Beating the Blues: New Approaches to Overcoming Dysthymia and Chronic Mild Depression

207 Pages·2004·1.1 MB·English

by  Michael E. Thase

Beating the Blues:
New Approaches to
Overcoming Dysthymia
and Chronic Mild
Depression
Michael E. Thase, M.D.
Susan S. Lang
OXFORD UNIVERSITY PRESS
BEATING THE BLUES
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BEATING THE BLUES

New Approaches to

Overcoming Dysthymia and

Chronic Mild Depression

Michael E. Thase, M.D.

and

Susan S. Lang

2004
Auckland Bangkok Buenos Aires Cape Town Chennai

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Copyright © 2004 by Oxford University Press, Inc.

Published by Oxford University Press, Inc.

198 Madison Avenue, New York, New York 10016

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Oxford is a registered trademark of Oxford University Press

All rights reserved. No part of this publication may be reproduced,

stored in a retrieval system, or transmitted, in any form or by any means,

electronic, mechanical, photocopying, recording, or otherwise,

without the prior permission of Oxford University Press.

Library of Congress Cataloging-in-Publication Data

Thase, Michael E.

Beating the blues : new approaches to overcoming dysthymia

and chronic mild depression /

by Michael E. Thase and Susan S. Lang.

p. ; cm.

ISBN 0–19–515918–7

1. Depression, Mental—Popular works. 2. Affective disorders—

Popular works. 3. Mood (Psychology)

[DNLM: 1. Dysthymic Disorder—rehabilitation—Popular Works.

2. Depressive Disorder—rehabilitation—Popular Works.

WM 171 T367b 2003]

I. Title: New approaches to overcoming dysthymia

and chronic mild depression.

II. Lang, Susan S. III. Title.

RC537 .T477 2003

616.85'27—dc21

2003006657

Excerpt from “Back” ©1966 by the Estate of Jane Kenyon.

Reprinted from Otherwise: New Selected Poems with the

permission of Graywolf Press, Saint Paul, Minnesota.

1 3 5 7 9 8 6 4 2
Printed in the United States of America
on acid-free paper
For my parents, Carl and Evelyn Thase,(cid:5)
for giving me a good start in life(cid:5)
M.E.T.(cid:8)
For Tom and Julia, who buoy my spirits by being there,(cid:5)
and for Bea (in memoriam)(cid:5)
S.S.L.(cid:8)
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Contents

Preface ix

Acknowledgments xi

PART ONE: UNDERSTANDING DYSTHYMIA AND
ITS MILDER FORMS
1. What Is Dysthymia? 3

2. The Spectrum of Dysthymia and Depression 14

3. How Dysthymia Is Diagnosed 30

4. Who Gets Dysthymia and Why: Causes and Risk Factors 41

PART TWO: HOW TO FEEL BETTER
5. The Psychology of Feeling Good 57

6. Psychotherapy 87

7. Medications 98

8. Exercise and Nutrition 112

9. Herbal and Other Types of Supplements 118

10. Supplemental Strategies 128

vii
viii CONTENTS
PART THREE: SPECIAL CONCERNS OF VARIOUS
POPULATIONS
11. Dysthymia in Children, Adolescents, and Young Adults 141

12. Gender and Dysthymia 147

13. Dysthymia and Aging 154

CONCLUSION: Putting It All Together 161

APPENDIX 1. Daily Symptom Log 165

APPENDIX 2. Most Commonly Used Antidepressants for

Dysthymia 166

APPENDIX 3. Resources (Organizations, Web Sites, Discussion

Groups, etc.) 168

REFERENCES 175

INDEX 185
Preface

This book is a collaboration of a leading depression researcher and an
award-winning, longtime science writer. Our purpose is to raise aware­
ness that suffering from chronic, low-grade depression does not have
to be a way of life. Low-grade depression corrodes the quality of life of
millions of people, with most never realizing that they have a highly
treatable condition.
It is not normal to be apathetic, passive, glum, sad, irritable, joyless,
hopeless, helpless, or negative, even for relatively brief periods of time.
In this book we focus on chronic forms of depression, which can last
years or decades. People who chronically have these feelings suffer from
a condition as legitimate as anemia, gastric reflux, or arthritis—if you
do nothing about it you may periodically feel okay, but the problem
probably won’t go away by itself, and in the long term, it could be­
come debilitating.
We have written this book to be as readable as possible, since we
know that depression can affect even the best reader’s attention span.
Our purpose is to inform and motivate readers to take action, not to
serve as a reference book for scholars. Therefore, we do not footnote
each statistic (which usually vary from study to study, depending on
methodology) but, rather, refer the reader seeking sources to an ex­
tensive bibliography, the appendices, or the ever-changing body of
ix