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Dysthymia or Dysthymic Disorder
Dysthymic Disorder is characterized by chronic depression, but with less severity than a major depression. The essential symptom for dysthymic disorder is an almost daily depressed mood for at least two years, but without the necessary criteria for a major depression. Low energy, sleep or appetite disturbances and low self-esteem are usually part of the clinical picture as well.People who have dysthymic disorder will often report that they don't recall ever not feeling depressed, but they may be relatively functional in managing their life, although the symptoms are severe enough to cause distress and interference with important life role responsibilities. It is important to have a complete physical to rule out any physical illnesses that might be causing the depression. Also, if the person has a chronic medical condition that appears to be the cause for the depression (such as any chronic debilitating condition), then the correct diagnosis might be a Mood Disorder due to a general Medical Condition, even if all the criteria for dysthymic disorder are met. The question is whether the medical condition is physically causing the depression, rather than creating chronic psychological distress that is causing the depression.
Despite the long term nature of this type of depression, psychotherapy is effective in reducing the symptoms of depression, and assisting the person in managing his/her life better. Some individuals with dysthymic disorder respond well to antidepressant medication, in addition to psychotherapy, so an evaluation for medication may be appropriate. You should consult your psychologist if you have questions about treatment.
Identifying Dysthymic Disorder Depression causes changes in thinking, feeling, behavior, and physical well-being. Changes in Thinking - Many people experience difficulty with concentration and decision making. Some people report problems with short term memory, forgetting things all the time. Negative thoughts and thinking are characteristic of depression. Pessimism, poor self-esteem, excessive guilt, and self-criticism are all common. Some people have self-destructive thoughts during more serious depression. Changes in Feelings - Many people report feeling sad for no reason. Others report that they no longer enjoy activities that they once found pleasurable. You might lack motivation, becoming more apathetic. You might feel "slowed down" and tired all the time. Sometimes irritability is a problem, and more difficulty controlling your temper. Often, dysthymic disorder leads to feelings of helplessness and hopelessness. Changes in Behavior - You might act more apathetic, because that's how you feel. Some people do not feel comfortable with other people, so social withdrawal is common. Some people experience a change in appetite, either eating more or less. Because of the chronic sadness, excessive crying is common. Some people complain about everything, and act out their anger with temper outbursts. Sexual desire may disappear, resulting in lack of sexual activity. In the extreme, people may neglect their personal appearance, even neglecting basic hygiene. Needless to say, someone who is this depressed does not do very much, so work productivity and household responsibilities suffer. Some people have trouble getting out of bed. Changes in Physical Well-being - We already talked about the negative emotional feelings experienced during depression, but these are coupled with negative physical emotions as well. Chronic fatigue, despite spending more time sleeping is common. Some people can't sleep, or don't sleep soundly. These individuals lay awake for hours, or awaken many times during the night, and stare at the ceiling. Others sleep many hours, even most of the day, although they still feel tired. Many people lose their appetite, feel slowed down by depression, and complain of many aches and pains. Now imagine these symptoms lasting for months. Imagine feeling this way almost all of the time. This may be dysthymic disorder, if several of these symptoms are present most of the time, for the past two years. Remember, all of the symptoms do not need to be present! Of course, it's not a good idea to diagnose yourself. If you think you might be depressed, talk to a psychologist for a consultation. A licensed psychologist can assess whether you are depressed, and can determine the proper treatment for your depression. Remember, depression is treatable.