Dysthymia (dis-THIE-me-uh) is a mild but long-term (chronic) form of depression. Symptoms usually last for at least two years, and often for much longer than that. Dysthymia interferes with your ability to function and enjoy life.
With dysthymia, you may lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem and an overall feeling of inadequacy. People with dysthymia are often thought of as being overly critical, constantly complaining and incapable of having fun.
Dysthymia symptoms in adults may include:
In children, dysthymia sometimes occurs along with attention-deficit/hyperactivity disorder (ADHD), behavioral or learning disorders, anxiety disorders, or developmental disabilities. Examples of dysthymia symptoms in children include:
Dysthymia 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. In general, you may find it hard to be upbeat even on happy occasions — you may be described as having a gloomy personality.
When dysthymia starts 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
Because these feelings have gone on for such a long time, you may think they'll always be part of your life. But if you have any symptoms of dysthymia, seek medical help. If not effectively treated, dysthymia commonly progresses into major depression. Sometimes, a major depression episode occurs in addition to dysthymia — this is called double depression.
Talk to your primary care doctor 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 major depression, including:
Certain factors appear to increase the risk of developing or triggering dysthymia, including:
Complications that dysthymia may cause or be linked with include:
Preparing for your appointment
Your doctor may ask about your mood during a routine medical appointment if you seem to be sad or down. Or you may decide to schedule an appointment to talk about your concerns. 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.
What you can do
Taking a family member or friend along can help you remember something that you missed or forgot.
Basic questions to ask your doctor include:
Don't hesitate to ask questions any time you don't understand something.
What to expect from your doctor
Tests and diagnosis
If your doctor suspects you have dysthymia, exams and tests may include:
Checking for other conditions
Diagnostic criteria for dysthymia
For a diagnosis of dysthymia, the main indication for an adult differs somewhat from that of a child:
In addition to that, you must have at least two of these symptoms, and they must cause distress or interfere with your ability to function in your daily life:
Treatments and drugs
The two main treatments for dysthymia are medications and talk therapy (psychotherapy). Medications appear to be more effective at treating dysthymia than psychotherapy when either is used alone. Using a combination of medications and psychotherapy may be slightly more effective.
Which treatment approach your doctor recommends depends on factors such as:
Medications for dysthymia
Finding the right medication
If you're bothered by side effects, don't stop taking an antidepressant without talking to your doctor first. Some antidepressants can cause withdrawal symptoms unless you slowly taper off, and quitting abruptly may cause a sudden worsening of depression. Don't give up until you and your doctor find a medication that's suitable for you. Talk with your doctor or pharmacist about possible side effects to weigh the benefits and risks. In some cases, side effects may go away as your body adjusts to the medication.
When you have dysthymia, you may need to take antidepressants long term to keep symptoms under control.
Antidepressants and increased suicide risk
Psychotherapy for dysthymia
You and your therapist can discuss which type of therapy is right for you, your goals for therapy, and other issues, such as the length of treatment.
Lifestyle and home remedies
Dysthymia generally isn't a disorder that you can treat on your own. But, in addition to professional treatment, you can take these steps:
Make sure you understand the risks as well as possible benefits if you pursue alternative or complementary therapy. Keep in mind that the Food and Drug Administration (FDA) doesn't regulate herbal supplements, so you can't always be sure of what you're getting or know whether it's safe. Also, some herbal supplements can interfere with certain prescription medications or cause dangerous interactions.
For example, St. John's wort has been used for depression, although in the United States it's not approved by the FDA to treat depression. It may help mild or moderate depression, such as dysthymia, but the overall evidence is not conclusive. However, it should be used with caution — St. John's wort can interfere with many medications, such as antidepressants, birth control pills, blood thinners, chemotherapy drugs, HIV/AIDS medications, and drugs to prevent organ rejection after a transplant.
Talk to your doctor before taking any herbal supplement.
Relying solely on these therapies is generally not enough to treat dysthymia. However, they may be helpful when used in addition to medication and psychotherapy.
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 behavior and activities that can help you feel better. In addition to the treatments recommended by your doctor or therapist, consider these tips:
There's no sure way to prevent dysthymia. Because dysthymia often starts in childhood, identifying children at risk of the condition may help them get early treatment. Strategies that may help ward off dysthymia symptoms include the following.
Last Updated: 2012-12-20
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