natural self. Do people remember you as a happy person?
11m 16s
Kevin O'Donoghue
Do you remember yourself when you were happy? Do people now see you as somebody who is not happy, maybe not miserable, but not happy. And somehow can't bring themselves up to be animated and excited about anything. You know, I can see a connection with alexithymia, which is not having any words for your emotions. This stymie is you're not really who you could be, who you would normally be. If you didn't have this weight that you've managed, that you've adjusted to, that you've actually even mastered. So I just want to say, this is a very stubborn disorder.
11m 59s
Kevin O'Donoghue
It's people do come to therapy, psychiatrist for this, and medication can be part of it, but it's very stubborn because even therapists can get frustrated with it. They can see you as happy. They can see the happy part of you, but something keeps dulling it down.
12m 20s
Niseema Dyan Diemer
Well, there's something to this, that, that sufferers talk about it. They become identified with it. And in a way it can become like a comfort zone. They're so used to it. And it's a way to maybe not engage in life. And it's, it's kind of a funny catch 22, because there is a real, true physical feeling of heaviness. Like somebody says, it's like, it's feels like the weight of two elephants on each shoulder, two elephants, that's huge. And another suffer says it's like holding a weighted umbrella. Like there's just something, a pressure coming down. And it's very specific.
12m 59s
Niseema Dyan Diemer
And if you're, if you are with this, you don't see any way out of it. You might just think this is the way I am. This is, this is how I'm wired. This is how my mother was. Is that my grandma, you know, who knows? You know, it's like, w we're just that way, or I'm just that way. And it can be, I can imagine very difficult to be in social situations where people seem happier, look happier, but I just can't get there. Is there something wrong with me? Or maybe there isn't, this is just who I am. I am going to, you know, embrace it in a way and just be that I've, I'm reminded, I think the poster child for this, if people are recalling, Winnie the Pooh, the character of Igor, the sad donkey, who always has something sad to say about everything.
13m 44s
Niseema Dyan Diemer
And he just doesn't feel any self confidence to, you know, even join a party or how to join a party. And, and when he does, you know, he just kind of mopes around the party and maybe leaves it very early
14m 0s
Kevin O'Donoghue
And frequently. You know, these are deficits in, in social ability, right? If you can teach an adolescent at an early age, how to connect to peers and enjoy their peers, they might not fall into this dystonia. And I think it's actually even more S subtle and pernicious than that. And Niseema, because I think some people might not even see it on you. They might not see the two elephants on your shoulder. And so many people that suffer with this. I don't think that they even see it because they've become so familiar to it. That it might not feel like two elephants every day. It feels like something.
14m 40s
Kevin O'Donoghue
So I think people, my experience clinically with people who have it they're okay. In terms of their relations with people, they get by, they're not thought of as in any way, they know that something's not right, but nobody else really they've. They've mastered this disguise. So when I have a client or somebody comes to me with this, I ask them this one question, where are you allowed to be happy in your childhood? Where are you allowed? Was there a message somehow don't be too happy, right?
15m 23s
Kevin O'Donoghue
Because there is a message. You know, a struggling parent could struggling parents. I mean, if your parents are struggling daily and whose parents aren't these days struggling daily, and here they have a child who gets their three meals. They go to school, everything's safe, they're protected. You know, all of their needs are taken care of. And their parents are, you know, doing what parents are doing their responsibilities, but you know, the child sees, well, they're not really that happy. My parents, my parents are not happy. So I better not be too happy because what happens when you're living with people that are chronically not happy, not necessarily unhappy, but not happy chronically that way.
16m 6s
Kevin O'Donoghue
And then this happy kid comes along every day, day in and day out. Well, you're going to become a target that's human nature. Right? So my first question to anybody, and I didn't say, let's assume that you were not allowed to be happy in your home, but there's happiness inside of you. You still have it. You haven't lost connection to it. It's your nature. It's all of our nature. It's your parents nature as well. But they, they got lost up in their responsibilities, but you're still young enough. But when I come into the house, open the door, close the door, and I'm now home.
