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Dysthymic Disorder

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. it is a serious state of chronic depression, which persists for at least 2 years; it is less acute and severe than major depressive disorder. As dysthymia is a chronic disorder, sufferers may experience symptoms for many years before it is diagnosed, if diagnosis occurs at all. As a result, they may believe that depression is a part of their character, so they may not even discuss their symptoms with doctors, family members, or friends.


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 longterm 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

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.

Diagnosis of Dysthymic Disorder

A. A person has depressed mood for most the time almost every day for at least two years. Children and adolescents may have irritable mood, and the time frame is at least one year. B. While depressed, a person experiences at least two of the following symptoms: Either overeating or lack of appetite. Sleeping to much or having difficulty sleeping. Fatigue, lack of energy. Poor self-esteem. Difficulty with concentration or decision making. Feeling hopeless. C. A person has not been free of the symptoms during the two-year time period (one-year for children and adolescents). D. During the two-year time period (one-year for children and adolescents) there has not been a major depressive episode.

E. A person has not had a manic, mixed, or hypomanic episode. F. The symptoms are not present only during the presence of another chronic disorder. G. A medical condition or the use of substances (i.e., alcohol, drugs, medication, toxins) do not cause the symptoms. H. The person's symptoms are a cause of great distress or difficulty in functioning at home, work, or other important areas.

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) -escitalopram (Lexapro) Other antidepressants used to treat dysthymia include: -serotonin norepinephrine reuptake inhibitors (SNRIs) -bupropion (Wellbutrin) -tricyclic antidepressants -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 same problems.

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."