As a teenager and young man I struggled with an undiagnosed case of dysthymia. Dysthymia is defined as a consistent case of major depression lasting longer than 6 months time more days than not. I was so, so sad. All the time.

Looking from the outside in, I’m sure I looked like a perfectly fine kid — maybe reserved, but overall doing fine in life. I had friends of all kinds, but particularly in the “popular” group of folks were the people I regularly hung out with — though I was still on the outs of that group it seemed, never truly fitting in. But internally, I was struggling, struggling so deeply. Inside it felt like I was at the bottom of a deep, dark, dirty well. And it felt like no one was coming to save me. It felt like even God turned His face away from me. 

A few people tried to throw me a rope. I remember one particular time when I was feeling much lower than usual, and I walked the track during gym class all by myself. Around halfway through, a girl, who we’ll call Lindsey, came up to me and asked “Hey, are you okay? Do you want to come walk with us?” She was walking with a group of her friends, friends who I all knew and was completely fine associating with personally, but my primary friend group of the time would have questioned why I was associating with “them.”

“Oh, no I’m fine Lindsey! I just feel like walking alone today, but thank you! Nothing to be worried about!” I lied.

It was so hard to let people in during that time. It was like if I invited someone to come join me at the bottom of that deep well, they’d realize just how deep I was and would say “Oh my, this is too much for me. You’re too much for me. I don’t like what I see, I’m going to leave and tell everyone to stay away.” 

Then I’d really be alone.

A more accurate definition of dysthymia, a lived definition, might go something like this: the knowledge that you are unwanted, unloved, but you have some small whisper that says you might be wrong, that there might be someone out there who will love you, who will see you. But if you trust in that, your small voice might get squashed, you might find out that no one loves you, no one wants you and it was magical thinking all along. Dysthymia is the fear, the terror really, that no one in this world actually wants you — that they just put up with you.

Dysthymia is the fear, the terror really, that no one in this world actually wants you — that they just put up with you.

Work with me long enough as you’re therapist and you’ll come to find out that I’m not one for the labels of the DSM-V. Overall, they seem limiting. Sure, it puts a name to the symptoms you experience, and that can be a helpful thing, but it also can be limiting. I Am major depression,  I Am Generalized Anxiety, I Am Obsessive Compulsive, I Am unable to pay attention or be still (ADHD). I say that knowing I am one man, one therapist, one minister, and many others who are smarter, wiser, more educated, more experienced, may think much differently. But this young man, this inexperienced therapist, and moderately experienced minister, believes you are not your symptoms. 

Maybe I say that to tell myself I am not my symptoms, like it’s my own personal way to get through this world intact. But I have to believe it. If I live in a world where my mental health symptoms define me, that they can’t be helped, that I have to live with managing them the entirety of my life, then I rob myself from the possibility that I can move past them and live into the Imago Dei within me. And, for this young, inexperienced male pastoral therapist, I believe the Imago Dei within me — the part of God Himself, a unique part of God that no one else on this earth has within them, that He has placed within me — is what defines me, not my symptoms. Not Dysthymia.

The Imago Dei within me… is what defines, me not my symptoms.

I am part of I Am (YHWH) (Gen. 1:26-27; 1 John 4:13). I am not Dysthymia. You are not your diagnosis, or rather your symptoms, either.

Of course, I would be a fool to say that our diagnoses don’t affect us, or that they are not real. They very much are. For me, I have a diagnosis that names I have difficulty seeing the brighter side of life. It takes a lot of intention and attention to see it. For you, fill in the blank of your diagnosis. That’s real.

Some diagnoses are a part of identity — meaning they do need some level of management, whether through medicine, wholistic, or consistent counseling, to create what we deem as society to be “normal” cognitive functioning or emotional regulation. A few diagnoses I would argue are defining such as Schizophrenia, Dementia, and other disorders that severely impede cognitive functioning. In short, I’m saying — as with many things in the world — that it’s grey. It is not black and white.

What I am saying is that our diagnoses aren’t a definition for the overwhelming majority of us, rather they are an explanation. A label that may or may not be helpful to us to say “Oh, the things I’ve been through in my life show up within me in X way.” There is a step beyond diagnosis to question “Now WHY do these things that I have been through my life show up within me in X way? What did these things make me believe about myself (AKA how did I interpret them)? Are those thoughts really true?”

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For me: WHY do the things that I have been through in my life show up within me in a persistent depression or sadness in my life? Why did these things make me believe that no one really wants me or loves me, and that everyone puts up with me? Is that really true? Am I really that unwanted? Am I being reasonable, or is my trauma taking over?

What is your why? Most mental health diagnoses aren’t created in a vacuum — they are fostered by messages we received, things that happened to us, and events we are exposed to in the greater culture (9/11, Covid, 2008 Housing Crisis, etc). Your mental health diagnosis did not appear out of nowhere. It was created over years of conditioning — from others and possibly yourself.

But all is not lost; you can flip the script. By doing the hard work of encountering the hardest parts of your life, the most painful messages, you can become someone you never thought you could be. Someone who is wise, grounded, and at peace. You can become more in line with the unique Imago Dei within you.