DYSTHYMIA

General Information

DEFINITION--A chronic depressive mood (or irritability in children and adolescents) with symptoms that are milder but longer-lasting than a major depressive episode. The onset of dysthymia is often unnoticed and many people are not aware of the change in their lives. Symptoms may begin in childhood or in adolescence and continue over years or decades.

BODY PARTS INVOLVED--Nervous system.

SEX OR AGE MOST AFFECTED--Both sexes; late teens, young to middle-age adults.

SIGNS & SYMPTOMS--

Several of the following signs and symptoms have been going on for most of the day, for most days, for two years or more (one year for children or teens) and with no more than two months being symptom free:

• Poor appetite or eating too much.
• Sleep problems (too much or too little).
• Lack of energy; feel tired all the time.
• Preoccupied with failure, inadequacy and negative thoughts (hopelessness).
• Feelings of self-pity; pessimistic attitude.
• Lack of productivity at home and work.
• Trouble with concentration and making decisions.
• Lack of interest or enjoyment in pleasurable activities or social activities.
• Irritability.
• Crying for no reason.
• Over critical or complaining
• Skeptical.

CAUSES--Probably due to a combination of genetic factors, development factors and psychosocial factors (job loss, divorce).

RISK INCREASES WITH

• Family history of depressive illnesses.
• Alcohol dependency or abuse. It may be a contributor to the depression, or depression gives people a reason to start drinking.

HOW TO PREVENT--No specific preventive measures. Anticipate and prepare for major life changes where possible.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Psychotherapy or counseling (may be combined with antidepressant medications). Several techniques are effective in treating dysthymia such as cognitive-behavior therapy (focuses on changing negative thought patterns into positive ones), interpersonal therapy (focuses on building better relationships) and cultural analysis (deals with the role of society in contributing to low self-esteem and powerless feelings).
• Vocational counseling for some patients to be sure their work suits their temperament.

POSSIBLE COMPLICATIONS

• Chronic course; major depression.
• Alcohol abuse or dependency.

PROBABLE OUTCOME--The majority of people can be helped with treatment. It may take several months before symptoms show improvement. Sometimes, it's not until they are treated and feeling better that people realize how depressed they were.

How To Treat

GENERAL MEASURES--

• Join a support group. They help many people with the sharing of problems and fostering friendships.
• Avoid alcohol. If you need help with stopping, ask your doctor or contact an Alcoholics Anonymous group in your community.
• Reduce emotional stress in your life (see How to Cope with Stress in Appendix).
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe antidepressants such as fluoxetine. The medication may be needed for several months or several years. If one medication doesn't work, it's likely that another will.

ACTIVITY--No restrictions. A routine physical exercise program is recommended.

DIET--Eat a nutritionally-balanced diet to help maintain optimum health.

Call Your Doctor If

• You have symptoms of dysthymia.
• Symptoms worsen or don't improve despite treatment.
• You have thoughts of death or suicide.