Dysthymia: Chronic Depression

Dysthymia (or dysthymic disorder) is considered a less severe but longer-lasting form of depression. Dysthymia usually begins at an earlier age than major depression with a more persistent impairment of daily function. This diagnosis is made when a moderately depressed mood persists for at least two years in adults (one year in children or adolescents) and is accompanied by at least two other depressive symptoms:

* Poor appetite or overeating
* Insomnia or hypersomnia
* Low energy or fatigue
* Low self-esteem
* Poor concentration or difficulty making decisions
* Feelings of hopelessness

Many people with dysthymic disorder also experience major depressive episodes. If they have both dysthymia and major depression, they are said to suffer from “double depression.”

People with dysthymia usually can still function but at a greatly reduced efficiency. Some people can hold down jobs and can be in relationships with this type of depression, but their ability to excel or make a positive impact in any area of their lives is greatly diminished. Dealing with a lack of energy or motivation over a long period of time often results in poor self-esteem and an expectation of failure. This type of thinking can reinforce a vicious self-reinforcing cycle —the individual expects nothing to change, and so nothing ever does.

Both antidepressant medication and psychotherapy are effective in treating dysthymia. Medications usually are used to try to help lift the person’s energy levels, while psychotherapy helps to find ways the individual can better cope with and improve his or her life. Psychotherapy can be challenging, however, as the individual often is not motivated to make changes. Enlisting the person’s support system, such as family or friends, can be beneficial in treatment.


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