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Dysthymic Disorder is characterized by chronic depression, but with less
severity than a major depression. The essential symptom for dysthymic disorder
is an almost daily depressed mood for at least two years, but without the
necessary criteria for a
major depression. Low energy, sleep or appetite
disturbances and low self-esteem are usually part of the clinical picture as
well.
People who have dysthymic disorder will often report that they don't recall
ever not feeling depressed, but they may be relatively functional in managing
their life, although the symptoms are severe enough to cause distress and
interference with important life role responsibilities. It is important to have
a complete physical to rule out any physical illnesses that might be causing the
depression. Also, if the person has a chronic medical condition that appears to
be the cause for the depression (such as any chronic debilitating condition),
then the correct diagnosis might be a Mood Disorder due to a general Medical
Condition, even if all the criteria for dysthymic disorder are met. The question
is whether the medical condition is physically causing the depression, rather
than creating chronic psychological distress that is causing the depression.
Despite the long term nature of this
type of depression, psychotherapy is
effective in reducing the symptoms of depression, and assisting the person in
managing his/her life better. Some individuals with dysthymic disorder respond
well to antidepressant medication, in addition to psychotherapy, so an
evaluation for medication may be appropriate. You should consult your
psychologist if you have questions about treatment.
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Identifying Dysthymic Disorder Depression causes
changes in thinking, feeling, behavior, and physical well-being.
Changes in Thinking - Many people experience difficulty with concentration
and decision making. Some people report problems with short term memory,
forgetting things all the time. Negative thoughts and thinking are
characteristic of depression. Pessimism, poor self-esteem, excessive guilt, and
self-criticism are all common. Some people have self-destructive thoughts during
more serious depression.
Changes in Feelings - Many people report feeling sad for no reason. Others
report that they no longer enjoy activities that they once found pleasurable.
You might lack motivation, becoming more apathetic. You might feel "slowed down"
and tired all the time. Sometimes irritability is a problem, and more difficulty
controlling your temper. Often, dysthymic disorder leads to feelings of
helplessness and hopelessness.
Changes in Behavior - You might act more apathetic, because that's how you
feel. Some people do not feel comfortable with other people, so social
withdrawal is common. Some people experience a change in appetite, either eating
more or less. Because of the chronic sadness, excessive crying is common. Some
people complain about everything, and act out their anger with temper outbursts.
Sexual desire may disappear, resulting in lack of sexual activity. In the
extreme, people may neglect their personal appearance, even neglecting basic
hygiene. Needless to say, someone who is this depressed does not do very much,
so work productivity and household responsibilities suffer. Some people have
trouble getting out of bed.
Changes in Physical Well-being - We already talked about the negative
emotional feelings experienced during depression, but these are coupled with
negative physical emotions as well. Chronic fatigue, despite spending more time
sleeping is common. Some people can't sleep, or don't sleep soundly. These
individuals lay awake for hours, or awaken many times during the night, and
stare at the ceiling. Others sleep many hours, even most of the day, although
they still feel tired. Many people lose their appetite, feel slowed down by
depression, and complain of many aches and pains.
Now imagine these symptoms lasting for months. Imagine feeling this way
almost all of the time. This may be dysthymic disorder, if several of these
symptoms are present most of the time, for the past two years. Remember, all of
the symptoms do not need to be present! Of course, it's not a good idea to
diagnose yourself. If you think you might be depressed, talk to a psychologist
for a consultation. A licensed psychologist can assess whether you are
depressed, and can determine the proper treatment for your depression. Remember,
depression is treatable.
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Treatment for Dysthymic Disorder
Psychotherapy is the treatment for choice for this psychological problem.
Often, antidepressant medication is also recommended because of the chronic
nature of the depression in Dysthymia. Psychotherapy is used to treat this
depression in several ways. First, supportive counseling can help to ease the
pain, and can address the feelings of hopelessness. Second, cognitive therapy is
used to change the pessimistic ideas, unrealistic expectations, and overly
critical self-evaluations that create the depression and sustain it. Cognitive
therapy can help the depressed person recognize which life problems are
critical, and which are minor. It also helps them to learn how to accept the
life problems that cannot be changed. Third, problem solving therapy is usually
needed to change the areas of the person's life that are creating significant
stress, and contributing to the depression. Behavioral therapy can help you to
develop better coping skills, and interpersonal therapy can assist in resolving
relationship conflicts.
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Reviewed: 01/2006
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