Dysthymic Disorder: When Depression Lingers

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What is dysthymic disorder?
Dysthymic disorder, or dysthymia, is a type of depression that lasts for at least 2 years. Some people suffer from dysthymia for many years. Their depression is usually mild or moderate, rather than severe. Most people with dysthymia can’t tell for sure when they first became depressed.

Symptoms of dysthymic disorder include a poor appetite or overeating, difficulty sleeping or sleeping too much, low energy, fatigue and feelings of hopelessness. People with dysthymic disorder may have periods of normal mood that last up to 2 months. Family members and friends may not even know that their loved one is depressed. Even though this type of depression is mild, it may make it difficult for a person to function at home, school or work.

How common is dysthymic disorder?
Dysthymic disorder is a fairly common type of depression. It is estimated that up to 3% of people have dysthymia. Dysthymia can begin in childhood or in adulthood. No one knows why, but like most types of depression, it appears to be more common in women.

What causes dysthymic disorder?
No one knows for sure what causes dysthymia. It may be related to some changes in the brain that involve a chemical called serotonin (say “seer-o-tone-in"). Serotonin helps your brain handle emotions and make judgments. Personality problems, medical problems and ongoing life stress may also play a role.

How is dysthymic disorder diagnosed?
If you think you have dysthymia, discuss your concerns with your doctor. Your doctor will ask you questions to find out if you have depression and, if so, to identify the type of depression you have. Your doctor may ask you questions about your health and your symptoms, such as how well you’re sleeping, if you feel tired all of the time, and if you have trouble concentrating. Your doctor will also consider medical reasons that may cause you to feel depressed, such as problems with your thyroid or a certain medicine you may be taking.

What is the treatment for dysthymic disorder?
Dysthymic disorder can be treated with an antidepressant medicine. This type of drug relieves depression. Antidepressants are commonly prescribed, and they are safe. They do not create an artificial “high,” and they are not habit-forming.

If you are given an antidepressant, it may take a number of weeks, or even several months, before you and your doctor know whether the drug is helping you. It is important for you to take the medicine exactly as your doctor tells you to. If the antidepressant helps you feel better, you may need to take this medicine for several years. You should continue to take the antidepressant drug until your doctor tells you to stop, even if you begin to feel better. If you stop taking the medicine, you may get depressed again.

Will I have to see a psychiatrist or psychotherapist?
You may not have to see a psychiatrist or psychotherapist unless medication is not working or you have problems taking the drugs that are usually prescribed for depression. Sometimes, in addition to taking an antidepressant medicine, patients are referred for psychotherapy to help them deal with specific problems. This type of therapy can be very helpful for some people.

What can I do to help myself feel better? Talking to your doctor about how you’re feeling and getting treatment for dysthymic disorder are the first steps to feeling better. The following are other ways to make yourself feel better: Get involved in activities that make you feel good or make you feel like you’ve accomplished something. For example, go to a movie, take a drive on a pleasant day, go to a ball game or work in the garden. Eat well-balanced, healthy meals. Don’t use drugs or drink alcohol. Both can make depression worse. Get plenty of exercise. Exercising 4 to 6 times a week for 30 to 60 minutes each time is a good goal. Exercise can help lift your mood.

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