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What is dysthymia?

Dysthymia, also known as dysthymic disorder, is classified as a type of affective disorder (also called mood disorder) that often resembles a less severe, yet more chronic form of major (clinical) depression. However, persons with dysthymia may also experience major depressive episodes at times.

Depression is a mood disorder that involves a person's body, mood, and thoughts. It can affect and disrupt eating, sleeping, or thinking patterns, and is not the same as being unhappy or in a "blue" mood, nor is it a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Treatment is often necessary and many times crucial to recovery.

There are three primary types of depression, including:

  • Major depression (clinical depression)

  • Bipolar disorder (manic depression)

  • Dysthymic disorder (dysthymia)

Who is affected by dysthymia?

Dysthymia affects women twice as often as men. Dysthymic disorder affects approximately 1.5 percent--or 3.3 million American adults age 18 years of age or older--during their lifetime. According to the National Institute of Mental Health Disorders, about 40 percent of adults with dysthymic disorder also meet criteria for major depressive disorder or bipolar disorder in a given year.

What are the symptoms of dysthymia?

Although less severe, yet more chronic than major depression, the following are the most common symptoms of dysthymia. However, each individual may experience symptoms differently. Symptoms may include:

  • Persistent sad, anxious, or empty mood

  • Loss of interest in activities once previously enjoyed

  • Excessive crying

  • Increased restlessness and irritability

  • Decreased ability to concentrate and make decisions

  • Decreased energy

  • Thoughts of death or suicide, or suicide attempts

  • Increased feelings of guilt, helplessness, and/or hopelessness

  • Weight and/or appetite changes due to over- or under-eating

  • Changes in sleep patterns

  • Social withdrawal

  • Physical symptoms unrealized by standard treatment (i.e., chronic pain, headaches)

For a diagnosis of dysthymia to be made, an adult must exhibit a depressed mood for at least two years (one year in children and adolescents), accompanied by at least two other depressive symptoms (noted above). The symptoms of dysthymia may resemble other psychiatric conditions. Always consult your health care provider for a diagnosis.

How is dysthymia diagnosed?

Because depression has shown to often coexist with other medical conditions, such as heart disease, cancer, or diabetes, and other psychiatric disorders, such as substance abuse, or anxiety disorders, seeking early diagnosis and treatment is crucial to recovery. A diagnosis is often made after a careful psychiatric examination and medical history performed by a psychiatrist or other mental health professional.

Treatment for dysthymia

Specific treatment for dysthymia will be determined by your health care provider based on:

  • Your age, overall health, and medical history

  • Extent of the condition

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Treatment may include either, or a combination, of the following:

  • Antidepressant medications (especially when combined with psychotherapy has shown to be very effective in the treatment of depression)

  • Psychotherapy (most often cognitive-behavioral and/or interpersonal therapy that is focused on changing the individual's distorted views of themselves and the environment around them, working through difficult relationships, and identifying stressors in the environment and how to avoid them)

  • Electroconvulsive therapy (ECT)

Because episodes of dysthymia usually last for longer than five years, long-term treatment of the disorder may be necessary.