16m 47s
Kevin O'Donoghue
There's a message. I can't be how I normally feel out in the world. So you learn this thing and then it comes and then it swims around in your body and finds a place. And it's a great strategy. I mean, depression. That's why I think depression is a strategy. It's the best thing you have for now. I need my depression because if I'm not, then I become a target. So let me use my depression. Some people use it for years, a decade, two decades, three decades, they're in a job. And if they were bringing all their resources to their job and spoke up about how the job is not functioning, well, it's not functional.
17m 32s
Kevin O'Donoghue
The organization is XYZ and they know it. And, but they're not allowed to speak up. Then a depression can take hold. And so we're in this pandemic with three months now in, and certain things can be taking hold and they might not be your natural self. And that's okay. And we start now with irritability and with sleep disturbance and with concentration issues.
17m 59s
Niseema Dyan Diemer
So before we go into more symptoms, I wanted to circle back to what you're talking about with childhood. And, you know, we did a show about childhood trauma and how it affects us in our day-to-day now. And something that is underlying and kind of the foundation for this dysthymia is a, is an intense sense of shame. And what you're talking about, this child who has a sense of happiness or joy inside of them, and they come home to a house where that's not allowed. That becomes a shame spiral, like I'm wrong, I'm wrong somehow for feeling happy. So I am not going to do that. And, and I'm going to take the blame for that too, because that's what children do.
18m 40s
Niseema Dyan Diemer
It's a way to control or make sense of their environment. Like they can't make sense of their parents being stressed, depressed, angry, whatever's going on. They can't make sense of that because these are the people that are supposed to be taken care of me. I can hurt them more. Yeah. I don't want to hurt the more, I don't want them to feel more stressed. So I'm the problem. I'm the one who's coming home. I'm the one who's feeling happy. I'm the problem. So I'm just going to internalize all that and make me bad and wrong
19m 12s
Kevin O'Donoghue
And shame. And let me have shame as my lifelong partner now that I can, I don't have to look to mom and dad anymore. I can just, I know that I'm, I came home and I'm happy. I know I'm supposed to be ashamed. So let me be ashamed,
19m 27s
Niseema Dyan Diemer
Right? And this moves into just a real low self-esteem and like feelings of inadequacy. Those are shame, you know, hallmarks of shame is that I'm just not good enough. I'm not worthy of love. I'm not worthy of, of being,
19m 43s
Kevin O'Donoghue
Are we painting a picture for you? I hope we're giving you this insight into psychology and what this fascinating capacity of the mind and of human beings to do this to ourselves and often stimulated from the outside environment. Some people are blessed the same as some people, the external world, it doesn't affect them in any way. Do you know anybody going through this and just, they're not disturbed in any way, they're blessed. They're lucky. You know, and then there are others that, you know, a change in the light, a change in the temperature, something in the environment can, can just trigger off a lifelong condition. And there's no blame here that we're not blaming.
20m 25s
Kevin O'Donoghue
We're just pointing out. This is a time that an unusual time, and we're all subject to some of these feelings, and it's better to be armed with awareness and know what these symptoms are either for yourself or for others. And know that it's not unnatural. It's, you know, it's not a death sentence.
20m 46s
Niseema Dyan Diemer
Well, someone who has been with this for most of her life relates how it was so relieving to find out that this was a condition that this wasn't necessarily who she was. That it's something that's very real and it has origin and it has cure. So to speak. I mean, you know, it's, it's not easy, but you can do it. You can shift this.
21m 11s
Kevin O'Donoghue
So we said the three so far concentration sleep and irritability. And now let's talk about appetite, you know, have you put on your Covid 15, right? There's a thing everybody's putting on 15 pounds. And what's that about? What is that about that, that is sort of like an irritability seeping in the pounds are coming along and it's just, am I getting lazy? What is it? I'm not just because I'm not as active. Am I allowing certain types of food more than I normally would have interfered with interrupted.
21m 54s
Kevin O'Donoghue
And so maybe there's a less vigilance.
