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Dysthymic Disorder

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Unhappy, gloomy, uninspired, apathetic, inactive, withdrawn, sluggish - these words best describe the state of mind of those affected by dysthymic disorder. In all, the social, emotional and physical functioning is impaired. At least for the last two years or more, their world has had nothing to be happy about but filled with sadness.


Here is information about dysthymic disorder. Check how to differentiate dysthymic disorder from other types of depression disorders. Know dysthymic disorder symptoms, diagnostic procedures and various treatment options. Does a multi-dimensional approach of medications, therapy, exercise, change in diet and self-help contribute to a permanent cure? Find out.


Dysthymic disorder

Dysthymic disorder is also known as 'dysthymia'. Dysthymic disorder is a chronic, mild form of depression. It is considered chronic, as it tends to start at an early age, may be childhood or early adulthood and remains for a long span of time. Spotting dysthymic disorder can be difficult. People closely associated with the individual may feel that it is normal lazy behavior, a pessimist, and overly serious or sluggish personality. Even the affected individual may not consider it any different to feel 'low' or depressed almost day in and day out.


It is a matter of concern if it has been the way for at least two years or longer. Besides a depressed mood, the individual may show typical signs of depression such as low self-esteem, low energy and sleep disturbances. But they are able to function adequately well and hardly appear to be sick.


If not given the deserved attention, it can become a more serious depression called Major Depressive Disorder. The combination, dysthymic disorder plus major depression is referred to as 'double depression'. Those affected by double depression are so depressed that eventually they can become a threat to themselves and others around. It is at this stage, hospitalization becomes necessary as the individual becomes functionally impaired.


Dysthymic disorder symptoms


The most essential feature of dysthymic disorder is that the individual is consistently been depressed for most days at least for two years. The time period for children and adolescents is at least 1 year. Also, the individual must have experienced two or more of the following symptoms for a minimum period of two months.

  • Inability to enjoy or have fun.
  • Poor appetite or overeating.
  • Insomnia or hypersomnia.
  • Low energy or fatigue
  • Low self-esteem
  • Lack of interest
  • Poor concentration or difficulty making decisions.
  • Feelings of helplessness, hopelessness, worthlessness
  • Feelings of guilt.
  • Physical ailments like headaches, cramps or digestive problems that do not respond to treatment.

Dysthymic disorder causes

Definite causes of dysthmia are yet to be ascertained. Researchers have listed these contributing factors.


The chemical connection: Imaging studies conducted indicate that the naturally occurring brain chemical serotonin, a neurotransmitter isn't sufficiently balanced. Serotonin helps the brain handle emotions and make judgments.


Genes: The chance of being affected is high where an immediate family member is suffering from major depression. Biological and genetic factors only increases the risk by three times but other factors like environmental circumstances, stress may trigger the disorder.


Environment: Situations that are difficult to cope with, especially not finding enough emotional support contribute to developing the disorder. This is true especially when a child develops the disorder early in life. Associated factors are lack of love and attention from parents; physical or sexual abuse, excessive parental pressure etc contribute to developing low-self esteem and negative thinking.


Identifying dysthymic disorder

Dysthymia can affect men or women; but is more common in women. Understanding the symptoms and identifying these changes are vital in extending required attention to the affected individual. Postponement may lead to more severe forms of the condition, as well as drug or alcohol abuse.


Changes in appetite: It can be abstinence or over indulgence. If left untreated, it can lead to eating disorders like anorexia or bulimia.


Change in sleeping habits: Depression and excessive sleeping are closely related. Sleeping provides an avenue to escape and disconnect from day-to-day happenings of life. Not content with the rest, some may still feel tired and sleepy. The other extreme is sporadic or chronic insomnia.


Lethargic attitude/behavior: It is common to hear them say 'feeling tired all the time'. When the mood elevates at times they are happy but otherwise they complain of being unhappy or find it difficult to find pleasure in activities, which they used to enjoy. They like to isolate from others


Feeling insecure: A simple conversation is good enough to understand what they perceive of themselves. Low self-esteem, lack of confidence, absence of self-worth and value are some common insecure thoughts the individuals are likely to have.


Lack of concentration and attention: The affected individual may find it difficult to concentrate and process information.Some people report problems with short-term memory, forgetting things all the time. Also, they find it hard to arrive at decisions.


Changes in feelings: Feeling sad all the time for no apparent reason, excessive crying, visible signs of irritability, anger, feelings of helplessness and hopelessness, waning sexual desire, not caring for personal appearance, neglecting basic hygiene, reduction in productivity - these are noticeable changes in an individual affected by dysthymia.


Dysthymic disorder diagnosis

Early and accurate diagnosis is very important. The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM). According to DSM- IV an adult must exhibit a depressed mood for at least two years (1 year in adolescent and children) accompanied by at least two of the symptoms, to be diagnosed with dysthymia.

It is the responsibility of the mental health care professional to understand the history of patient's mood and other mental health symptoms that have been experienced over the past several months.


Also, the health care provider should confirm if any major depressive episodes have occurred in the first 2 years of the illness (the first 1 year in children) and history of mania has not existed. The symptoms should not be the aftermath of drug or alcohol abuse, a medical condition or another psychological disorder.


Dysthymic disorder treatment

Any type of depression is treatable. Although dysthymic cannot be cured, it can be treated. Dysthymia, once diagnosed, is a very treatable condition. If left untreated, the condition can develop into clinical depression. It can lead to severe functional impairment; increased morbidity from physical disease and the threat of suicide is high.

Those treated have hardly had another episode of the disorder. There are a number of effective treatment approaches to help treat dysthymic disorder. The best treatment approach appears to be a combination approach - psychotherapy combined with antidepressant medication and some self-help. But the combination may vary from person to person.


Medications: There are different classes of antidepressants that are available to treat dysthymic disorder. Taking into account the physical and mental health of the patient, the health care provider will decide the most effective one and also the dosage requirements.

The patient will be required to take the prescribed medicines for at least six to nine months. Antidepressant medicines Zoloft, paxil and Effexor all belong to the category of SSRIs or Selective Serotonin Reuptake inhibitors.


These antidepressant medications help keep energy up levels and also alleviate mood disorders. Antidepressant medicines are safe, are not habit-forming and are likely to relieve symptoms within 1 or 2 months after it is started. It is important to inform the health care provider if the patient is experiencing any uncomfortable side effects so that a change can be considered.


Psychotherapy: Individual psychotherapy, group therapy and family therapy, the aim is to provide support and help the person develop appropriate coping skills to deal with life. The therapist makes all attempts to establish good rapport with the affected individual and slowly explain the importance of taking medications regularly and how it helps in restoring a normal life. Ultimately, the patient should be able to function normally in all spheres of life.


Self-help: Health care providers also explain how the patient can make minor lifestyle changes which can contribute to dysthymic treatment. Eating well-balanced diet, getting regular exercise, avoiding alcohol and smoking can all make the patient feel better and bring about positive changes.


Tips to overcome dysthymic disorder

Here is what you can do to yourself or anyone you know is trying hard to overcome dysthymic disorder.

  • Accept the condition and be confident of getting well gradually over a period of time.

  • Co-operate with health care provider and be regular with appointments. Do not skip medications but adhere to life style changes recommended.

  • Find time to relax. It can be going to a movie; window shopping, watching a favorite sport or listening to music, religious talks etc.

  • Take help from someone you like and trust most. Set realistic goals in life.

  • Consider postponing important decisions until you feel all right like changing jobs, committing a new relationship, making investments etc

  • Make all efforts to be optimistic and shun being pessimistic.

  • Remember you deserve to be happy and enjoy life to the fullest.


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