Dysthymic disorder

Dysthymia is a mild but chronic form of depression. Dysthymia symptoms usually last for at least two years, and often much longer than that, especially when the condition starts in childhood. Although the symptoms are less severe than major depression, they can affect your life seriously because they last so long. With dysthymia, you may lose interest in normal daily activities, feel hopeless, lack productivity and have a low self-esteem. In general, dysthymia prevents you from living life to its fullest, and your overall quality of life may be low.

Dysthymia symptoms typically come and go over a period of years, and their intensity can change over time, as well. In general, you may find it hard to be upbeat even on happy occasions — you may be characterized as having a gloomy personality.

Symptoms of dysthymic disorder are very similar to those of major depression: loss of interest in daily activities, feeling sad or low, poor appetite, overeating, hopelessness, sleep problems, lack of energy, fatigue, low self-esteem, trouble concentrating, self-criticism, excessive anger, decreased productivity, feelings of guilt and avoidance of social activity. People who have dysthymic disorder will often report that they don’t recall ever not feeling depressed, but they may be relatively functional in managing their life, although the symptoms are severe enough to cause distress and interference with important life role responsibilities.

Like major depression, these symptoms don’t go away on their own and may even get worse if left untreated; commonly, untreated dysthymic disorder can evolve into major depression. Dysthymia and depression is known as double depression.

Some complications of dysthymia can include:

• Reduced quality of life
• Major depression
• Suicidal behavior
• Substance abuse
• Relationship difficulties
• Family conflicts
• Social isolation
• School and work problems
• Decreased productivity

What causes dysthymic disorder?

Like major depression, the causes of dysthymic disorder aren’t known, although it is felt to have causes similar to that of major depression; i.e., biochemical, genetic and environmental.

Risk factors for dysthymic disorder

It isn’t exactly clear how many people suffer from dysthymia; however, it is felt to be more common than major depression. The reason for this is that dysthymia tends to start earlier in life, often in childhood or during the teen years, and lasts longer than depression.

Certain factors seem to increase the risk of developing dysthymia and include:

• Having biological relatives with depression
• Having biological relatives with dysthymia
• Being female
• Stressful life events
• Having a chronic medical condition

When to seek medical attention

The first step in getting over any type of depression is recognizing the symptoms and realizing that not everyone spends their life feeling like this. The second step is to see your doctor and talk with him or her about getting specialized medical attention to treat the disorder.

If your primary care physician feels your symptoms are mild or haven’t been present for a long period of time, he or she may treat you with anti-depressants; if that isn’t felt to be effective, you may be sent to a specialist for further care. As only MDs can prescribe medication, you may be sent to a psychiatrist, rather than a psychologist or licensed clinical social worker (LCSW), or your physician may choose to continue prescribing your medications while sending you for psychotherapy.

Be prepared to tell your physician how long you have had symptoms, how your daily life is affected, if you have had other treatment and what that treatment has been, if you are taking medication or have tried medication and what those medications are, what you have tried on your own to treat, whether you are taking illicit drugs (be honest about this – it’s important), and whether any of your relatives suffer from any kind of depressive disorder or addictions.