21m 58s
Niseema Dyan Diemer
And if I have a codependency unlike work and being reflected by my workmates and how I'm doing my work, that's going to maybe trigger the low self-esteem. And I just want to eat to comfort myself or, or naughty. Maybe you don't eat. Maybe it's really like, wow, I don't have my normal routine. I don't have people supporting me or my sense of me being able to do anything.
22m 22s
Kevin O'Donoghue
Some people are so worried still three months in having gotten it, but are still worried that they could get it or someone they love is getting it. And one thing about worry, worry, and food, don't go together, right? Bubble Gum and food might go together. Yes. Smoking and more, we go together, but food and worry don't often go together. So, you know, there's people that are so worried that they're not eating at all. So this is another insight into what could be happening to you. As you go through this.
22m 59s
Niseema Dyan Diemer
The thing about this quarantine is that you might've been doing well. So to speak with this dysthymia, like just managing your life, but this quarantine may have sent it's like a double depression. It like something came on top of you. That is like, wait, no, I have to now hold like five heavy umbrellas instead of just my one. Right? So just to sort of normalize, like if it's feeling worse, then it has, you know, prior to this whole situation, that makes sense. If you're someone whose tendency is to be like this, this situation of being isolated, maybe losing your job, losing contact with people in places that helped you feel somewhat okay.
23m 42s
Niseema Dyan Diemer
Losing all that could be sending you into a major depression.
23m 46s
Kevin O'Donoghue
Right? I think one of the issues is what you're talking about is rewards. We get a paycheck because we've produced something, we've done something. And sometimes we even get strokes like, Oh, you did a great job on that. And great job on this. And you, you get a sense of accomplishment yourself with your work and being with your work mates. And with that interrupted, you're not getting any of those re are you getting any reinforcement anywhere? Are you getting any compliments anywhere frequently? The stymied people are, are compliment deprived people because they've, they've practiced at becoming not noticed, right?
24m 28s
Kevin O'Donoghue
If I'm, if I get noticed at home as a child, the people that notice me are going to be unhappy. So I better not get noticed. Do you feel invisible? Have you been walking through life feeling invisible? Chances are you have this time here? And again, it's a two year. You must have had it for two years. It's a, low-level functioning depression. Most people who have it can function and only 3% of the population have it. And, and, but it's the most unreported type of depression out there. Most people don't seek treatment for it. But I did want to also talk about isolation.
25m 8s
Kevin O'Donoghue
Are you isolated because isolation it's, first of all, you learn to isolate because why, if I'm happy, I better hide because you know, if I'm happy in home diamond danger. So I might as well learn to isolate. And now we're in forced to isolate isolation is required. So it's going to deepen this depression and you're not used to seeking help for it. So it took in one of the additional questions. Am I even more isolated? Chances are you are, and I'm not getting any positive feedback reinforcement from anybody.
25m 50s
Kevin O'Donoghue
So this is the groundswell for low self-esteem. I do not deserve to be happy. And so there's really one of the basic questions. A lot of people didn't seem to don't even know they have low self-esteem, you know, they don't know it. They just, you know, they might think, Oh, I esteem myself really well. I isolate, I don't take on the problems of the world. I don't interact with people that, you know, are dysfunctional. I don't really, I I'm, if you leave me alone, I'll be totally fine. And they, they think that they don't have low self-esteem, but low self-esteem is low self esteem.
26m 32s
Kevin O'Donoghue
You don't esteem yourself worthy of being fully happy. That's low self-esteem. So on a scale of one to 10, you know, how happy are you and how much do you deserve to be happy? And if you came from an unhappy home, you might say, well, I don't want to be happier than my parents because then I'll, I'll do my parents. And I don't want to do that. So I guess I I'm, I should have steamed myself at a four or a five,
27m 5s
Niseema Dyan Diemer
Right. And something that I work with, you know, in, in looking at someone's capacity, that's, you know, with trauma, we're very often working with building capacity to, to feel different States like feeling the state of happy feeling, the state of sad. And if you don't have the capacity to sort of hold that feeling because you couldn't, it wasn't, you know, you couldn't be shamed for it. It's, you know, not what everybody else is doing. You kind of just drop it out of your system. You like, you just open the, open the door, open the trap door and let happiness leave you.
