Dysthymia is a mild, but chronic, form of depression. Dysthymia (dis-THI-me-uh) symptoms usually last for at least two years, and often for much longer than that.
Although dysthymia symptoms may be less intense than those of depression, dysthymia can actually affect your life more seriously because it lasts for so long. With dysthymia, you may lose interest in normal daily activities, feel hopeless, lack productivity and have a low self-esteem. People with dysthymia are often thought of as being overly critical, constantly complaining and incapable of having fun.
Dysthymia symptoms in adults include:
In children, dysthymia symptoms may include:
Dysthymia symptoms typically come and go over a period of years, and their intensity can change over time, too. But in general, you may find it hard to be upbeat even on happy occasions — you may be characterized as having a gloomy personality.
When dysthymia starts on or before age 21, it's called early-onset dysthymia. When it starts after that, it's called late-onset dysthymia.
When to see a doctor
If you have any symptoms of dysthymia, seek medical help. If not effectively treated, dysthymia commonly progresses into depression (major depression).
If you have a primary care doctor, talk to him or her about your symptoms. Or seek help directly from a mental health provider. If you're reluctant to see a mental health professional, reach out to someone else who may be able to help guide you to treatment, whether it's a friend or loved one, a teacher, a faith leader or someone else you trust.
The exact cause of dysthymia isn't known. Dysthymia may have causes similar to depression, including:
Although the precise cause of dysthymia isn't known, certain factors appear to increase the risk of developing or triggering dysthymia, including:
Complications that dysthymia may cause or be associated with include:
Preparing for your appointment
Sometimes, a health care provider or other professional may ask you about your mood. Your doctor may bring it up during a routine medical appointment if you seem to be sad or down, for instance. Or you may decide to schedule an appointment with your family doctor or general practitioner to talk about your concerns. In either case, because dysthymia often requires specialized mental health care, you may be referred to a mental health provider, such as a psychiatrist or psychologist, for evaluation and treatment. Or, you may seek out a mental health provider on your own first.
What you can do
In addition to the questions that you've prepared to ask, don't hesitate to ask questions that you think of during your appointment.
What to expect from your doctor
Tests and diagnosis
When doctors suspect someone has dysthymia, they typically run a series of medical and psychological tests and exams. These can help rule out other problems that could be causing your symptoms, pinpoint a diagnosis and also check for any related complications. These exams and tests generally include:
Checking for other conditions
Diagnostic criteria for dysthymia
Make sure you understand if you have been diagnosed with dysthymia or another condition so you can learn more about your specific situation and get appropriate treatment.
Treatments and drugs
The two main treatments for dysthymia are:
As stand-alone treatments, medications appear to be more effective at treating dysthymia than psychotherapy. But, using a combination of medications and psychotherapy may be slightly more effective in treating dysthymia than using only medications or only psychotherapy.
Which treatment approach you take depends on such factors as:
Medications for dysthymia
SSRIs are often the antidepressant of choice because, in general, they work well and their side effects are more tolerable. MAOIs are usually last choices because they can have serious side effects and require strict dietary restrictions because of rare, but potentially fatal, interactions. Which one is best for you depends on your individual situation. When you have dysthymia, you may need to take antidepressants long term to keep symptoms under control.
All antidepressant medications have potential side effects, such as weight gain, sexual problems and diarrhea. Of particular concern is the worry that young people taking these medications might have a higher suicide risk. The Food and Drug Administration (FDA) requires that all antidepressant medications carry warnings about suicide risk in young people. The antidepressant warnings note that in some cases, children, adolescents and young adults ages 18 to 24 may have an increase in suicidal thoughts or behavior when taking antidepressants.
Psychotherapy for dysthymia
You and your therapist can talk about which type of therapy is right for you, your goals for therapy, and other issues, such as the number of sessions and length of treatment.
Lifestyle and home remedies
Dysthymia generally isn't an illness that you can treat on your own. But you can do some things for yourself that build on your treatment plan. In addition to professional treatment, follow these lifestyle and self-care steps for dysthymia:
You may be interested in trying to relieve dysthymia symptoms with complementary or alternative medicine strategies, such as nutritional and dietary supplements and mind-body techniques.
Keep in mind that nutritional and dietary products aren't regulated. The FDA doesn't test them for safety, purity or effectiveness. You can't always be sure of what you're getting and if it's safe. Also, be aware that herbal and dietary supplements can interfere with the way certain prescription medications work or can cause dangerous interactions that can harm your health. Talk to your doctors and other health care providers before taking any herbal or dietary supplements.
Nutritional and dietary supplements
As with dietary supplements, take care in using these techniques. Although they may pose less of a risk, relying solely on these to treat dysthymia may not be effective enough. If you try mind-body techniques first to treat your dysthymia but your symptoms worsen or don't improve, be sure to consult your health care providers.
Mind-body techniques that have been used on people with dysthymia symptoms include:
Coping and support
Coping with dysthymia can be challenging since it can have such a strong hold on your life. Dysthymia makes it hard to engage in the behavior and activities that may help you feel better. Talk to your doctor or therapist about improving your coping skills, and consider these tips to cope with dysthymia:
There's no sure way to prevent dysthymia. Because dysthymia often starts in childhood, identifying children at risk of the condition may be of some benefit, though, by encouraging early treatment. Also, taking steps to control stress, to increase your resilience and to boost low self-esteem may help ward off dysthymia symptoms. Friendship and social support, especially in times of crisis, can help you weather rough spells. Also, treatment at the earliest sign of a problem can help prevent dysthymia from worsening. Long-term maintenance treatment also may help prevent a relapse of dysthymia symptoms.
Last Updated: 2010-08-26
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