Why can’t I recover from dysthymia?

I am struggling with trying to have normal conversations with people where my body is not tense and in fight/flight, anxiety, fear and sadness mode.
Asked by Cici

Hi Cici! I am so glad to see that you have reached out for support on the BetterHelp platform. The fact that you are seeking out guidance on this topic shows your courage and strength. My hope is that I can help to guide you in coming up with a plan of action as you continue the process of recovering from dysthymia.

I understand that you have been struggling with managing symptoms consistent with dysthymia for quite some time now. What type of symptoms have you been having? Have you been experiencing fatigue? Are you feeling irritable lately? Have you experienced a sense of hopelessness? How would you rate the frequency and intensity of your symptoms on a scale of 1 to 10? Also, what have you been doing to manage your symptoms thus far? I hope that you have been doing what you can to take care of yourself.

I realize that dysthymia is a chronic mental health disorder that typically lasts for two or more years. When were you first diagnosed with this condition? From your perspective, how did your symptoms begin to worsen over time to the point of clinical significance? Do you have a childhood history of depression? 

Take some time to reflect on your experiences with dysthymia. Perhaps you can write a reflective journal entry about how these experiences have impacted you. Draw or create a timeline about your mental health history if you are willing to do so. Some additional questions that may be helpful for you to explore include: What are some of your personal triggers or warning signs for feeling depressed? What are some of your hopes about feeling better? How will you start to keep track of your symptoms in order to be able to notice improvements? If you could change one thing about your dysthymic condition, what would that be? What would your life look like if you were to fully recover from dysthymia? Take some time to envision your future without having to continuously cope with dysthymia.

I know that you mentioned that you have been trying to uphold meaningful conversations with the people in your life. Who would you identify as being actively involved in your support system? Are there people in your life who you can trust and talk about this experience with? I think that it would be a good idea for you to recognize your support system and build upon the supports that you already have in place.

What are some of the major barriers that are preventing you from feeling better? Are some days worse for you to get through than others? Based on how you mentioned the concept of recovery in your question, it seems like you have hope that things may begin to improve for you in the future.

I realize that what you have going through is not easy, to say the least. I would like to recommend that you try some self care related activities on a daily basis. Active minds has some great ideas, resources and podcasts on this topic. Here is the link to some ideas for self care and coping skills:


I understand that you have been noticing yourself go into fight or flight mode and that you also notice yourself feeling tense. I would like to encourage you to practice some grounding exercises. Connect to the five senses and notice your feet firmly planted in the ground. Allow yourself some time to discover your sensory experiences through mindful breathing.

Here is a link for additional ideas on grounding:


Also, I would like to encourage you to participate in meaningful activities, such as creative art making interventions. Art making can facilitate and fuel the healing process. You may want to start by coloring in mandalas using colored pencils, markers, or water colors. Drawing within a circular format can bring a sense of wellness and physiological relaxation to the body. Perhaps you can draw a picture of the things that you are feeling grateful for. Another art based projective drawings technique is the Draw a Person in the Rain directive. By drawing a person in the rain, you may obtain a clearer understanding about your own resilient nature. Here is a link to more information about this unique art therapy intervention:


At this time, I would like to recommend that you begin attending individual counseling sessions. Having time to express your feelings and concerns with a trained therapist on a regular basis will likely be beneficial for you. You may want to explore cognitive behavioral therapy (CBT) approaches with your counselor. The basis of CBT is that thoughts, feelings and behaviors are interconnected. Another option that you have on BetterHelp is to attend group therapy sessions or a groupinar. Connecting with other individuals who are experiencing similar symptoms of persistent depressive disorder could be helpful for you, as well. Take the time that you want to consider your needs and explore your options for therapy.

Thank you again for your time in asking this valuable question about dysthymia on the BetterHelp platform. I hope that my response has been helpful for you in some way. I want to wish you all the best on your therapeutic journey. Please harbor some hope that you can conquer the dysthymic experience. Have a good day!