27m 43s
Kevin O'Donoghue
And I think on that note, Niseema we'll take our musical break. You're listening to the positive mind. I'm Kevin O'Donoghue. We will be back after this musical break.
28m 55s
Kevin O'Donoghue
Welcome back to the positive mind. I am Kevin O'Donoghue a licensed New York state mental health counselor.
29m 0s
Niseema Dyan Diemer
And I'm Niseema Dyan Diemer, licensed massage therapist and trauma specialist.
29m 5s
Kevin O'Donoghue
And I just wanted to make a note and to say, man, you know, it's five years to the passing of my mentor and somebody, many, many people in New York know of Armand DiMele who started this show, the positive mind center. And I have to say, you know, it, so seamlessly came out for me today that this idea of dythymia could have had its roots. And it often does clinically. We know in the literature that it could have had its roots in adolescence, but I put it together that it might've been that you weren't allowed to be happy as an adolescent or young, or your parents were unhappy.
29m 45s
Kevin O'Donoghue
And as allegiance almost to them, you took on some of their unhappiness and made it a home inside yourself. And that the weight of that could have led to a Debbie downer syndrome or in your, or a mild case, you know, you know, so this is sort of an act of love. I almost think that an adolescent might do for his parents take on their unhappiness, make it a home in himself. And I, I think Armand would be happy that his ideas are still coming out five years later because you know, I'm convinced I'm very convincing. And I find it has been very useful therapeutically to ask people when they come in, how long have you not been yourself?
30m 33s
Kevin O'Donoghue
How long has it been? And now, you know, they can go to other therapists, psychiatrists, and they won't ask them that question. And yet that would be the first question, Armand, how long have you not been yourself and dythymia and major depression and general anxiety disorder and PTSD and all of these other diagnoses that we have. Imagine if they're, well, they're really just versions of you not being really you and our work here is for you to get back to being you. So let's take the blame and the guilt and the shame and everything else off the table and just get to work on finding the real you.
31m 15s
Niseema Dyan Diemer
And it's something that when I, when I coach my clients around this, it's like, what's that part of you that hasn't changed from the whole time you've been on this planet? Like there's some part and we'll use in trauma. It's like, what didn't they get my love, that what part didn't they get? And that's a really important part to get to know, and to remember like, who, like, what's the con constant through your life? Like, there's a, there's something of you that has always been there and like that, you know, but you kind of don't know and you lose track of in these different things that in different manifestations of the disease of yourself and being in relating in the world.
32m 2s
Niseema Dyan Diemer
So
32m 3s
Kevin O'Donoghue
I love that idea. Like what has been through it all indestructible in me, what has persisted, nevertheless, in spite of my upbringing, in spite of my environment, what has persisted in the positive way? Nonetheless, I love that framing. And, you know, in positive psychology, we, we refer off into these strengths, the 24 strengths in positive psychology, you know, and somebody could say, well, they never got my hope. I never lost hope. I always knew XYZ, you know? And so they never got that or they never took away my, my love of learning. My curiosity never got my persistence and perseverance.
32m 44s
Niseema Dyan Diemer
They never got my appreciation of beauty or humor.
32m 49s
Kevin O'Donoghue
Yes I am. Or my kindness. Right, right. So these, these strengths are still there. And as the therapist, you know, w we, we get practiced at seeing these in spite of the sloped shoulders, in spite of the chronic anxiety and the depression and, and the negative thoughts we could practice it. And while this is not, you, they don't know it. They think this is them, and we're sitting there and we'll know that's not you.
33m 15s
Niseema Dyan Diemer
So I I'd venture to say that anybody who's, you know, walked into any kind of treatment knows this, knows that there is an opportunity for something else. And, and to the discovery of yourself, like, like a recognition that I've lost something. And I really want to get it back. I really want to get myself back. I think what also brings people into treatment is maybe an exacerbation, like it just got so much worse. Like it became unmanageable, maybe a relationship issue, or a financial issue kind of pushed you over the edge or this quarantine thing, or agree for a loss during this quarantine or this, this time of the pandemic.
