Dysthymia

The word dysthymia is of Greek origin and means bad mood or ill humor. Dysthymia is considered to be a chronic form of depression. Also known as neurotic depression, dysthymic disorder, and chronic depression, dysthymia is characterized by moods that are consistently low. The National Institute of Mental Health (NIMH) reports that dysthymia occurs more frequently in women than in men and affects up to 5 percent of the general population. It may occur alone or with more severe depression.

If you suffer from dysthymia, you'll continue to function in everyday life, but you're miserable doing it. More than half of those with dysthymia eventually have an episode of major depression, and about half of patients treated for major depression have this double depression. Many patients who recover partially from major depression may continue to have milder symptoms that persist for years.

This type of chronic depression is difficult to distinguish from dysthymia. Symptoms of dysthymia include the following:

  • Sad mood lasting two years or longer

  • Changes in eating habits

  • Chronic fatigue

  • Low self-esteem

  • Sleeping problems

  • Lack of concentration

  • Feelings of hopelessness, guilt, or worthlessness

  • Thoughts of suicide

Fact

Nearly half those with dysthymia have a symptom that also occurs in major depression, shortened REM latency. This means the rapid eye movement that indicates vivid dreams begins quite early in their sleep cycle. This means that less time is spent in the deeper, more restorative stages of sleep. Researchers are studying a possible connection between shortened REM latency and dysthymia.

Causes

There may be a genetic predisposition to dysthymia. Researchers are studying neurochemical imbalances in the brain, along with other factors of childhood and adult stress and trauma. Studies show that dysthymia usually has a gradual onset and those individuals who are socially isolated or who lack strong support groups may be especially vulnerable to this disorder. This makes the elderly a population of concern for dysthymia.

Diagnosis and Treatment Options

Dysthymia is diagnosed symptomatically, but is probably not detected as often as it occurs. Some people report a vague list of physical symptoms, which may or may not trigger the correct diagnosis. Also, some people just learn to live with their symptoms, never seeking help.

Essential

Remember that once you start medication, you shouldn't stop taking it abruptly. Certain drugs must be tapered off under the supervision of a doctor or bad reactions can occur. If you are having trouble with side effects, talk to your doctor. Sometimes taking your medication at a different time of day or just a minor dosage adjustment is all you need.

Dysthymia is treated with psychotherapy and antidepressant medications. Results tend to vary. Some people experience a full recovery, while others continue to have symptoms. Recovery from dysthymia often takes a long time, and the symptoms often return.

In these instances, maintenance therapy and medication may be indicated. The most common drug treatments are selective serotonin reuptake inhibitors (SSRIs): fluoxetine (Prozac) and sertraline (Zoloft), or one of the dual-action antidepressants, such as venlafaxine (Effexor). Some patients may do better with a tricyclic antidepressant, such as imipramine (Tofranil).

Talk therapies, such as cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), have also been shown to be effective, and the combination of medication and psychotherapy may result in the most improvement.

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