Dysthymia (patient information)
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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Associate Editor-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.
Overview
Dysthymia is a chronic type of depression in which a person's moods are regularly low. However, symptoms are not as severe as with major depression.
What are the symptoms of Dysthymia?
- The main symptom of dysthymia is a low, dark, or sad mood on most days for at least 2 years. In children and adolescents, the mood can be irritable instead of depressed and may last for at least 1 year.
- In addition, two or more of the following symptoms will be present almost all of the time that the person has dysthymia:
- Feelings of hopelessness
- Too little or too much sleep
- Low energy or fatigue
- Low self-esteem
- Poor appetite or overeating
- Poor concentration
- People with dysthymia will often take a negative or discouraging view of themselves, their future, other people, and life events. Problems often seem more difficult to solve.
What causes Dysthymia?
- The exact cause of dysthymia is unknown.
- It tends to run in families.
- Dysthymia occurs more often in women than in men and affects up to 5% of the general population.
- Many people with dysthymia have a long-term medical problem or another mental health disorder, such as anxiety, alcohol abuse, or drug addiction.
- About half of people with dysthymia will also have an episode of major depression at some point in their lives.
- Dysthymia in the elderly is often caused by:
- Difficulty caring for themselves
- Isolation
- Mental decline
- Medical illnesses
When to seek urgent medical care?
- Call for an appointment with your health care provider if:
- You regularly feel depressed or low
- Your symptoms are getting worse
- Call for help immediately if you or someone you know develops these symptoms, which are signs of a suicide risk:
- Giving away belongings, or talking about going away and the need to get "affairs in order"
- Performing self-destructive behaviors, such as injuring themselves
- Suddenly changing behaviors, especially being calm after a period of anxiety
- Talking about death or suicide, or even stating the desire to harm themselves
- Withdrawing from friends or being unwilling to go out anywhere
Diagnosis
- Your health care provider will take a history of your mood and other mental health symptoms.
- The health care provider may also check your blood and urine to rule out medical causes of depression.
Treatment options
- Treatment for dysthymia includes antidepressant drug therapy, along with some type of talk therapy.
- Medications often do not work as well for dysthymia as they do for major depression. It also may take longer after starting medication for you to feel better.
- The following medications are used to treat dysthymia:
- Selective serotonin reuptake inhibitors (SSRIs) are the drugs most commonly used for dysthymia. They include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).
- Other antidepressants used to treat dysthymia include: serotonin norepinephrine reuptake inhibitors (SNRIs), bupropion (Wellbutrin), tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs).
- People with dysthymia often benefit from some type of talk therapy. Talk therapy is a good place to talk about feelings and thoughts, and most importantly, to learn ways to deal with them. Types of talk therapy include:
- Cognitive behavioral therapy (CBT): teaches depressed people ways of correcting negative thoughts. People can learn to be more aware of their symptoms, learn what seems to make depression worse, and learn problem-solving skills.
- Insight-oriented or psychodynamic psychotherapy can help someone with depression understand the psychological factors that may be behind their depressive behaviors, thoughts, and feelings.
- Joining a support group of people who are experiencing problems like yours can also help. Ask your therapist or health care provider for a recommendation.
Where to find medical care for Dysthymia?
Directions to Hospitals Treating Dysthymia
What to expect (Outlook/Prognosis)?
- Dysthymia is a chronic condition that lasts many years. Though some people completely recover, others continue to have some symptoms, even with treatment.
- Although it is not as severe as major depression, dysthymia symptoms can affect a person's ability to function in their family, and at work.
- Dysthymia also increases the risk for suicide.
Possible complications
If it is not treated, dysthymia can turn into a major depressive episode. This is known as double depression.