33m 58s
Niseema Dyan Diemer
So it's, it's been such a challenge. And I really, you know, want to support people in finding help and that there is help to be had, and to not give up on the help. Like you might go to one session and it didn't fix the problem. And one session isn't going to do it. You know, it's like when moving into therapy, you need to, to, to feel good enough about yourself to engage in the, the, the relationship of being with a therapist and to also trust yourself, like, you know, some therapists you may connect with some, you may not, but just to give it a chance.
34m 33s
Kevin O'Donoghue
Yes. So we also know when couples work missing, when a couple comes through, we, we, and this is something, all couples therapists know. We know that on average, it takes a couple of seven years to actually make it to the door of the therapist's office seven years. And they acknowledge it. Most clients, most couples do not deny that they say, yep, we could have used you seven years ago. And the same thing for individuals. So, so oftentimes it's something nagging. I'm living with this. It's bothering me. I'm getting by. People don't necessarily see it. I know it, but I can manage it.
35m 16s
Kevin O'Donoghue
I still manage to squeeze out some good moments so I can get by. I don't need a therapist, but for me, the ideal therapy and the one, my mentor, Armand DiMele was when did you stop being yourself? And let's not feel guilty about it. Let's just start talking from there. Right. And then talk about this. So I do want to just finish with these symptoms. We talked about concentration appetite, self-esteem concentration, irritability, negative self-talk low self esteem.
35m 57s
Kevin O'Donoghue
And the last one I want to say is fatigue, because we did a show about a month ago on fatigue, quarantine fatigue. And this is a major quality of depression. You know, I have to live at a slow pace. Have you adapted to a slower pace? Do you know that you're not living? What would it be like for you to be rushing? You know, I remember my dad, I would think I have never seen him rush. I had never saw him run a block. I never saw him in a hurry. I never saw him anxious or, you know, under stress.
36m 40s
Kevin O'Donoghue
He had his coping mechanisms and way of managing that I had no access to, but I remember thinking, man, I've never seen this guy run. And you know, and he had all these children and this high level job, he was tired. There's no question about it. That he was fatigued. So he conserved his energy and he probably said to himself, I'm not running. I'm never running. I'm never putting myself in a position where I have to run. So with this last symptom of dysthymia, have you adapted to a slower pace, then, then your energy would w would naturally have designed or, or lived at?
37m 30s
Kevin O'Donoghue
I mean, I know I have tremendous energy and I slow it down. I keep a tamp on it because I need to stay in control or for whatever the reasons. And it comes across as fatigue. So say something about
37m 49s
Niseema Dyan Diemer
It makes sense that that fatigue would be a big factor in this, because if you're talking about energy and the repression and depression of energy, that takes a lot of energy, it takes a lot of energy to not be happy in a way. And again, like I said earlier, like if we don't have the ability to hold that as lighter feelings in our bodies, then we're only living with the heavy ones and there's no balance. And, you know, again, if you're carrying around a weighted umbrella all day long, or you have two elephants sitting on your shoulders, this sensation it's fatiguing. And if there's no, if it feels like you're in quicksand all the time, and you're trying to keep your head above water and above the sand and, and breathing that all just takes a tremendous amount of energy.
38m 40s
Niseema Dyan Diemer
So fatigue makes sense. And the, and the quality of feeling like completely laid out by it at times, or maybe when things get harder yet suddenly there's five umbrellas you're having to carry. It makes sense that you would just not want to get out of bed.
38m 56s
Kevin O'Donoghue
That makes sense. And I think a question people with dysthymia know is always, how am I managing my energy? I have to manage my energy all the time. I feel this weight I'm off balance. I need, if I make a wrong move, I could be even further off balance. I need to always measure my energy level. Do I have the energy, how much energy do I have, right. And never to ever take on something where you will not have the energy for that could push you over the edge. So, so my relationship to energy and burning, burning that energy efficiently is a real question for this dynamic.
