Dysthymia

CBT's pathway out of chronic depression & suicidality

Next session:  Wed, November 18, 2026 (12:00PM–3:30PM Eastern)

Earlybird deadline:  Fri, November 13, 2026 at 5:00PM Eastern

OVERVIEW

The Dysthymia module covers three related topics: brief CBT for dysthymia (assumes ten-minute appointments), brief CBT for suicidality (focusing on what to say in the moment), and victimhood culture (an exacerbant on the rise). 

NOTE: The new DSM-5-TR (released on March 18, 2022) refers to dysthymia as persistent depressive disorder.

1. DYSTHYMIA.  The persistently depressed deserve great compassion. After faring poorly in the genetic lottery, many proceed to experience worse day-to-day luck than your average bear. 

May 18, 2000 was a historic & happy day in psychiatry. That morning the New England Journal of Medicine published the results of a landmark dysthymia treatment study. The large NIMH investigation found that with "CBT 2.0", over 85% of the chronically depressed improved 50% or more. Notably, the 681 patients in the multicentre trial were “real-life” dysthymics: they’d been depressed more-days-than-not for over 23 years (with an average “double depression” duration of over 8 years), over 59% had a personality disorder, and over 33% had a substance abuse history.

More happy news: If you're selective & strategic, you can incorporate many key elements of the "CBT 2.0" treatment package into the ten-minute appointments typical of primary care. And if you do, your dysthymic patients will thank you—thereby lifting a heavy weight off your shoulders. 

2. SUICIDALITY. Most physicians have a sense of despair regarding suicidality. There is a widespread lack of confidence in screening, a deep uncertainty about how to manage the risk, and often a feeling of shame (accompanied by nasty self-criticism) when Something Bad happens.

In this highly anxiolytic component of the Dysthymia module, we begin with a review of the science and CPGs regarding suicide risk factors, suicide screening, and suicide-prevention interventions.

We then focus on what really matters: precisely what to say (and how to say it) in the here & now with the suicidal patient to reduce their motivation to act. Several dozen strategies are reviewed and practiced within the workshop.

3. VICTIMHOOD CULTURE.  Victimhood culture is on the rise, and its impacts are becoming very widespread. Although victimhood culture is a short topic in the Dysthymia module, it's undoubtedly the spiciest one.  

Historically, we had an honor culture (e.g., “Offend my house, and we shall duel with pistols at noon”). When the smoke cleared, honor culture was largely replaced by the dignity culture in which most of us were raised (e.g., “Sticks and stones may break my bones, but names will never hurt me”). Today victimhood culture is ascending. Victimhood culture is characterized by an external locus of control, a sensitivity to slight, and a heavy reliance on compensation mediated by third parties.

Where did victimhood culture originate, and why is it growing so fast? What is its impact on the prognosis of our dysthymic patients? Where might victimhood culture lead, and what solutions are at hand?  

Please do join us! After completing the Dysthymia module, many physicians report they wish they’d taken it at the start of their careers, asserting that they could have spared themselves a significant amount of stress & heartache.

Recommended companion courses

1. Depression  The Complete CBT Package
2. GriefWork Growing from Life's Inevitable Losses
3. Happiness Science  Evidence-Based Guidance for the Universal Quest

Head instructor Greg Dubord, MD is the CME Director of CBT Canada, and the prime developer of medical CBT. He has presented over 500 workshops, including over 50 for the College of Family Physicians of Canada, and is a University of Toronto CME Teacher of the Year.

Register promptly and save $200

Sponsors of CBT Canada's workshops have included the CFPC, 
Dalhousie, McGill, McMaster, Memorial, Queen's, UAlberta, 
UBC, UCalgary, UdeM, USask, UToronto, and Western (UWO).

Select your preferred date

Times below are Eastern

If you ever need to cancel your registration for any reason whatsoever, you may transfer 100% of your tuition to another workshop without any penalty, or receive a full refund minus a 25% processing fee (policy). 

* Unbiased, frank, and open exploration of very challenging topics... 10/10.  —Edward Fitzgibbon, MD, CCFP(PC) (Ottawa, ON)

* I loved the practical approach to these problems. My experience with patients with "dysthymia" would have been less frustrating!  —Linda Thyer, MD, CCFP(SEM) (Burnaby, BC)

* Many practical applications. Gives me hope for the future!  —Barend Olivier, MD (Edmonton, AB)

* Super helpful… An enlightening thought provoking and entertaining workshop as always.  —Janice Wong, MD, FCFP (Vancouver, BC)

* Good review of the symptoms and approach to treatment dos and don'ts —Elivia Morrison, MD (Moncton, NB)

* I was beginning to feel that I was the only one not on board with the new trends in our society. If I'd taken this earlier, I would have lost a lot less sleep over things that I have said. A great course!  —Wilna Wildenboer-Williams, MD, CCFP(AM), FCFP (Bath, ON)

*I greatly enjoyed the workshop. Dr. Dubord is able to present and illuminate complicated topics in such a way that I gained real insights and take home points that will improve my effectiveness as a physician.  —Karl Heinz Mascher, MD (Lillooet, BC)

* Solutions to timely issues that plague our patients and society.  —Derek Poteryko, MD, FCFP (Nanaimo, BC)

* Very interesting. Good discussion around really practical topics.  —Philip Bock, MD, CCFP (Fredericton, NB)

* Such great topics! I wanted the speaker to keep going!  —Richard Buck, MD, CCFP(EM), FCFP (Lethbridge, AB)

* Very practical for day to day challenges with patients. I've been 22 years in this practice and some of my patients have been depressed since I started.  I could have helped them better.  —Jeanette Dietrich, MD, FCFP (Sydenham, ON)
* The topics are most relevant, and I really like Greg's direct and no nonsense approach to the content. 10 out of 10.  —Anna-Marie Maguire, MD (Powell River, BC)
* Practical, evidence based advice for a prevalent, thorny problem. I can hardly begin to add up the hours and frustration I would have saved through my 35 years of practice if I'd taken this workshop earlier!  —Tim Erickson, MD, CCFP (Spruce Grove, AB)

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