That Curious Word “Dysthimia” and How It Relates to Autism

Subjective well-being (SWB) is an area of interest in psychology that focuses on how people experience quality of life. Ultimately it is a subjective field based on people’s introspection and indices to the same are gathered from answering questionnaires although a few objective measures can influence this construct, e.g., lack of financial stressors. My own impression is that many autistics are dissatisfied with their quality of life and suffer an imbalance between their desires and goals and the fact that they not have available the means to achieve them. This imbalance can procreate a global tendency to perceive life in a negative manner. If not recognized and addressed early enough the individual may fall into a state of despair where he/she will feel helpless under almost any unpleasant circumstance. This lack of control over the outcome in our experiences carves a path to depression.

Absence of happiness is depression and everybody experiences it differently. Some symptoms of depression are well known including hopelessness, tiredness, loss of interest in daily activities, irritability or excessive anger, and sleep problems. When these problems persist for long periods of time (years), the patients may have “dysthimia” (from a Greek word that means a “bad state of mind”). The term itself has been changed in the latest Diagnostic and Statistical Manual (DSM) that defines psychiatric diagnoses to a Persistent Depressive Disorder. Curiously I have not been able to find studies on the prevalence of dysthimia in autism spectrum disorder (ASD).

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People with dysthimia tend to withdraw from daily activities in order to avoid the possibility of failure. They can withdraw to their room and play with the computer but find little pleasure in doing this or any other activity. They experience a feeling of worthlessness and blame themselves for things that have not even happened.

Nature and nurture both tend to play a role in dysthimia. Some people with dysthimia have a family history of depression. Major life stressors provide for risk factors for chronic depression. Some of these factors, usually seen in ASD, include stress, social isolation and lack of social support.

Since the disorder usually starts in childhood it is important to intervene early in order to increase resilience and boost self-esteem. It is important to provide rewarding positive emotions from regular involvement in the things that they like. Let them enjoy the moment of involvement for its won sake. Teach them about altruism. If their participation is meaningful enough it will allow them to experience something larger than themselves, something that will catapult you into the world of others. Help children create goals, mastery and thus accomplishments. Make a list of everything that is currently stressing them, rank the feeling of control they feel that they have over each one of them. List them in order of importance. Be ready to seek the assistance of a psychologist/psychiatrist. This health-related professional will examine the family and medical history (some types of drugs can precipitate depression) and see whether the patient is a candidate for antidepressant medications. Another type of therapy may be offered by someone trained in cognitive behavioral therapy (CBT). This technique trains people to adjust their thought life so that their emotional life can adequately respond to stressors. CBT is problem focused and action oriented. There are many popular books on the subject and helpful computerized programs available through the Internet.

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