39m 38s
Niseema Dyan Diemer
And it can be also a symptom if you're dealing with chronic illness. So this sounds a lot like how chronic illness, chronic pain sufferers manage their days too. Like how much do I have energy for? And that can be so life limiting. And again, sort of accentuating the depression of, you know, low self esteem and the, and the shame of not being able to live a life. You want to live the, the dilemma more of a dilemma rather than.
40m 8s
Kevin O'Donoghue
So we're going to talk about treatments in a minute and the same, I just wanted to give our audience this little test so they can ask themselves. And the first one obviously is about slowness. Have I adapted to a slow lifestyle during this pandemic? I mean, I know the people around me have slowed down and boy have they slowed down and some have gained weight, for sure. I haven't thankfully, but there is a slowness, a deliberateness to moving to movement because, and I, if it makes sense, you know, I mean, there aren't many opportunities to squander your energy. There are in places to go and to lose yourself.
40m 50s
Kevin O'Donoghue
So it wouldn't make sense to constantly be measuring my movement and going at it slowly. And since the demands of the world are less, you would move slower. So question one on this depression test, I do things slowly, not at all, just a little, somewhat, moderately, quite a lot or very much so that's six questions. Do I do things slowly or slower? Am I doing them slower than I was doing before the pandemic? And again, this is natural. We're not saying this is something to accuse yourself for.
41m 31s
Kevin O'Donoghue
Just to really, am I having a hard time concentrating? Not at all, just a little, somewhat, moderately, quite a lot, very much. I have difficulty making decisions. Not at all, et cetera. I feel unhappy, sad or blue. I am agitated and keep moving around. You know, those people imagine time got to keep moving. I got to find another thing to do, and I feel fatigued. So it's only nine questions. I'm only touching five or six of them. You can go online and, and find that. But those are the typical questions we would ask. Are you moving more slowly?
42m 12s
Kevin O'Donoghue
Are you having trouble concentrating? Are you restless? Are you unhappy? Chronically, do you feel fatigued? How about decisions? Have you lost interest in things? So anhedonia would be, be one of them. And imagine you're asked these questions and there's no guilt. There's no bad feeling about it. Yes. This is where I'm at. I need to say, okay, let's get you back to who you were.
42m 37s
Niseema Dyan Diemer
So how to do that. I mean, a lot, there are a lot of suggestions out there online, a lot of different treatment modalities. One of them being CBT, cognitive behavioral therapy, which really works with shifting the thought process and evaluating the thought process. And that can be really helpful and a great first start there, of course there's medication. And that is helpful for some cases and not for others. It's definitely, it can get you sort of over the hump and to a place of feeling a little better so that you can build some skills and tools and, and resource,
43m 18s
Kevin O'Donoghue
And to actually see how you're living. Because the first thing that happens with the chronic depression is that you don't even see. And so you walk into your house one day and see it's untidy. And most of the time, you're not seeing that. So if you take medication, sometimes it improves your ability to actually see how you're living, seeing yourself, but you don't have to see my, I think the number one is get outside and to exercise. You know, if people are exercising and getting outside and they're depressed, then we have, have to work on this. Then, then we really need to focus on this because, you know, activity gets the blood flowing and it gets you breathing.
44m 5s
Kevin O'Donoghue
It gets the breathing, going your body, oxygenated blood.
44m 9s
Niseema Dyan Diemer
So get that. A lot of people who are really depressed or have, are having such a hard time that that is, that could be a tall order. And sometimes when I, when I work with clients who were struggling with us, I had one recently who felt like there was a part of her that was just sinking, just deep into her body. And it was deep and going deep and there didn't seem to be a bottom. So I just encouraged her. I'm like she was living in a five story apartment. And I said, is it going through to the next floor? She's like, yeah. And the next floor. Yeah. And the next floor, I'm like, how about the basement? She's like, Oh yeah. That's where it stops having the awareness of a bottom to her depression, a support structure underneath like some place where it ends, where it stops, moving down was really helpful for her to just feel, Oh, okay.
