Dysthymia, when melancholy takes over your mind

The Dysthymic Disorder (dysthymia) is a mild variant of Depression. Dysthymia is often located at the edge of the depression spectrum. At the other extreme, more serious, we could place the most acute depressive disorders.

What is Dysthymia?

The word comes from the Greek, "altered mood." Those affected by dysthymia usually continue with their routine for years without receiving any type of treatment or assistance. They can be recognized by showing signs of dejection, but there is nothing in their behavior or attitudes that, a priori, can make us notice that that person really has a psychological disorder. Dysthymia is a affective disorder, and the efficacy rate of the treatments is very high.

Affected people

Dysthymia affects almost 2% of the population, being slightly less frequent than major depression (which affects around 4% of people) and in the same way as other emotional disorders, there is usually a higher rate of dysthymia among women.

An episode of occasional sadness or grief should not be confused with dysthymic disorder. Every person is susceptible to being able to feel sad in the course of some life stage, and this does not suggest any anomaly. For the period of melancholy to be considered as dysthymia, it must be displayed every day for at least two years.

Symptoms

The most common symptoms in affected patients are melancholia and the sadness. They generally find it almost impossible to find happiness and satisfaction in their daily routine. They also have low self-confidence and are unable to make decisions.

Tiredness and low activity they are also usually signs of dysthymia. Often times, sleeping and eating patterns are disturbed. Regarding rest, those affected by dysthymia may suffer insomnia, or sleep more hours than recommended. In relation to nutrition, sometimes they present episodes of excessive intake, or a notorious lack of hunger.

Concentration and memory are affected. It is usual for those affected to begin to isolate themselves socially little by little, a problem that in the long run can lead to social disability, and even social phobia.

On the other hand, unlike what happens in some cases of major depression and bipolar disorder, in dysthymia, no psychotic symptoms appear like hallucinations or delusions.

Causes

There is some controversy about the causes of dysthymic disorder. Some research points to a prevalence of hereditary factor, although new studies suggest that the causes are environmental: social isolation, specific setbacks in life and prolonged stressful situations.

The unique peculiarity of dysthymic disorder is that more than 75% of those affected suffer from some other chronic problem, such as a physical ailment, drug addiction, or other psychiatric disorder. Medical personnel often have difficulty establishing which problem is earlier, as the onset times are often scattered.

Treatment and therapy

The different treatments require intense work with the affected person in order to detect the underlying causes. The two most effective treatment modalities are cognitive behavioral therapy and psychotherapy.

In addition, pharmaceutical supports can significantly help patients affected by dysthymia.

In any case, talking to the patient about her concerns usually helps the patient a lot, and tends to fade negative thoughts and feelings such as guilt or feelings of futility. Psychological treatment also aims for the person to be able to manage their emotions.

In addition to individual therapy, group therapy helps to regenerate the affected person's lost self-esteem and improve social skills.

How is Dysthymia different from Depression?

Those affected by dysthymia usually have a fairly routine and normal life despite their disorder. In contrast, the depressed patient is not able to maintain that routine. Therefore, the fundamental difference is the degree of incapacitation that the subject presents.

• In dysthymic disorder, there is no lack of interest. They can experience pleasure, too.
• There is no agitation, nor is motor slowness.
• Outbursts or recurring thoughts about suicide or death are unusual.
• An accurate diagnosis must be made by a psychologist or psychiatrist specialized in these types of disorders. If you think that you or someone close to you may suffer from dysthymia, we recommend attending treatment professional, since it is common for dysthymic symptoms to lead to depression if they are not treated adequately.

Bibliographic references:

• American Psychiatric Association (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.
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• White C.; Alegría, A.A.; Liu, S.M.; Secades-Villa, R.; Sugaya, L.; Davies, C.; Nunes, E.V. (2012). Differences among major depressive disorder with and without co-occurring substance use disorders and substance-induced depressive disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 73 (6): pp. 865 - 873.
• Type R, Maestre C, Amores P, Pastor A, Miralles E, Escobar F. (2005). Prevalence of depression in adolescents. Actas Esp Psiquiatr.
• Harrington R. (2005). Affective disorders. Child and Adolescent Psychiatry. 4th ed. Oxford: Blackwel Publising.
• World Health Organization. (2007). Depression. Geneva: World Health Organization.