Dysthymia

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Dysthymia (pronounced /d?s’?a?mi?/) is a mood disorder that falls within the depression spectrum. It is considered a chronic depression, but with less severity than major depressive disorder. This disorder tends to be a chronic, long-lasting illness.[1] Dysthymia is a type of low-grade depression. Harvard Health Publications states that, “the Greek word dysthymia means ‘bad state of mind’ or ‘ill humor’. As one of the two chief forms of clinical depression, it usually has fewer or less serious symptoms than major depression but lasts longer.” Harvard Health Publications says, “at least three-quarters of patients with dysthymia also have a chronic physical illness or another psychiatric disorder such as one of the anxiety disorders, drug addiction, or alcoholism”. The Primary Care Journal says that dysthymia “affects approximately 3% of the population and is associated with significant functional impairment”. Harvard health Publications says: “The rate of depression in the families of people with dysthymia is as high as 50% for the early-onset form of the disorder.” “Most people with dysthymia can’t tell for sure when they first became depressed”.[citation needed]

The symptoms of dysthymia are similar to those of major depression, though they tend to be less intense. In both conditions, a person can have a low or irritable mood, lack of interest in things most people find enjoyable, and a loss of energy (not all patients feel this effect). Appetite and weight can be increased or decreased. The person may suffer from insomnia or excessive sleeping. He or she may have difficulty concentrating. The person may be indecisive and pessimistic and have a negative self-image. The symptoms can grow into a full blown episode of major depression. This situation is sometimes called “double depression”[2] because the intense episode exists with the usual feelings of low mood. People with dysthymia have a greater-than-average chance of developing major depression. While major depression often occurs in episodes, dysthymia is more constant, lasting for long periods, sometimes beginning in childhood. As a result a person with dysthymia tends to believe that depression is a part of his or her character. The person with dysthymia may not even think to talk about this depression with doctors, family members or friends. Dysthymia, like major depression, tends to run in families. It is two to three times more common in women than in men. Some sufferers describe being under chronic stress. When treating diagnosed individuals, it is often difficult to tell whether they are under unusually high environmental stress or if the dysthymia causes them to be more psychologically stressed in a standard environment.

The Diagnostic and Statistical Manual of Mental Disorders[3] (DSM), published by the American Psychiatric Association, characterizes Dysthymic disorder. The essential symptom involves the individual feeling depressed almost daily for at least two years, but without the criteria necessary for a major depression. Low energy, disturbances in sleep or in appetite, and low self-esteem typically contribute to the clinical picture as well. Sufferers have often experienced dysthymia for many years before it is diagnosed. People around them come to believe that the sufferer is ‘just a moody person’. Note the following diagnostic criteria:[1]

The most commonly prescribed anti-depressants for this disorder are the selective serotonin reuptake inhibitors (SSRIs), which include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa).[citation needed]. SSRIs are easy to take and relatively safe compared with older forms of anti-depressants.[4]. Other new anti-depressants include bupropion (Wellbutrin), venlafaxine (Effexor), mirtazapine (Remeron), and duloxetine (Cymbalta).

Sometimes two different anti-depressant medications are prescribed together, or a doctor may prescribe a mood stabilizer or anti-anxiety medication in combination with an anti-depressant.

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