45m 5s
Niseema Dyan Diemer
So it's not this constant drag and pull down, there's actually an end to that. Right. And that was really helpful too, to feel that. And to imagine that, Oh, wait, there is a support. Even for that, even if it's much lower than I am right now, it has an endpoint. And I think that helped to sort of open a little door for her to be able to, yeah. I mean, that's one of the first things I give people is can you feel supported exactly. As you are, can you feel the support of the surface you're sitting on standing on the earth, whatever.
45m 41s
Kevin O'Donoghue
And then where do you go from there? Okay. Yes. I feel supported, but I still feel this depression or, or do, do you get a, an image of, okay, I'm here. I need to climb out of this. I know what I need to do to climb out of this
45m 57s
Niseema Dyan Diemer
Eventually. But there also becomes like a container to contain the feeling. And if you contain that can contain the bad feeling. Maybe we get a little bit of a good feeling like, like Nancy Napier says, if there's one molecule that feels good on your body or feels like you from before now, it has a container to live in. It's not just flying about it has a container of you in your body. And, and we can start to build this capacity to hold that one molecule of goodness. Right. That one molecule of, okay,
46m 30s
Kevin O'Donoghue
You see, in my work, what I know is that I have to help them get angry. I have to get them angry eventually. And eventually it's going to be, I have to get angry at my mother and father, or I have to get an angry at my situation. I grew up in because that's where it started for me. I took this on because I had no other way to adapt. And for me to get my energy back, I have to get angry at these people that made me do this. Yeah. So we slowly climbed down the elevator. We'd go down the elevator like that in my work. And then I'm saying, so tell him, tell him what you're angry. I tell you, tell your mom what you're angry at you because frequently they will get the image of when they had to go inside and carry this inside.
47m 15s
Kevin O'Donoghue
Or they get the image of closing the front door when they went home and their shoulder sloping or something. And I said, okay, well, this is depression. Often we say is anger turned inward. Absolutely. So to stymie, I'm like, I know you're not your natural self. We're going to have to help you get angry and, you know, expert this anger, anger, and it's fine. It's fine. Cause I have a soundproof room. And you know, if a lot of problems with therapists won't do this with their clients because they're next to somebody else who's with their client and then somebody across the hall. And if they can't be yelling in that office. So I have a soundproof office, cause I know eventually all of my clients are going to yell and I want them to yell and yelling is going to help them tremendously.
48m 4s
Niseema Dyan Diemer
Absolutely. And to be able to feel the feeling after that, the sort of lightness that, that energy now finally expressed, maybe leaves a little space for some of that good feeling to bubble in. And if you have a sense of being able to hold and contain that a little bit and to say that that's, that's me, that's me starting to fill out. It's a beautiful experience to start seeing someone come into their energy. Cause what is anger? But there been an energy that's saying I'm me. I have a right to be me. I'm here. I'm alive. Anger is so part of that.
48m 43s
Kevin O'Donoghue
Yeah. So we want to ask people, have you had an anger, ectomy, will you anger, rectum, Mead. When was the last time you were anger, justifiably anger. And it felt good. You know, there used to be a, I remember reading an article, anger tastes good. You know, I view, are you allergic to anger? Have you been keeping yourself under control in an office? You know, I, it's amazing to see my, I see people who just would never have known to never get angry. And then they were allowed to get angry in my office and they're like total liberation. It's like, my wife doesn't know me anymore because I have so many different colors. Now. I'm not just this guy who's in control all the time.
49m 26s
Kevin O'Donoghue
I actually have a range of feelings. I was actually sad. The other day I cried in a movie the other day, you know, I saw the color in my child's bedroom and wow. I didn't know, is that color? So they're starting to come alive because, because they're allowed to get angry. They've said. Yeah.
49m 46s
Niseema Dyan Diemer
So for those clients who aren't in your office and maybe at home, listening to us, those folks out there who, who might feel like there's a little bit of this in their life, there are other strategies that you can use to start to support yourself, to be able to move into maybe another way of being, what did you have in mind? Well, reaching out to your friends or talking to a therapist. Of course.
50m 12s
Kevin O'Donoghue
Well, I would say let's, let's, let's not gloss over that one because I mean, what is the value of peer engagement for you? Have you lost your friends? Do you have friends? What's your relationship to friends? What's relationship to colleagues. Do you have easy access to conversation with people?
