Dysthymia (Persistent Depressive Disorder): Information, Symptoms, Treatment and More

Dysthymia, also referred to as Persistent depressive disorder, is a long-term mental health condition that involves an individual having longstanding depressive feelings.

An individual with Dysthymia, which is a type of Depression, will often struggle to remember a time when they have been happy, feeling they are incapable of having fun.

Dysthymia is a very difficult condition to live with – especially given its chronic nature. But, with the right treatment and support, it is possible to recover.

Dysthymia differs from Clinical depression due to the fact a sufferer will persistently feel down for a long period of time, while someone with Clinical depression will normally have some bouts of normal moods in between depressive episodes.

What are the symptoms of Dysthymia?

The symptoms of Dysthymia are similar to that of Clinical depression – the most common type of depression. However, in Dysthymia, it is very rare though for these symptoms to not be present for longer than a few weeks.

Everyone tends to experience depression in different ways. However, there are some general symptoms that are consistent throughout. For a diagnosis of Dysthymia to be made, these symptoms will need to have been present for a significant amount of time.

Symptoms are normally either psychological or physical.

Psychological

• Continuous low mood or sadness
• Feelings of hopelessness and helplessness
• Low self-esteem
• Lack of emotion
• Irritability
• Poor concentration
• Anxiety

Physical

• Lack of energy
• Loss of libido
• Losing or gaining appetite and weight
• Insomnia or excessive sleep
• Tiredness

As mentioned, these symptoms – which are not an exhaustive list -will normally last a long time. They negatively impact functioning in day-to-day life.

What are the causes of Dysthymia?

It isn’t known what causes Dysthymia. Similarly, it isn’t known why some people suffer from certain types of depression. Most believe that multiple factors contribute to the onset of the illness.

Trauma, genetics, stressful situations, loneliness and illness are just some potential causes. In some cases, there doesn’t seem to be an obvious cause.

Depression may also be linked to a chemical imbalance in neurotransmitters in the brain like serotonin and dopamine – which are linked to the regulation of mood.

Moreover, it should be noted that Clinical Depression can become Dysthymia. The two can also co-exist, a state known as Double Depression.

Diagnosis of Dysthymia

It is important to see a doctor or mental health professional if you believe you may be suffering from Dysthymia. Once a diagnosis has been made, treatment can ensue.

Getting an appointment with a doctor is a good starting point. At an appointment, a doctor will ask the patient some questions about their situation, mental state, thoughts and feelings. They may also ask about the impact of symptoms, how long they have been present, and family history.

In terms of the actual symptoms, for Dysthymia to be diagnosed, a patient will generally:

• Have exhibited a depressed mood, or appears depressed to others, for the majority of days over a two year period or more.
• Exhibit at least two of the following:
  • Decreased/increase in appetite
  • Decrease/increase in sleep.
  • Fatigue/low energy
  • Low self-esteem
  • Poor concentration
  • Feelings of hopelessness
• Have not undergone a period of longer than 8 weeks where the above symptoms haven’t been exhibited.
• The symptoms have negatively impacted the life of the individual, causing distress in areas of their life.
• Have not endured a manic, hypomanic or mixed episode, nor have met the diagnosis for another mental health condition such as Cyclothymia or Schizophrenia.

How is Dysthymia treated?

The treatment plan of Dysthymia will generally depend on the severity of symptoms. Individual circumstances will be taken into account.

Self help

In some cases, self help materials on the internet can help. Regular exercise, a healthy diet and getting enough sleep can also help.

While this may seem simplistic, small changes can make a big difference in some cases.

Talking Therapy

Talking therapy is a key part of treatment for cases of Dysthymia. There are several different types of therapy that are used. Common types include:

Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.

Schema Therapy: Schema Therapy is a talking therapy that combines aspects of Cognitive-Behavioural Therapy, Gestalt therapy and psychoanalytical thinking into one form. It can be useful in treating personality disorders due to its ability to help people change longstanding patterns of thought and behaviour. The therapy is normally based on the idea that childhood needs were not met, leading to deeply-held obstructive beliefs. The therapist will attempt to change long-standing patterns that have contributed to problems, and can be very useful. Schema therapy is mainly intended for use in the treatment of personality disorders.

Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.

There are a range of other types of talking therapies available. There are many ways that talking therapy can help. We have more information on our Therapy section.

Medication

In cases of moderate and severe Dysthymia, medication can prove helpful. It may also help in mild cases. Normally, antidepressants are used.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

Other

The last line of treatment – which should only ever be used in very select circumstances – is electroconvulsive therapy.

Electroconvulsive Therapy (ECT): Electroconvulsive Therapy (commonly referred to as shock treatment) is a treatment that sees an electric current sent through the brain of an individual. The aim is to trigger an epileptic seizure, with the ultimate objective to relieve symptoms of a mental health problem. The human body is fully restrained during the procedure, which also involves a general anaesthetic. Electroconvulsive therapy is normally a last resort. Despite this, ECT actually has an impressive efficacy rate, with many people finding it helps immeasurably.

Summary

Dysthymia is a very difficult condition to live with – it can feel like there is no way out, especially when a person has suffered for so long.

But seeking help is important. Better times can happen. If needed, there is a lot of information on our website to assist you.

See Also

• Depression Section
• What is the Prognosis for Depression?
• Therapy Homepage
• Medicine Homepage