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What is Dysthymia?

written by: renasherwood • edited by: Paul Arnold • updated: 3/14/2011

Your doctor says you have dysthymia and you want to know what it is. Also known as dysthymic disorder or low-level depression, it has many symptoms including feelings of hopelessness, changes in appetite and an inability to make decisions.

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    What is Dysthymia? Age Range of Sufferers

    Dysthymic disorder symptoms can begin in childhood or adolescence but usually do not appear until the teen years or even later, according to Depression For Dummies. (Wiley Publishing; 2003.) But the University of Michigan Depression Center reports that many patients with low-level depression do not seek treatment until years or even decades after symptoms begin. Dysthymia can be a life-long mental illness.

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    What is Dysthymia? Symptoms

    A patient only needs to show at least two of the following symptoms for two years or more before they can be diagnosed with dysthymic disorder. Symptoms are chronic and last all day as opposed to coming in episodes or cycles:

    1. Loss of concentration, including tremendous difficultly making decisions. This can make the person seem to have learning disabilities.
    2. Changes in sleep patterns which can greatly affect a person’s ability to concentrate, learn and make decisions. A person may not be able to sleep (insomnia) or sleep far too much (hypersomnia).
    3. Changes in appetite - from not being able to eat to overeating.
    4. Constant fatigue, aggravated by changes in sleep or appetite.
    5. Very low self-esteem and a feeling of being worthless; the person considers they were better off not being born. This may or may not lead to thoughts of suicide.
    6. Feelings of hopelessness or that they cannot be helped. A patient may resist seeking treatment just because he or she sees no point in it.

    For a diagnosis to be given the symptoms must not be due to other causes. So, the person should not be a drug abuser or alcoholic nor have had any episodes of major depression or other mental illnesses for at least two years.

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    If Left Untreated

    Ten percent of untreated patients with dysthymic disorder eventually worsen to where they are diagnosed with major depression or major depressive disorder. It is unknown just why this happens. It could be that patients are so sure that they cannot be helped that they believe their feelings and problems are a normal part of life. Patients only seek treatment after a crisis such as a failed suicide attempt.

    Patients generally withdraw from any social life. Those whose symptoms started before the age of 21 are more likely to develop a personality disorder than those who develop symptoms after 21. Just why this happens is unclear.

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    Different from Major Depression?

    The University of Michigan Depression Center has a different answer to the question, “What is dysthymia?” They theorize that dysthymic disorder may actually be major depression. This is because many people diagnosed with dysthymia have a close relative with major depression.

    The gold standard of mental health diagnosis is the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (or DSM-IV.) According to the DSM-IV, these two depressive disorders are distinct. In major depression, people only need to experience symptoms for two weeks straight in order to be diagnosed. Some people may have symptoms in episodes or after traumatic events, while dysthymic disorder symptoms are ever present.

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    Sources

    Morey, Bodie and Kim T. Mueser, Ph.D. The Family Intervention Guide to Mental Illness. New Harbinger Publications; 2007.

    Smith, Laura L., Ph.D. and Charles H. Elliot, Ph.D. Depression For Dummies. Wiley Publishing; 2003.

    University of Michigan Depression Center. “Dysthymic Disorder.” http://www.med.umich.edu/depression/dysthymia.htm

    University of Michigan. “DSM-IV Dysthymia.” http://www.icpsr.umich.edu/CPES/diagnostics/DSM-IV_Dysthymia.pdf