Dysthymia
(Dysthymic Disorder)
Pronounced: Dis-thigh-mee-uh
Definition
Dysthymia is similar to depression , but its symptoms are milder and it lasts longer—at least two years. People with dysthymia experience mild to moderate depression that may subside during periods of normal mood that last up to two months. Dysthymia can be treated with medications, so contact your doctor if you think you have this condition.
Causes
The cause of dysthymia is not known. It is thought that changes in the brain’s production of the chemical serotonin may play a role. Serotonin helps your brain handle emotions and make judgments.
Brainstem—Location of Serotonin Production
Risk Factors
These factors increase your chance of developing dysthymia. Tell your doctor if you have any of these risk factors:
- Sex: female
- Family history of major depression or dysthymia
- Chronic mental or physical illness
People who have dysthymia may also experience one or more episodes of major depression in their lifetime.
Symptoms
Dysthymia may be difficult to differentiate from depression due to many overlapping symptoms. People with dysthymia have more emphasized symptoms of:
- Social withdrawal
- Lack of hope for the future
- Pervasive feelings of inadequate performance
Other symptoms include:
- Feelings of sadness and/or hopelessness
- Poor appetite or overeating
- Difficulty functioning at work or school
- Difficulty sleeping or sleeping too much
- Trouble concentrating
- Fatigue
- Low self-esteem
Diagnosis
Your doctor will ask about your symptoms and medical history, giving special attention to:
- Level of fatigue and how well you are sleeping
- Ability to concentrate
- Family history of depression
Your doctor may perform tests and/or a physical exam to determine if you have another medical condition (eg, a thyroid disorder) or are taking a medication that is causing you to feel depressed. You may be referred to a therapist who specializes in treating depression.
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include:
Antidepressant Medications
Dysthymia can be treated with antidepressant medications that relieve depression. It may take a few weeks or months before you and your doctor can tell whether antidepressant medications are helping. You may need to take these medications for a number of years. It is important to keep taking them until your doctor tells you to stop.
Psychotherapy
Psychotherapy may include:
- Cognitive behavioral therapy
- Counseling
- Family therapy
- Interpersonal therapy
Lifestyle Modifications
In addition to medications and therapy, the following lifestyle modifications may help you feel better:
- Participate in enjoyable activities.
- Eat a healthful diet .
- Avoid illegal drugs and alcohol.
- Begin a safe exercise program with the advice of your doctor.
- Have a regular sleep schedule.
RESOURCES:
National Institute of Mental Health
http://www.nimh.nih.gov/
National Mental Health Association
http://www.nmha.org/
CANADIAN RESOURCES:
Canadian Psychiatric Association
http://www.cpa-apc.org/
Mood Disorder Association of Ontario
http://www.mooddisorders.on.ca/
References:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 4th ed. Arlington, VA: American Psychiatric Publishing, Inc; 2000.
Depression. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/depression/complete-publication.shtml . Accessed January 20, 2008.
Dysthymia. National Mental Health Association website. Available at: http://www1.nmha.org/infoctr/factsheets/26.cfm . Accessed January 20, 2008.
Dysthymia. University of Michigan Depression Center website. Available at: http://www.med.umich.edu/depression/dysthymia.htm . Updated February 2006. Accessed February 23, 2009.
Dysthymic disorder: when depression lingers. American Association of Family Physicians website. Available at: http://familydoctor.org/054.xml Accessed January 20, 2008.
Lim MA, Moncrieff J, Soares BGO. Drugs versus placebo for dysthymia. Cochrane Database of Systematic Reviews . 2005;2:CD001130.
Last reviewed January 2009 by Theodor B. Rais, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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