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Dysthymia (Mild, Chronic Depression): Causes, Symptoms, Diagnosis and Treatment

Dysthymia

Depression comes in many different forms, one known as Dysthymia, also known as Persistent Depressive Disorder (PDD). Dysthymia is less severe and has fewer symptoms than major depression. Although dysthymia is a milder form, symptoms can last for a long time, sometimes years. Since the effects of this form of depression last a long time, an individual experiences serious challenges in daily life. People suffering from dysthymia can also go through short periods of major depression.

What Causes Dysthymia

Experts are divided over what exactly causes dysthymia. Many believe that genetics play a role; however, there is controversy as to how big that role. Many of those receiving treatment for chronic depression have reported no cases of other family members who have suffered from the disease as well. It is commonly accepted that changes in brain chemistry are involved. It is also believed that chronic illness, life stress and some medications also contribute.

Dysthymia Symptoms

Symptoms of chronic depression are the same as for major depression but are much less severe. These include the feeling of sadness that lasts most of the day, the lack of enthusiasm for the things that were once pleasant and important, changes in appetite or weight, oversleeping or insomnia, physical restlessness, fatigue, feelings of hopelessness, difficulty concentrating and making decisions, and suicidal thoughts.

Of all forms of depression, symptoms of dysthymia appear at a much longer age. In addition, the level of compromised daily function is more persistent.


For a diagnosis of dysthymia to be made, symptoms would have to be present for a minimum of two years. In addition, an individual would have to present with at least two of the following symptoms:
  • Insomnia or hypersomnia
  • Sense of hopelessness
  • Low self-esteem
  • Under or over-eating
  • Fatigue and/or low energy level
  • Trouble with concentration and decision-making
Keep in mind that it is possible for a person to have both dysthymia and major depression. In this case, the number and severity of symptoms would be magnified. Now, one effect with this type of depression is that performing daily tasks is possible although difficult. However, for someone to excel at something would be near impossible due to poor concentration, fatigue, low self-esteem, and decreased motivation.

Dysthymia Diagnosis

The diagnosis of dysthymia is made by examining the symptoms by a physician. The doctor will rule out other possible physical causes such as hypothyroidism. He or she will examine your family history and discuss with you the medications that could be causing your symptoms. Unfortunately, there is no blood test that can conclusively indicate that the symptoms are caused by depression and no other cause.

Treatment for Dysthymia

As with any chronic illnesses, early diagnosis and treatment are essential to decrease the duration and severity of symptoms of dysthymia. Early treatment is also indicated to be effective in reducing the possibility of relapse. Treatment for this illness usually consists of psychotherapy, medication, or a combination of the two. (See also: Most Common Treatments for Depression).

It is important to note that a person should work closely with a doctor qualified in treating this form of chronic depression. Even then, the right treatment would be unique to the individual in that everyone has a somewhat different experience with this illness. In fact, there are times when more than one treatment must be tried before the best one can be identified. In fact, many doctors will use a combination of treatments for the best results.

Psychotherapy for Dysthymia

For dysthymia, several options for psychotherapy would be considered. For the best method to be chosen, a mental health professional would determine the person’s current state of function, gather family and personal history regarding mental health issues, and in some instances, order that a series of medical tests be performed.

The primary type of therapy recommended is Cognitive Behavioral Therapy. For this, the individual would work with a therapist in a comfortable environment on ways of identifying cognitive behavior and then making appropriate changes. Typically, addressing problems in short therapy sessions, during which time the main focus is on setting reasonable and attainable goals.

In addition to Cognitive Behavioral Therapy, many people with dysthymia find group therapy also beneficial. If deemed beneficial, it might be recommended for both forms of therapy to be part of the overall dysthymia treatment plan. Unlike one-on-one time with a therapy, a group setting provides a means of support and encouragement to the individual from other people who struggle with the same type of depression.

Medication for Dysthymia

Another way of treating Dysthymia is with prescription medication. Usually, antidepressants such as Paxil, Zoloft, Luvox, and Prozac are prescribed, which boost serotonin levels within the brain. Since serotonin is the chemical that affects mood, a re-uptake inhibitor brings levels back in balance, which in turn reduces the effects of depression.

Of all the different treatment options, medication can be somewhat tricky since people respond in unique ways to medication. For that reason, a doctor would probably have to prescribe one to four different drugs before finding the right one. Even then, doses might need to be modified from time-to-time.

It is also to be noted that regardless of the antidepressant medication being prescribed, it can take up to eight weeks for a beneficial level to build within the bloodstream. During this period, a person with dysthymia would need to be patient and if needed, work with a mental health professional on short-term treatments that would help.

Self-Help  for Dysthymia

It has also been shown that certain self-help treatments work well for dysthymia. Depending on the severity of the problem and the individual, self-help treatments might be used along with more conventional treatments initially. There are many options for self-help to include support groups found locally, books, online websites, and more. Of course, having the support of close family members and friends would be critical to recovery.

As part of self-help, an individual could consider various forms of alternative medicine. For instance, acupuncture, yoga, natural foods, supplements, daily exercise, and even home remedies could provide relief. (See: Foods for Fighting depression)

The actual results would again depend on the specific dysthymia treatment chosen and the person concerned, but for the most part, self-help has been proven beneficial.

Education is the key to improving the quality of life of those suffering from some form of depression. Most people can be helped by treatment, and can go to fully realize their potential after being freed from the debilitating effects of the disease.

Conclusion

Dysthymia typically produces much longer symptoms. For that reason alone, getting a proper diagnosis followed by effective treatment is imperative. While this type of depression can be challenging to live with, it is important to know that with the right treatment, it is possible to get symptoms under control.

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