Persistent Depressive Disorder (Dysthymia)
Dysthymia Treatment – McLean VA Psychiatrist
People with Dysthymia [dis-thahy-mee-uh], describe their mood as sad or “in the dumps”, but Dysthymia is more than simply feeling sad. Dysthymia is a chronic form of Depression that can cause people to lose interest in normal life activities. Low self-esteem, a feeling of inadequacy, feelings of hopelessness, and difficulty with daily productivity are the chronic nature of Dysthymia. These feelings are typically long lasting and may negatively impact family, relationships, employment, education, and other daily activities. Those suffering Dysthymia often find it difficult to be “upbeat”, even during good times. They might be perceived as gloomy, pessimistic, or a complainer.
Symptoms of Dysthymia
The essential feature of Dysthymia is a depressed mood that occurs for most of the day, for more days than not, for at least two years for adults or one year for children and adolescents.
Symptoms of Dysthymia can come and go over time, and the intensity of the symptoms can change, but symptoms generally don’t disappear for more than two months at a time.
Symptoms of Dysthymia can include:
- Poor appetite or overeating
- Loss of interest in daily activities
- Insomnia or hypersomnia
- Low energy or fatigue
- Low self-esteem, self-criticism, or feeling incapable
- Poor concentration or difficulty making decisions
- Feelings of hopelessness
- Decreased activity and/or productivity
- Social isolation
- Irritability or anger
- Sadness or feeling down
- Feelings of guilt
In children, depressed mood and irritability are often primary symptoms.
Causes of Dysthymia
The exact cause of Dysthymia is unknown, but as with major depressive disorder it may include more than one cause, including some of the following:
- Brain chemistry: a number of brain regions have been implicated in Dysthymia.
- Genetics: having a first degree relative with a depressive disorder increases the risk.
- Environmental/life events: loss of a parent during childhood, traumatic events such as loss, financial problems, and high levels of stress can trigger Dysthymia.
- Personality traits that include: negativity, low self-esteem, pessimistic, self-critical, dependent upon others.
- History of other mental disorders.
Statistics on Dysthymia
While the depressed mood experienced with Dysthymia is not as severe as major depressive disorder, a diagnosis of Dysthymia requires having experienced a combination of depressive symptoms for two years or more.
According to the National Institute of Mental Health (NIMH), Dysthymia affects approximately 1.5% of the adult population in the United States. 49.7% of these cases are considered “severe” and the average age of onset is 31 years.
Dysthymia can affect children and adolescents. Data from NIMH shows that depressive disorders (major depressive disorder or Dysthymia) affect approximately 11.2% of 13 to 18-year-olds at some point during their lives, and that girls are more likely than boys to experience a depressive disorder.
Treatment of Dysthymia
Due to the chronic symptoms, people sometimes feel like persistent sadness is just part of life. If you are experiencing any symptoms of Dysthymia, it’s important to seek treatment.
A great first step is to get a physical evaluation from your primary care physician to rule out any potential medical causes of the symptoms. Keep a log of your symptoms over a few weeks to help your doctor gain a better understanding of how the symptoms impact your daily living.
The two main treatments for Dysthymia include medication and psychotherapy, but your treatment plan will depend upon factors such as severity of the symptoms, your preferences, your ability to tolerate medications, and previous mental health treatment. For children and adolescents, psychotherapy is usually the first recommendation.
Medications
The types of antidepressants most commonly used to treat Dysthymia include the following:
- SNRIs (Serotonin and norepinephrine reuptake inhibitors)
- TCAs (Tricyclic antidepressants)
- SSRIs (Selective serotonin reuptake inhibitors)
It’s important to ask your doctor for detailed information about any potential side effects of medication and to discuss any history of suicidal thoughts or attempts. Though antidepressant medications can cause uncomfortable side effects for some, you should never abruptly stop taking these medications. Always consult your prescribing physician before making any changes to medication.
Lifestyle changes
Any treatment plan for Dysthymia should include healthy changes in lifestyle, including:
- Establishing healthy sleep patters
- Daily exercise
- Nutrition
- Assistance with life skills, if necessary
While there is no “cure” for depressive disorders, people living with Dysthymia can live happy and fulfilling lives. Symptoms can ebb and flow over time, but creating a solid support system and seeking professional help will help you along your journey to recovery.
Contact our office and setup an appointment to see Dr. Rehman. Don’t wait another day. Call our office at (571) 236-8516.
Dr. Amir Rehman is a Psychiatrist located in McLean serving patients in the greater Washington, DC metro area. He is a board certified medical doctor of Psychiatry with over 25 years in his field. He has a fellowship in Addiction Medicine treating Opiate and Alcohol addictions and received his postgraduate training from Howard University Hospital and University of South Florida. He has extensive experience treating children and adults, supervision of medical students and residents from Georgetown University, George Washington University and Howard University.