what is the usual course of dysthymic disorder

Symptoms

In this edition of The Interface, we review the mood disorder, dysthymia. Dysthymia, or dysthymic disorder (DD), is a longstanding mood disorder that is characterized by fluctuating dysphoria that may be punctuated by brief periods of normal mood.

Causes

The symptoms of dysthymia listed in the DSM-IV were similar to major depression but less severe. These symptoms included: Either poor appetite or eating too much. Sleep difficulties. Fatigue. Low self-esteem. Difficulty concentrating or making decisions.

Complications

Dysthymic disorder is a smoldering mood disturbance characterized by a long duration (at least two years in adults) as well as transient periods of normal mood. The disorder is fairly common in the US general population (3–6%) as well as in primary care (7%) and mental health settings (up to one-third of psychiatric outpatients).

What is dysthymic disorder?

Treatment may include pharmacotherapy and psychotherapy, although the overall treatment course is oftentimes characterized by protracted symptoms and relapses. Keywords: dysthymia, dysthymic disorder, depression, mood disorder

What are the signs and symptoms of dysthymia?

What is the prevalence of dysthymic disorder?

What is the treatment for dysthymic disorder?

How long is dysthymic disorder?

Persistent depressive disorder symptoms usually come and go over a period of years, and their intensity can change over time. But typically symptoms don't disappear for more than two months at a time.

What is the onset of dysthymia?

In the current Diagnostic and Statistical Manual of Mental Disorders, dysthymic disorder is categorized as either early-onset or late-onset, based upon the emergence of symptoms before or after the age of 21, respectively.

Is dysthymic disorder long term?

What is dysthymia? Dysthymia is a milder, but long-lasting form of depression. It's also called persistent depressive disorder. People with this condition may also have bouts of major depression at times.

What are the causes of dysthymia?

The cause of dysthymia, although not clear, is likely multifactorial. A biopsychosocial formulation considering the interplay of family history and other genetic factors, medical problems, psychological make-up and coping strategies, and social stressors is helpful when considering the cause of dysthymia.

Does dysthymia have manic episodes?

In addition, the individual has never experienced a manic episode, a mixed episode, or a hypomanic episode. Mood symptoms must also occur solely during the course of the mood disorder and not as part of some other disorder that may be occurring simultaneously (such as Schizophrenia or Delusional Disorder).

Which of the following is associated with dysthymia?

Dysthymia characteristics include an extended period of depressed mood combined with at least two other symptoms which may include insomnia or hypersomnia, fatigue or low energy, eating changes (more or less), low self-esteem, or feelings of hopelessness.

Can dysthymia last a lifetime?

Dysthymia is a low-grade depression that comes and goes but can last a lifetime. Usually, it's not the kind of depression that keeps you in bed for weeks or makes you want to kill yourself, but it can leave you feeling that you'd be better off if you weren't here.

How do you deal with dysthymia?

The two main treatments for persistent depressive disorder are medications and talk therapy (psychotherapy). The treatment approach your doctor recommends depends on factors such as: Severity of your symptoms. Your desire to address emotional or situational issues affecting your life.

Is dysthymia a form of bipolar?

Dysthymia cannot be diagnosed at the same time as bipolar disorder, however, because in order to qualify for a diagnosis of Dysthymia, you have to show evidence of consistently mild depressive symptoms occurring more days than not over a period of at least two years.

Is dysthymic disorder serious?

Dysthymia is a serious disorder. It is not "minor" depression, and it is not a condition intermediate between severe clinical depression and depression in the casual colloquial sense. In some cases it is more disabling than major depression.

Will my dysthymia go away?

If you think you may have dysthymia, it's essential to seek help. Seeing a mental health professional is the first step to recovery. Taking the time to go to therapy is an investment in your health and well-being; the condition will not go away on its own.

Is dysthymia a disability?

It can manifest like other forms of depression, but instead of being cyclical it can last for long periods of time, and even years on end. If you suffer from dysthymia and are unable to work, you could qualify for Social Security disability benefits but only if you are able to provide documentation.

What is 1DD in the DSM?

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision(DSM-IV-TR),1DD is an Axis I mood disturbance distinguished by seemingly low-grade depressive symptoms as well as symptom persistence (i.e., at least two years in duration).

What is a DD?

Dysthymia, or dysthymic disorder (DD), is a longstanding mood disorder that is characterized by fluctuating dysphoria that may be punctuated by brief periods of normal mood. Far less symptomatically dramatic than its cousin major depression, DD is fairly common in the community and in primary care and mental health settings.

Is DD a genetic predisposition?

While no consistent biological findings are evident, DD appears to have a genetic predisposition. In both psychiatric and primary care settings, DD can be difficult to detect. Treatment may include both pharmacotherapy and psychotherapy, although responses to either may be modest and/or short-lived.

Can DD be identified as a personality disorder?

