Dysthymia: A Form of Mild Chronic Depression

Introduction

Also called neurotic depression, dysthymic disorder, or chronic depression, is defined as a mood disorder consisting of the same cognitive and physical problems as in depression, with less severe but longer-lasting symptoms. DSM-IV's definition of dysthymia, it is a serious state of chronic depression, which persists for at least 2 years (1 year for children and adolescents); it is less acute and severe than major depressive disorder. Dysthymia has a number of typical characteristics: low energy and drive, low self-esteem, and a low capacity for pleasure in everyday life. Dysthymia is characterized by depressed mood experienced the majority of the time for a minimum of at least two years, along with at least two of the following symptoms:

Main Item

• Low self-esteem
• Low energy or fatigue
• Feelings of hopelessness
• Insomnia or excessive sleep
• Poor appetite or overeating
• Poor concentration or indecisiveness

More severe symptoms that mark major depression, to include, 'anhedonia,' or the inability to feel pleasure, thoughts of death or suicide, and psychomotor symptoms - especially agitation or lethargy, are many times absent in dysthymia. The disorder may happen alone or in conjunction with other psychiatric or mood disorders. For example; greater than 50% of those who experience dysthymia will experience at least one episode of major depression. When this occurs it is known as double major depressive disorder. Dysthymia is nearly as common as major depression and affects approximately 6% of the population in America. As with major depression, dysthymia occurs twice as often in women as it does in men.

Causes of Dysthymia

While the exact cause remains unknown, dysthymia seems to have its roots in a combination of biochemical, genetic, psychological and environmental factors. In addition, trauma and chronic stress may provoke dysthymia.

Stress is believed to impair a person's ability to regulate moods and prevent mild sadness from persisting and deepening. Social circumstances, especially isolation and the unavailability of social support, contribute to dysthymia as well. The cause may be particularly debilitating considering that depression many times alienates people who are in a position to provide support, resulting in increased isolation and a worsening of symptoms.

As a person becomes older, dysthymia is more likely to be the result of medical illness, bereavement, cognitive decline, and physical disability. In addition, the loss of a loved one, trauma, a difficult relationship, or any stressful situation might trigger a depressive episode. Subsequent depressive episodes might happen - with or without a clear trigger.

Research indicates that depressive illnesses are disorders of the brain. Brain imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of those who experience depression look different than the brains of people without depression. The parts of the brain responsible for regulating:

• Mood
• Sleep
• Thinking
• Appetite
• Behavior

appear to function abnormally. In addition, important neurotransmitters, chemicals that a person's brain cells use to communicate, seem to be out of balance. Yet MRI images do not reveal why the depression has occurred.

Dysthymia Research Finding:

• Almost 50% of people with dysthymia have a symptoms that also occurs in major depression.
• A telephone survey of more than 800 adults found only 20% had seen a mental health professional. Only 25% had received medication and only 33% had received some kind of counseling.
• A survey by the Depression and Bipolar Support Alliance found that doctors and patients often have poor communication about the symptoms and treatment of depressive disorders, including information about the side-effects of medication and the need for follow-up visits.

Treating Dysthymia With Psychotherapy and Medication

A number of people with dysthymia do not receive the treatment they need. In many instances this is because they only see their family doctors, who often times fail to diagnose the disorder. A part of the problem is that people who experience dysthymia believe their symptoms are an inevitable part of life and living. In people who are older, apathy, dementia, or irritability may disguise dysthymia. Asking open-ended questions such as, 'How are things going at home' may help a doctor to start noticing the signs of dysthymia.

As with major depression, dysthymia may be treated with supportive therapy that provides reassurance, advice, education and sympathy. Like the process of learning, which involves the formation of new connections between nerve cells in a person's brain, psychotherapy works by changing the way a person's brain functions. Certain types of psychotherapy including supportive therapy, psycho-dynamic therapy, cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), may help to relieve dysthymia.

Supportive therapy provides reassurance, advice, education and sympathy about the disorder. CBT helps to identify and change the negative styles of thinking that promote self-defeating attitudes and behaviors and improves social skills while teaching ways to manage stress and unlearn learned helplessness. Psycho-dynamic therapy helps people to resolve emotional conflicts, particularly ones derived from childhood experiences. IPT helps people to cope with personal disputes, transitions between social roles, loss and separation. Preliminary evidence from an ongoing study indicates that IPT in particular might hold promise in the treatment of dysthymia.

As with other forms of depression, there are a number of medication options for people who experience dysthymia. The most common drug treatments include selective serotonin reuptake inhibitors such as sertraline and prozac, or one of the newer dual-action antidepressants such as venlafaxine. Some people might respond to tricyclic antidepressants such as imipramine. Antidepressant medications have a number of side effects that may complicate treatment. For example; SSRI's may cause mild insomnia, stomach upset, or a reduced sex drive.

For many people, a long term combination of medication and psychotherapy that includes a solid relationship with a mental health professional is the most effective course of treatment. Recovery from dysthymia may take an extended period of time and the symptoms often return. Due to this reason, a number of people are encouraged to continue doing whatever made them well - whether it was therapy, a medication, or a combination of both; even after they have recovered.

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Cite This Page (APA): Thomas C Weiss. (2014, March 21 - Last revised: 2021, August 30). Dysthymia: A Form of Mild Chronic Depression. Disabled World. Retrieved October 9, 2024 from www.disabled-world.com/health/neurology/depression/dysthymia.php

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