50m 33s
Niseema Dyan Diemer
Do you have any friends like Tigger or pu who are accepting of you who have maybe a little more confidence, a little more levity and can you be around them? Do you have friends like that? You might want to seek out some people like that too, to help balance a little bit of how you're feeling.
50m 51s
Kevin O'Donoghue
This is leading into an idea for the next show, because people will be going back eventually and we want to help them envision going back. You know, it can be like a very empty experience going back to work and back to certain environments having been away for three or four months. And if we help people prep prepare for, for that, it might lighten the, the trauma, the, the real disorientation that can happen. So that's that I think is bringing up a good idea, but targeting colleagues or friends that I actually would benefit being around that that sounds like a strategy, like own it.
51m 34s
Kevin O'Donoghue
I want it as a strategy. I'm going to only associate, I'm not gonna associate with the guys who want to do this or talk sports or, you know, whatever it is or just the downers, the other Debbie downers. Right. I'm going to target that other guy who I've been curious about a woman that I've been curious about and go to lunch with them and walk around the block with them.
51m 54s
Niseema Dyan Diemer
Notice how you start your day. Do you wake up and turn on the news immediately? Or do you take some time to process that you're waking up that you're here and maybe you listen to some nice music or you read a quote from a book that lifts you up or you go downstairs and make yourself a leisurely breakfast. That was a huge change in my life. I, I, instead of, you know, depending on the guys in the deli to make me a bagel, I said, you know what, I'm going to wake up half an hour earlier.
52m 29s
Kevin O'Donoghue
Surprise. I've noticed this about you. And I, I respect it. I mean, I've look at you and you do that. And I'm like, she really takes care of herself in the morning. Not you're not rushed. You're not rushed at all. And you, so, and it looks so natural and a habit with you when you wear your bathrobe, you know, you're just sliding around the floor. So I agree with that. I noticed like you don't need the television on right away in the morning. No. So, okay. So that's, I liked that one. So yeah, I think doing, you know, nurturing activities.
53m 8s
Niseema Dyan Diemer
Yeah. And being gentle with yourself. I mean, this change is hard. Change is difficult and slowing down in a good way. Not because you want to conserve your energy, but because you want to just take some time for yourself and to feel yourself before you enter your day,
53m 26s
Kevin O'Donoghue
What is it like to feel yourself? Yeah. You actually grab your muscle on your left arm or do you actually
53m 32s
Niseema Dyan Diemer
It's it's, it's getting back to what we said before I know about,
53m 37s
Kevin O'Donoghue
But meditation would be one of those as well, where, you know, and I was teaching, so a client the other day meditation, where we're just watching the thoughts, like the mind is a blue sky and a thought is a cloud. And you're just sitting, watching the cloud go right by whatever it is. And then another cloud is resurging up. And you're just watching that go by. And you're not reacting that's meditation and the breath and noticing your breath, always coming back to your breath. Let's give it a couple more. And before we go, you've been listening to the positive mind. I think friendshipness EMA. I think compatibility. I think sharing your world, we teach safe, safe conversations here on the positive mind.
54m 19s
Kevin O'Donoghue
That is always an accelerant to me for, if you want to feel better, have somebody mirror your words to them, tell them, you know, I feel awkward talking to you about this, but I need to talk about X. Could you listen to me? And then if they say yes, then they mirror back to you. Exactly what you say to them until you get to a point where you're finished at all and they will summarize everything you've said. And then they will say, you know what? It makes sense that you are thinking that way. You're not those thoughts. You're not those thoughts, but it makes sense. And then I can imagine you're feeling pretty down about this. You are more than this.We will talk more about safe conversations in our next show
54m 60s
Kevin O'Donoghue
you have been listening to the positive mind. I am Kevin O'Donoghue, licensed new york state mental health counselor. And I am Niseema Dyan Diemer, licensed massage therapist and trauma specialist
55m 3s
Niseema Dyan Diemer
Thank you for tuning in. If you have any comments about today's show, please send them to me at kevin@thepositivemind.com
55m 18s