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Dysthymia

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Dysthymia or Dysthymic Disorder is a mental illness on the depression spectrum. It is less severe than Major Clinical Depression and is diagnosed when a patient experiences depressive symptoms for most of the day, more days than not, for at least two years. In some cases, people have suffered Dysthymia for twenty or thirty years before seeking treatment, not knowing that their chronic low-grade depression was a disorder. In children Dysthymia sometimes presents as irritability rather than sadness or depression, and for children these symptoms need to only be experienced for one year rather than two for diagnosis. If the symptoms intensify during the two years, you may be diagnosed with Major Depressive Disorder rather than Dysthymia. It is common to experience Dysthymia for two or more years, and then develop Major Depressive Disorder later.

DYSTHYMIA SYMPTOMS

The symptoms of both Depression and Dysthymia are the same; the difference is in the degree of severity. These symptoms include an increase or decrease in your appetite, an increase or decrease in the amount that you sleep, fatigue or very low energy, poor self-image, inability to concentrate, inability to make decisions, feelings of hopelessness or pessimism, not taking pleasure in things you used to enjoy, and a feeling of a lack of mental clarity. Another symptom is when any of these feelings begin to interfere with your work or personal life, or if they cause you serious distress. If you are suffering from Dysthymia, you will feel two or more of these symptoms most of the time, and while they may ebb and flow, they will never be absent for more than two months at once.

DYSTHYMIA DIAGNOSIS

Some mental disorders disqualify you for a diagnosis of Dysthymia. If you have had any manic or hypomanic episodes, or any mixture of those two things, you do not have Dysthymia. If you have ever suffered from Cyclothymic Disorder, which is a milder form of Bipolar Disorder, you cannot be diagnosed with Dysthymia. Sometimes the symptoms described above can be caused by a different medical condition, or by the use of substances, including prescription and non-prescription medications, alcohol, or illegal drugs. If this is the case with your condition, you do not suffer from Dysthymia. If your depressive symptoms are part of another major disorder, such as Schizophrenia or Delusional Disorder, you should seek another course of treatment, but you will not be diagnosed with Dysthymia.

One significant aspect of Dysthymia is that it usually develops early in life, in childhood or adolescence. Sometimes it develops slowly, so that symptoms develop gradually over years and become quite hard to differentiate from what caregivers know of the child’s normal character or behavior. By the time children or adolescents with Dysthymia are adults, 75% of them will develop Major Depression. Similarly, 75% of adults who develop Dysthymia will develop Major Depression within five years. If you have a first-degree relative (parent or sibling) with Dysthymia or Major Depression, you are more likely to develop Dysthymia yourself.
dysthymia
Image: Dysthymia

DYSTHYMIA TREATMENT

Several different types of treatment exist for all forms of Depression, including Dysthymia. One option is psychotherapy, a non-medical psychological course of treatments in which the patient meets with a therapist or psychologist and learns new ways of thinking and behaving in order to change their mind-set and emotional reactions. In addition to psychotherapy, or sometimes instead of it, doctors may prescribe an antidepressant for you. Antidepressants are medications which work in various ways upon the chemicals in your brain, helping them to balance and work at their most efficient. It is generally accepted that any antidepressant that works well for Major Depression will also work well for Dysthymia. The American Psychiatric Association recommends psychotherapy alone or in conjunction with an antidepressant as the ideal therapy for those suffering mild to moderate Depression, such as that experienced in Dysthymia.

One of the criterion for diagnosing Dysthymia is also one of its complications. For Dysthymia to be diagnosed, your difficulties must interfere with your social, occupational, educational, or other important tasks. With Dysthymia, not only do you feel Depression and its effects, but other areas of your life begin to suffer. Your relationships may suffer because you are frequently sad, angry, or impatient. Your work or studies may suffer because you cannot concentrate and you cannot gather the energy required to complete your assigned tasks. You may have such a poor opinion of yourself that you feel there is no use trying, since you doubt your ability to do anything well or right. This may mean not working to your fullest capacity, and experiencing the corresponding suffering of grades and job advancement. The lower your grades or job performance, the worse you feel about yourself, resulting in a self-perpetuating cycle of Depression.


If, at the same time, you are alienating your friends and family by your unpleasantness or anger, your life may begin to feel as though there is little in it that can ever bring you happiness or satisfaction, and that may depress you further. For children and adults, it is the case that more people commit suicide who have Dysthymia than those who have Major Depression. Children and adolescents who suffer from Dysthymia are often angry, irritable, and cranky. They can be difficult to get along with, and often have very low self-esteem, poor social skills, and are often pessimistic and unmotivated. It is easy to see how a case of Dysthymia can lead to a full-blown, major Depression in both children and adults.

Dysthymia is often either a precursor to other disorders or it exists side by side with them. In adults, as we have discussed, it is often a precursor to Major Depressive Disorder, a more extensive and intense form of Clinical Depression. In children, Dysthymia is associated with a higher risk of Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, Anxiety Disorders, Learning Disorders or Disabilities, and Mental Retardation. Dysthymia is found in about 6% of the population, and women are two to three times more likely to develop it than men.
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