When the symptoms of DD have been longstanding (i.e., date back to childhood and/or adolescence), affected individuals may conclude that their maladies are actually personality characteristics. In other words, they may not identify the mood disturbance as separate from self. Misdiagnosis of symptoms.

Is DD a covert disorder?

In addition, compared with other types of psychiatric disorders, the symptoms of DD are relatively covert (e.g., concentration difficulties and low self esteem versus hallucinations in schizophrenia, compulsive behaviors in obsessive-compulsive disorder, or purging in bulimia nervosa).

Is dysthymia a genetic disorder?

While the etiology of dysthymia remains unknown, there appears to be a genetic susceptibility, which may manifest in the presence of various psychosocial stressors.

What is the treatment for dysthymia?

If the answers suggest dysthymia, a standard clinical interview can be used to confirm the diagnosis. Like major depression, dysthymia is treated with psychotherapy and medications — usually the same medications and the same kinds of psychotherapy.

How to distinguish dysthymia from depression?

The purpose is to distinguish dysthymia more clearly from major depression by emphasizing mood and personal relations over physical symptoms. Dysthymia is about as common as major depression. Given its chronic nature, that makes it one of the disorders most often seen by psychotherapists.

How to recover from dysthymia?

For many others, a combination of long-term psychotherapy and medication may be most effective. A solid relationship with a psychotherapist or other professional can be important in maintaining a willingness to continue medications. Recovery from dysthymia often takes a long time, and the symptoms often return.

What is the Greek word for "bad state of mind"?

The Greek word dysthymia means "bad state of mind" or "ill humor.".

Why does dysthymia occur in older men?

In old age, dysthymia is more likely to be the result of physical disability, medical illness, cognitive decline, or bereavement. In some older men, low testosterone may also be a factor.

Why is dysthymia a genetic disorder?

Like major depression, dysthymia has roots in genetic susceptibility, neurochemical imbalances, childhood and adult stress and trauma, and social circumstances, especially isolation and the unavailability of help.

What is depression in psychology?

Depression is a word with many meanings — anything from a passing mood of sadness or discouragement to a condition of inconsolable misery, suicidal thoughts, and even delusions as well as severe physical symptoms. It's regarded as a clinical disorder when depressed mood and related symptoms are serious enough or last long enough to interfere ...

What is dysthymic disorder?

Medically Reviewed By: Laura Angers. Dysthymic disorder, often called a persistent depressive disorder, or just dysthymia, is a chronic type of depression that can last for years if untreated. This article will cover what dysthymic disorder is and things that you should be aware of, and how you can get help ...

What is the term for a form of dysthymia?

The word dysthymic is a form of the word dysthymia. In the Diagnostic and Statistical Manual (DSM-5), persistent depressive disorder takes the place of two diagnoses from the previous version of this manual of mental disorders. These two are dysthymic disorder and chronic major depressive disorder.

What is dysthymia mental illness?

If you have dysthymia, you have a mental illness that’s also called persistent depressive disorder. This mental illness is one of the mood disorders listed in the DSM-5. It is a type of depression that starts early and persists over many years without any manic or hypomanic phases.

How long does it take to get diagnosed with dysthymia?

Treating dysthymia or persistent depressive disorder is very similar to the protocols used in major depression, and it will typically consist of medication and psychotherapy. Although you need to have had symptoms for at least two years to receive a diagnosis, you don’t need to wait two years to get help.

Why is dysthymia called double depression?

Dysthymia can also be called “double depression” because the “milder” symptoms may precede the more severe ones seen in major depression. Those with major depression are aware that they have a more baseline mood that can sometimes be considered good or satisfactory.

What are the symptoms of a persistent depressive disorder?

However, according to the DSM-5, patients who may have persistent depressive order need to have at least two of the following symptoms: A Poor Appetite Or Overeating. Source: rawpixel.com. Appetite changes are extremely common in depression, and it can often go both ways – individuals may struggle to eat enough.

Can bipolar disorder be diagnosed as dysthymia?

After all, if only one kind of person got bipolar disorder and a different kind of person got dysthymia, no doctor would ever make the mistake of diagnosing someone with bipolar as having dysthymia.

How to treat dysthymic disorder?

Now that Angie has a diagnosis of dysthymic disorder, she can begin exploring her options for treatment. Dysthymic disorder is treated primarily with medication and/or talk therapy. It is generally more effective to treat dysthymic disorder with both medication and talk therapy as opposed to using either alone. When only one of these two options is used alone, medication seems to be a better treatment for dysthymic disorder than talk therapy. Research also suggests that exercising on a regular basis can help treat dysthymic disorder.

What is the best treatment for dysthymic disorder?

Three types of talk therapy, also known as psychotherapy have been shown to be effective in treating dysthymic disorder. Cognitive behavioral therapy focuses on examining your thoughts, feelings, and behaviors to uncover unhealthy patterns and replace them with more adaptive ones.

What is the difference between major depression and dysthymic disorder?

