Dysthymic Disorder

What is dysthymic disorder?

• Dysthymic (dis-THI-mic) disorder, also called dysthymia, is a long-term mild to moderate type of mood (emotion) disorder. It is the most common type of depression and is often seen among women. Dysthymia is when you feel depressed most of the day and are depressed for more days than not for at least two years. Dysthymia affects how you feel about yourself and life in general. It can involve a depressed mood or a loss of interest or pleasure in all or almost all of your usual activities. This may greatly affect your daily activities at school, work, or at home. Dysthymia may also cause you to have problems getting along with your family, friends, and other people.
  
  
• When dysthymia occurs with more severe depression, you may have something called double depression. Double depression happens when you have both dysthymia and major depression. This condition has more symptoms and is harder to treat. Ask your caregiver for more information about double depression. Diagnosing and treating dysthymia as soon as possible may relieve your symptoms and improve your quality of life.

What causes dysthymic disorder?

The exact cause of dysthymia is not clear. You may not be able to tell exactly why you feel unhappy or depressed. Caregivers believe that dysthymia may be caused by chemical changes in your brain. It may also appear after a physical or emotional stress, such as the loss of a loved one. The following conditions may make you more likely to have dysthymia:

• Childhood history of physical or sexual abuse.
  
  
• Having a close family member with dysthymia or other mood disorders.
  
  
• Learning or memory problems.
  
  
• Long-term conditions, such as diabetes, drug abuse, and alcoholism.
  
  
• Other behavior or personality problems, such as anti-social or panic disorder.

What are the signs and symptoms of dysthymic disorder?

The most common symptom of dysthymia is feeling sad or unhappy most of the time. You may have little or no joy in your life. You may not even remember a time when you felt happy, excited, or inspired. You may also have one or more of the following:

• Always feeling negative, gloomy, or hopeless.
  
  
• Get tired easily, be inactive, and have a hard time enjoying things or having fun.
  
  
• Poor concentration and not able to think clearly.
  
  
• Problems eating, such as poor appetite or overeating.
  
  
• Sleeping too much or problems getting enough sleep.
  
  
• Trouble making decisions.
  
  
• Worry a lot, have a poor self-image, and think of yourself as a failure.

How is dysthymic disorder diagnosed?

• Tests and guides: There is no lab test that can diagnose dysthymia. Caregivers use a guide to diagnose dysthymia. You have dysthymia if you have at least two symptoms linked to your depressed mood. The symptoms must be present for at least two years, during which there has not been a period of more than one or two months where you have not had any symptoms. It should also not be caused by other problems. These symptoms must be bad enough to cause problems with your daily activities and relationships.
  
  
• Psychiatric assessment: Caregivers will ask if you have a history of psychological trauma, such as physical, sexual, or mental abuse. They will ask if you were given the care that you needed. Caregivers will ask you if you have been a victim of a crime or natural disaster, or if you have a serious injury or disease. They will ask you if you have seen other people being harmed, such as in combat. You will be asked if you drink alcohol or use drugs at present or in the past. Caregivers will ask you if you want to hurt or kill yourself or others. How you answer these questions can help caregivers decide on treatment. To help during treatment, caregivers will ask you about such things as how you feel about it and your hobbies and goals. Caregivers will also ask you about the people in your life who support you.

How is dysthymic disorder treated?

You may have any of the following:

• Anti-depressant medicines: These medicines may be used to help treat your depression by lifting up your mood.
  
  
• Therapies:
  
  
  • Behavior therapy: With a therapist, you will learn how to control your actions and change your behavior to help make yourself feel better. You will be taught how to change your behavior by looking at the results of your actions. You may learn that certain behaviors have good or bad results. These results may make you feel either good or bad about yourself. Good behaviors will be rewarded and encouraged, while unwanted or bad behaviors will be discouraged. Ask your caregiver for more information about behavior therapy.
    
    
  • Electroconvulsive therapy: This therapy, also called ECT, may be used when anti-depressant medicines, behavior therapy, or psychotherapy does not work. It is done by sending a small electric shock through the brain.
    
    
  • Psychotherapy: This is also called talk therapy. These talks are usually done in a series of meetings. Meetings or talks may be held with you and may include your family or friends. These meetings can help everyone better understand dysthymia.

Where can I find support and more information?

Having dysthymia is a life-changing disorder for you and your family. Accepting that you have dysthymia may be hard. Talk to your caregivers, family, or friends about your feelings. Your caregiver can help your family better understand how to support a person with dysthymia. You may want to join a support group with other people who also have dysthymia. Contact the following organizations for more information:

• Depression and Bipolar Support Alliance (DBSA)
  730 N. Franklin Street, Suite 501
  Chicago , IL 60610-7224
  Phone: 1- 800 - 826-3632
  Web Address: http://www.dbsalliance.org
  

• National Institute of Mental Health (NIMH), Public Information & Communication Branch
  6001 Executive Boulevard, Room 8184, MSC 9663
  Bethesda , MD 20892-9663
  Phone: 1- 301 - 443-4513
  Phone: 1- 866 - 615-6464
  Web Address: http://www.nimh.nih.gov/
  

• National Mental Health Association
  2001 N. Beauregard Street
  Alexandria , VA 22311
  Phone: 1- 703 - 684-7722
  Web Address: http://www.nmha.org
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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