Dysthymia

What is dysthymia?

Dysthymia is a milder, but long-lasting form of depression. It’s also called persistent depressive disorder. People with this condition may also have bouts of major depression at times.

Depression is a mood disorder that involves your body, mood, and thoughts. It affects the way you eat and sleep, think about things, and feel about yourself. It’s not the same as being unhappy or in a "blue" mood. It’s not a sign of weakness or something that can be willed or wished away. People with depression can’t "snap out of it" and get better. Treatment is key to recovery.

Dysthymia affects women twice as often as men. Some people may also have depression or bipolar disorder.

What causes dysthymia?

There is no clear cause for this type of depression. Mental health professionals think it’s a result of chemical imbalances in the brain. Many factors are thought to contribute to depression. These include environmental, psychological, biological, and genetic factors. Chronic stress and trauma have also been linked to this condition.

Dysthymia seems to run in families, but no genes have yet been linked to it.

What are the symptoms of dysthymia?

Dysthymia is  milder, yet more long lasting than major depression. Each person may experience symptoms differently. Symptoms may include:

• Lasting sad, anxious, or “empty” mood
• Less ability to concentrate, think, and/or make decisions
• Less energy
• Fatigue
• Feeling hopeless
• Weight and/or appetite changes due to over- or under-eating
• Changes in sleep patterns, such as fitful sleep, inability to sleep, early morning awakening, or sleeping too much
• Low self-esteem

To diagnose this condition, an adult must have a depressed mood for at least 2 years (or one year in children and adolescents), along with at least 2 of the above symptoms. The symptoms of this illness may look like other mental health conditions. Always talk with a healthcare provider for a diagnosis.

How is dysthymia diagnosed?

Depression often happens with other conditions, such as heart disease, or cancer. It may also happen with substance abuse or anxiety disorders. Often, people with dysthymia grow accustomed to the mild depressive symptoms and do not seek help. But, early diagnosis and treatment is key to recovery.

A diagnosis may be made after a careful psychiatric exam and medical history done by a mental health professional.

How is dysthymia treated?

Treatment may include one or a combination of the following:

• Medicine. Many different medicines are available to treat depression. It often takes 4 to 6 weeks for anti-depressants to have a full effect. It’s important to keep taking the medicine, even if it doesn’t seem to be working at first. It’s also important to talk to your healthcare provider before stopping. Some people have to switch medicines or add medicines to get results.
• Therapy. This is most often cognitive behavioral or interpersonal therapy. It focuses on changing distorted views of yourself and your environment. It also works to improve relationship skills, and identify and manage stressors.

Because this condition usually last for longer than 5 years, long-term treatment may be needed.

If you have depression, there are things you can do to help yourself. Depression can make you feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings may make you feel like giving up. It is important to realize that these negative views are part of the depression and may not reflect reality. Negative thinking fades as treatment begins to take effect. Meanwhile, consider the following:

• Get help. If you think you may be depressed, see a professional as soon as possible.
• Set realistic goals and don’t take on too much.
• Break large tasks into small ones. Set priorities, and do what you can as you can.
• Try to be with other people and confide in someone. It’s usually better than being alone and secretive.
• Do things that make you feel better. Going to a movie, gardening, or taking part in religious, social, or other activities may help. Doing something nice for someone else can also help you feel better.
• Get regular exercise.
• Expect your mood to get better slowly, not right away. Feeling better takes time.
• Eat healthy, well-balanced meals.
• Stay away from alcohol and drugs. These can make depression worse.
• It is best to postpone big decisions until the depression has lifted. Before making a big change -- change jobs, get married or divorced -- discuss it with others who know you well and have a more objective view of your situation.
• Remember: People rarely "snap out of" a depression. But they can feel a little better day-by-day.
• Try to be patient and focus on the positives. This may help replace the negative thinking that is part of the depression, and the negative thoughts will disappear as your depression responds to treatment.
• Let your family and friends help you.

Key points

• Dysthymia is a milder, yet more chronic form of major depression. People with this illness may also have major depression at times.
• There is no clear cause of this disorder, but mental health professionals think it’s a result of chemical imbalances in the brain. Some types of depression seem to run in families, but no genes have yet been linked to depression.
• In general, nearly everyone with depression has ongoing feelings of sadness, and may feel helpless, hopeless, and irritable. Without treatment, symptoms can last for many years.
• This condition is most often treated with medicine, therapy, or a combination of both.

Next steps

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.