People with dysthymia generally experience little or no joy in their lives. Instead things are rather gloomy most of the time. If you have dysthymia you may be unable to remember a time when you felt happy, excited, or inspired. It may seem as if you have been depressed all your life. You probably have a hard time enjoying things and having fun. Rather, you might tend to be inactive and withdrawn , you worry frequently, and criticize yourself as being a failure. You may also feel guilty, irritable, sluggish, and have difficulty sleeping regularly. See criteria for Dysthymia below.
Dysthymia is a milder yet more enduring type of depression that affects women two to three times more often than men. The diagnosis is given when a person has had continuous depressed mood for at least two years. For children, the duration only needs to be one year, and their mood may be irritable rather than sad or depressed. People with dysthymia may appear to be chronically mildly depressed to the point that it seems to be a part of their personality. When a person finally seeks treatment for dysthymia, it is not uncommon that he/she has had this condition for a number of years. Because dysthymia may develop early in a person's life, it is not uncommon for someone with this condition to believe that it is normal to always feel depressed. They often to do realize that the quality of their mood is anything out of the ordinary. This illness often goes unnoticed and, therefore, untreated.
Dysthymia is a condition that tends to develop early in a person's life, but most people delay approximately ten years before every seeking treatment. This is unfortunate since the sooner a person seeks help the sooner he or she can get relief and possibly avoid further distress. It is very important that children with symptoms of dysthymia receive an evaluation from a mental health professional or physician. Early treatment may help these youngsters avoid more serious mood disorders, difficulties in school and their social life, and possible substance abuse problems as they get older.
At any point in time, 3% of the population may be affected by dysthymia. Within a lifetime it appears to affect approximately 6%. Those with immediate relatives who have had major depressive disorder have a greater likelihood of developing dysthymia. If a person develops dysthymia it usually happens early in their lives- from childhood to early adulthood. The symptoms of dysthymia tend to be chronic, yet people often do not seek treatment unless they develop major depression. Having dysthymic disorder increases the risk of developing major depressive disorder. Of those with dysthymia approximately 10% will go on to develop major depression. The presence of both conditions is sometimes known as "double depression."
Dysthymia may also be associated with the presence of personality disorders (e.g., avoidant, dependent, histrionic, borderline, narcissistic). However, it can sometimes be difficult to determine the extent to which a personality disorder is present since some of the long-term problems of dysthymia may affect interpersonal relationships as well as how a person perceives him- or herself. Dysthymia may also be related to substance use. People with this type of chronic depression may abuse drugs or alcohol in trying to relieve their despondency and other unpleasant symptoms. Dysthymia in children may sometimes be related to anxiety disorders, learning disorders, attention-deficit/hyperactivity disorder (ADHD), conduct disorder, and mental retardation. Physical illnesses that may be associated with dysthymia include acquired immunodeficiency syndrome (AIDS), hypothyroidism, and multiple sclerosis.
Diagnosis of Dysthymic Disorder
Summarized from the Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition, Text Revision
A. A person has depressed mood for most the time almost every day for at least two years. Children and adolescents may have irritable mood, and the time frame is at least one year.
B. While depressed, a person experiences at least two of the following symptoms:
- Either overeating or lack of appetite.
- Sleeping to much or having difficulty sleeping.
- Fatigue, lack of energy.
- Poor self-esteem.
- Difficulty with concentration or decision making.
- Feeling hopeless.
C. A person has not been free of the symptoms during the two-year time period (one-year for children and adolescents).
D. During the two-year time period (one-year for children and adolescents) there has not been a major depressive episode.
E. A person has not had a manic, mixed, or hypomanic episode.
F. The symptoms are not present only during the presence of another chronic disorder.
G. A medical condition or the use of substances (i.e., alcohol, drugs, medication, toxins) do not cause the symptoms.
H. The person's symptoms are a cause of great distress or difficulty in functioning at home, work, or other important areas.
Possible specifiers to describe dysthymia:
Early Onset: Dysthymic symptoms begin before the age of 21. This may increase the likelihood of developing later major depressive episodes.
Late Onset: Dysthymic symptoms begin after the age of 21.
With Atypical Features: Describes symptoms experienced during the last two years