Dysthymia (patient information)

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Overview
Dysthymia is a chronic type of depression in which a person's moods are regularly low. However, symptoms are not as severe as with major depression.

What are the symptoms of Dysthymia?

 * The main symptom of dysthymia is a low, dark, or sad mood on most days for at least 2 years. In children and adolescents, the mood can be irritable instead of depressed and may last for at least 1 year.


 * In addition, two or more of the following symptoms will be present almost all of the time that the person has dysthymia:
 * Feelings of hopelessness
 * Too little or too much sleep
 * Low energy or fatigue
 * Low self-esteem
 * Poor appetite or overeating
 * Poor concentration


 * People with dysthymia will often take a negative or discouraging view of themselves, their future, other people, and life events. Problems often seem more difficult to solve.

What causes Dysthymia?

 * The exact cause of dysthymia is unknown.
 * It tends to run in families.
 * Dysthymia occurs more often in women than in men and affects up to 5% of the general population.


 * Many people with dysthymia have a long-term medical problem or another mental health disorder, such as anxiety, alcohol abuse, or drug addiction.


 * About half of people with dysthymia will also have an episode of major depression at some point in their lives.


 * Dysthymia in the elderly is often caused by:
 * Difficulty caring for themselves
 * Isolation
 * Mental decline
 * Medical illnesses

When to seek urgent medical care?

 * Call for an appointment with your health care provider if:
 * You regularly feel depressed or low
 * Your symptoms are getting worse


 * Call for help immediately if you or someone you know develops these symptoms, which are signs of a suicide risk:
 * Giving away belongings, or talking about going away and the need to get "affairs in order"
 * Performing self-destructive behaviors, such as injuring themselves
 * Suddenly changing behaviors, especially being calm after a period of anxiety
 * Talking about death or suicide, or even stating the desire to harm themselves
 * Withdrawing from friends or being unwilling to go out anywhere

Diagnosis

 * Your health care provider will take a history of your mood and other mental health symptoms.


 * The health care provider may also check your blood and urine to rule out medical causes of depression.

Treatment options

 * Treatment for dysthymia includes antidepressant drug therapy, along with some type of talk therapy.


 * Medications often do not work as well for dysthymia as they do for major depression. It also may take longer after starting medication for you to feel better.


 * The following medications are used to treat dysthymia:
 * Selective serotonin reuptake inhibitors (SSRIs) are the drugs most commonly used for dysthymia. They include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).


 * Other antidepressants used to treat dysthymia include: serotonin-norepinephrine reuptake inhibitor (SNRIs), bupropion (Wellbutrin), tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs).


 * People with dysthymia often benefit from some type of talk therapy. Talk therapy is a good place to talk about feelings and thoughts, and most importantly, to learn ways to deal with them. Types of talk therapy include:
 * Cognitive behavioral therapy (CBT): teaches depressed people ways of correcting negative thoughts. People can learn to be more aware of their symptoms, learn what seems to make depression worse, and learn problem-solving skills.
 * Insight-oriented or psychodynamic psychotherapy can help someone with depression understand the psychological factors that may be behind their depressive behaviors, thoughts, and feelings.
 * Joining a support group of people who are experiencing problems like yours can also help. Ask your therapist or health care provider for a recommendation.

Where to find medical care for Dysthymia?
Directions to Hospitals Treating Dysthymia

What to expect (Outlook/Prognosis)?

 * Dysthymia is a chronic condition that lasts many years. Though some people completely recover, others continue to have some symptoms, even with treatment.


 * Although it is not as severe as major depression, dysthymia symptoms can affect a person's ability to function in their family, and at work.


 * Dysthymia also increases the risk for suicide.

Possible complications
If it is not treated, dysthymia can turn into a major depressive episode. This is known as double depression.

Source
http://www.nlm.nih.gov/medlineplus/ency/article/000918.htm