Dysthymic disorder differs from major depression in that dysthymic disorder is less severe and lasts much longer. Dysthymic disorder symptoms are present for a minimum of two years, and often last way beyond that. Despite not being as severe as depression, dysthymic disorder can cause significant impairments in daily functioning, work, and relationships.

What is Angie's diagnosis of dysthymic disorder?

Let's look at Angie's symptoms and how they led to her being diagnosed with dysthymic disorder. Angie possessed the two main features of depression. That is, she was feeling sad and she lost interest in most activities. Both of these features must be present for a majority of the day on most days in order to be diagnosed with dysthymic disorder.

Why is dysthymic disorder so hard to diagnose?

Dysthymic disorder can be hard to diagnose due to the fact that the individual dealing with it may not immediately notice the symptoms, or may simply believe that they are part of their personality. However, persistent depressive disorder and major depressive disorder share many symptoms.

How do you know if you have depressive disorder?

Some of the symptoms you may see in persistent depressive disorder include: 1 Depressed mood, which is often experienced most days during the course of your depressive episode 2 Difficulty sleeping or sleeping too much 3 Eating too little or eating too much 4 Low energy and fatigue 5 Difficulty concentrating 6 Low self-esteem 7 Feelings of hopelessness 8 Physical aches and pains

Abstract

OBJECTIVE: There have been few naturalistic follow-up studies of dysthymic disorder. This study describes the 5-year course and outcome of dysthymic disorder. METHOD: The authors conducted a prospective, longitudinal follow-up study of 86 outpatients with early-onset dysthymic disorder and 39 outpatients with episodic major depressive disorder.

Method

The study group and methods for the initial evaluation have been described previously (9, 17). The original study group included 97 outpatients with DSM-III-R primary early-onset dysthymic disorder and 45 outpatients with nonchronic major depressive disorder.

Results

Patients’ baseline characteristics appear in Table 1. Patients with episodic major depressive disorder had significantly more education than patients with dysthymic disorder.

Discussion

This article describes the 5-year course and outcome of early-onset dysthymic disorder. To our knowledge, this is the longest prospective, naturalistic follow-up study of adults with dysthymic disorder in the literature.

What are the symptoms of dysthymia?

Sleep difficulties. Social withdrawal. Trouble concentrating. While people with major depressive disorder may have days or periods where they feel better, those with dysthymia have depressive symptoms almost all the time for a long time.

Where does the word "dysthymia" come from?

The word dysthymia comes from the Greek roots dys, meaning "ill" or "bad," and thymia, meaning "mind" or "emotions.". The terms dysthymia and dysthymic disorder referred to a mild, chronic state of depression.

What are the symptoms of depressive disorder?

The symptoms of persistent depressive disorder are very similar to major depressive disorder. However, these symptoms are chronic, meaning that people have these depressive symptoms most days for a period of at least two years for adults and one year for children and teens. The symptoms include: 1 Decreased productivity 2 Feelings of guilt 3 Feelings of helplessness 4 Feelings of sadness 5 Hopelessness 6 Increases or decreases in appetite 7 Irritability 8 Lack of energy or fatigue 9 Loss of interest and pleasure in daily activities 10 Low mood 11 Poor self-esteem 12 Sleep difficulties 13 Social withdrawal 14 Trouble concentrating

How long do you have persistent depressive symptoms?

However, these symptoms are chronic, meaning that people have these depressive symptoms most days for a period of at least two years for adults and one year for children and teens. The symptoms include:

How to help someone with persistent depression?

Because this type of depression is chronic, incorporating lifestyle changes and self-care with your medical treatments can be helpful. Some things that you can do that will complement therapy and medication:

How often do you have to have depression?

For adults, symptoms of depression must be experienced more often than not for at least two years prior. For children, the requirement was lowered to one year. Lastly, the symptoms must result in significant distress or impairment of normal functioning.

Is there a test for dysthymia?

Diagnosis. There was and still is no laboratory test for diagnosing dysthymia or any other form of depression. If you are experiencing symptoms of depression, your doctor will evaluate your symptoms and medical history. You will be asked questions about the nature, severity, and duration of your symptoms.

What is the diagnosis of persistent depressive disorder?

A child psychiatrist or other mental health professional usually diagnoses persistent depressive disorder following a comprehensive psychiatric evaluation. An evaluation of the adolescent's family, when possible, in addition to information provided by teachers and care providers may also be helpful in making a diagnosis.

How long does a depressed mood last?

For a diagnosis of persistent depressive disorder to be made, a depressed or irritable mood must persist for at least one year in children or adolescents and must be accompanied by at least two other major depressive symptoms (noted above).

Can persistent depressive disorder be treated?

Expectations for the course of the condition. Your opinion or preference. Mood disorders, including persistent depressive disorder, can often be effectively treated. Treatment should always be based on a comprehensive evaluation of the adolescent and family. Treatment may include one, or more, of the following:

Is There A Depressive Personality?

Looking For Causes

Treatment

Drugs Or Psychotherapy?