Thursday, October 30, 2014

24. Persistent Depressive Disorder (Dysthymia)

Dysthymia (dis-THIE-me-uh) is a mild but long-term (chronic) form of depression. Symptoms usually last for at least two years, and often for much longer than that. Dysthymia interferes with your ability to function and enjoy life.
With dysthymia, you may lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem and an overall feeling of inadequacy. People with dysthymia are often thought of as being overly critical, constantly complaining and incapable of having fun.
Dysthymic Disorder is a type of chronic depression similar to Major Depressive Disorder although much less severe. Like Major depressive disorder, Dysthymic Disorder is characterized by emotional and behavioral symptoms such as feelings of hopelessness, insomnia, inability to concentrate, low energy and irritability. However, those with Dysthymic Disorder often exhibit fewer and less extreme symptoms than those with Major Depressive Disorder for longer periods of time. To be diagnosed with Dysthymic disorder, one must exhibit two or more symptoms of the illness for two years or more in order to be considered for treatment. If left unaddressed, Dysthymic Disorder can disrupt normal functioning in the lives of those suffering from it. Talk to a doctor or mental health practitioner if you believe you or a loved one may have this condition.

Common Symptoms of Dysthymic Disorder

  • For the majority of days within a two-year period, the patient reports being depressed or appears depressed to others.
  • Typical symptoms of Dysthymic Disorder do not relent for longer than two months in a row.
  • Within the first two years of the illness the patient has not suffered a major depressive episode.
  • The patient has not had a manic episode or been or been diagnosed with Cyclothymic Disorder.
  • Another medical condition or medications or other substances do not cause the illness.

Treatment of Dysthymic Disorder

It should be noted that 75% of people with Dysthymic Disorder have had a chronic physical illness, anxiety disorders or substance abuse problems. Also, people with Dysthymic Disorder often come from families who have exhibited the depressive symptoms of Dysthymic Disorder. Treatment options for this condition include medications, psychotherapy and support groups among others. These treatments are very similar to those used for people with Major Depressive Disorder. Medications include anti-depressants like Zoloft, Prozac and Paxil. These medications, however, can sometimes come with very negative side effects. Suicidal thoughts and aggression have been reported as negative side effects, along with physical side effects such as low blood pressure, nausea, diarrhea, insomnia and short-term memory loss. Psychotherapy includes cognitive behavioral therapy and interpersonal psychotherapy. A doctor or mental health professional may help you or your loved one cope with the symptoms of Dysthymic Disorder. The long-term effects can disrupt the normal everyday functioning of a person with the condition, especially because of the illness’ persistence. Approximately 10% of people who suffer from Dysthymic Disorder later develop Major Depressive Disorder. Do not let your illness get to this point. There are plenty of experts willing to help and people who can relate.

Review Sources

  • University of Michigan Depression Center – This page provides information on dysthymic disorder, facts and figures, existing treatment options and possible long-term effects.
  • Wikipedia – This page contains information on dysthymic disorder, characteristics of someone suffering from the condition, causes and treatment.

Persistent Depressive Disorder, formerly known as Dysthymic Disorder (also known as dysthymia), has been recently renamed in the updated DSM-5 (2013). 
The essential feature of persistent depressive disorder (dysthymia) is a depressed mood that occurs for most of the day, for more days than not, for at least 2 years (at least 1 year for children and adolescents). This disorder represents a consolidation of DSM-IV-defined chronic major depressive disorder and dysthymic disorder. Major depression may precede persistent depressive disorder, and major depressive episodes may occur during persistent depressive disorder. Individuals whose symptoms meet major depressive disorder criteria for 2 years should be given a diagnosis of persistent depressive disorder as well as major depressive disorder.
Individuals with persistent depressive disorder describe their mood as sad or “down in the dumps.” During periods of depressed mood, at least two of the following six symptoms from are present.
  • Poor appetite or overeating
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness
Because these symptoms have become a part of the individual’s day-to-day experience, particularly in the case of early onset (e.g., “I’ve always been this way”), they may not be reported unless the individual is directly prompted. During the 2-year period (1 year for children or adolescents), any symptom-free intervals last no longer than 2 months.
In children and adolescents, the mood can be irritable and it must have lasted at least one year.
Furthermore, in order to be diagnosed with Persistent Depressive Disorder, there has never been a Manic Episode, aMixed Episode, or a Hypomanic Episode in the first 2 years, and criteria have never been met for Cyclothymic Disorder.
In order to meet the diagnostic criteria for Dysthymic Disorder, the symptoms may not be due to the direct physiological effects of a the use or abuse of a substance (for instance, alcohol, drugs, or medications) or a general medical condition (e.g., cancer or a stroke). The symptoms must also cause significant distress or impairment in social, occupational, educational or other important areas of functioning.


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