Persistent depressive disorder (Dysthymia)

Persistent depressive disorder (Dysthymia) is a form of mood disorder that is chronic, or long lasting. Although generally less severe than major depression, dysthymia may last for many years and recur throughout a patient’s life. Dysthymia shares many symptoms with other forms of depression and may have a strong negative impact on a patient’s feelings, behaviors, and overall quality of life. However, numerous treatment options exist, and most patients find a combination of psychotherapy and medication that works for them.

Background

Some people use the term “depression” to describe a bad feeling of short duration, based on temporary circumstances. However, in the clinical sense, depression is a serious mood disorder that affects millions of people each year. One of the hallmarks of clinical depression is that it persists and creates noticeable symptoms for at least two weeks.

Depression is a major concern in many parts of the world. According to the National Network of Depression Centers (NNDC) in 2024, depression is the leading cause of disability among people ages 15 to 44 in the United States. It also ranks with stress and family crisis among the most serious personal problems faced by US workers.

Depression can be challenging to study and diagnose because it varies in severity and duration and shares symptoms with other mental and emotional disorders. Some usually temporary types of depression include seasonal affective disorder (SAD), which is triggered by changing seasons, and postpartum depression, which is experienced by many women after giving birth. Very severe and potentially dangerous mental illnesses related to depression include psychotic depression and bipolar disorder.

Persistent depressive disorder, or dysthymia, is generally a mild but long-lasting form of depression. This disorder is generally less severe than major depressive episodes, but may last for many years. Many cases last so long that patients assume it is part of their personality or cannot remember not feeling depressed.

Overview

Persistent depressive disorder, or dysthymia, is a long-lasting form of depression that may vary in severity but is generally milder than major depression. Dysthymia may last so long that, if left untreated, it begins to seem like a personality trait rather than a disorder. People with unrecognized dysthymia may be viewed as gloomy, dissatisfied, or incapable of enjoyment. Dysthymia can interfere with many aspects of life, including school, work, family life, relationships, and self-esteem.

Symptoms of dysthymia can vary significantly and often resemble those of other forms of depression and other mental disorders. Generally, depressed mood, irritability, and hopeless feelings are among the most frequent symptoms. These may occur alongside fatigue, lack of concentration, impaired decision-making, and lack of interest in activities that once brought satisfaction.

People with dysthymia often avoid social events and may become preoccupied with excessive self-criticism and shame over past events. Their performance at school or work may suffer, as may their personal relationships. Dysthymia may also contribute to unhealthy variation in appetite (overeating or not eating enough) and difficulty getting a restful night’s sleep.

Such symptoms may ultimately contribute to a wide assortment of personal problems and health conditions. Overall, dysthymia can greatly reduce one’s quality of life and daily performance. It can lead to other and sometimes more serious disorders such as major depression and anxiety, and may even promote dangerous or self-destructive thoughts. People with dysthymia are also more likely than average to engage in substance abuse or conflicts with family and friends.

Although dysthymia can last a long time and become engrained in a person’s lifestyle and self-image, it is usually a highly treatable condition that may be reduced. People with dysthymia may start a treatment process by reaching out for help or understanding from friends, family members, or other trusted associates. They may also discuss their feelings with a primary care doctor or mental health professional. People with dysthymia or any other disorder should call for emergency help if they are considering suicide or another destructive behavior.

Currently, no laboratory tests exist to diagnose this disorder. Most diagnoses are made by mental health professionals based on the symptoms experienced. Other cases are first noticed by primary care doctors who notice unusual changes in their patients that may evidence dysthymia.

In some cases, dysthymia may be partly caused by testable medical conditions, including anemia or thyroid problems. However, there is no known exact cause for dysthymia. The condition often seems to be rooted in more than one cause or risk factor. Many cases are caused by external factors, such as traumatic life events like severe stress or the death of a loved one. In most cases, however, dysthymia is likely caused by internal circumstances.

Many people with dysthymia have a brain that is formed or functions differently. Malfunctions or variances in brain chemistry that regulates mood is also a likely cause of dysthymia and other forms of mood disorders. In many cases, dysthymia may also be linked to genetics, with the condition being more common in people who have family members with the disorder. However, research remains inconclusive, and scientists do not know the exact workings of the brain or dysthymia.

Many people with depression do not get the treatment they need to reduce their symptoms. However, treatments for depression, particularly mild depression, can be remarkably effective when practiced consistently during the depressive episode and checked and maintained afterward.

Most successful treatment plans involve a combination of psychotherapy and prescription medicines. Psychotherapy is based on discussions between a patient and a healthcare expert. In dysthymia therapy, the expert might ask questions and gather information about the patient’s symptoms, reactions, attitudes, and thought and behavioral patterns. By identifying strong and weak points in the patient, the therapist may be able to help establish and maintain more positive ways of viewing life and coping with dysthymia.

At the same time, many healthcare experts can prescribe medication, such as antidepressants, to help reduce problematic brain functions and promote more stable, positive moods. Many antidepressants exist, and patients may have to try more than one to find one that provides the needed results without harmful side effects. With proper treatment, people with dysthymia have a strong likelihood of reducing the severity and duration of their symptoms and increasing their quality of life.

Bibliography

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“Depression.” National Institute of Mental Health, Mar. 2024, www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed 16 Oct. 2024.

“Get the Facts.” National Network of Depression Centers, 2024, nndc.org/facts/. Accessed 16 Oct. 2024.

Greenstein, Luna. “Understanding Dysthymia.” National Alliance on Mental Illness, 17 Jan. 2018, www.nami.org/depression-disorders/understanding-dysthymia/. Accessed 16 Oct. 2024.

“Persistent Depressive Disorder (Dysthymia).” Harvard Medical School, 8 Mar. 2023, www.health.harvard.edu/a‗to‗z/dysthymia-a-to-z. Accessed 16 Oct. 2024.

“Persistent Depressive Disorder (Dysthymia).” Mayo Clinic, 2 Dec. 2022, www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/symptoms-causes/syc-20350929. Accessed 16 Oct. 2024.

“Persistent Depressive Disorder (Dysthymia).” Psychology Today, 15 Feb. 2022, www.psychologytoday.com/us/conditions/persistent-depressive-disorder-dysthymia. Accessed 16 Oct. 2024.