Knowing Dysthymia: Definition, Causes, And Symptoms Of Persistent Depressive Disorder (PDD)
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Depressive disorders affect over 61 million adults throughout the United States. However, not everyone experiences depression in the same way or for the same length of time, and there are many depressive disorders one may be diagnosed with, including dysthymia. For example, when depression is mild to moderate for years and not marked by clear episodes, it can sometimes be easy to miss. To understand this type of depression, it may be valuable to learn about persistent depressive disorder, previously called dysthymia.
Know your diagnosis: Dysthymia vs. major depression
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists several depressive disorders, including major depressive disorder (major depression), persistent depressive disorder (PDD), seasonal affective disorder, and postpartum depression, among others. To better understand dysthymic disorder, examining the difference between this condition and MDD can be helpful.
Major depressive disorder (MDD)
Major depressive disorder (MDD) is a serious mood disorder marked by severe low mood and a loss of interest in previously enjoyed activities. To receive a diagnosis of MDD, an individual must have five or more symptoms, including a depressed mood or a loss of interest in pleasurable activities lasting for two weeks or more.
According to the American Psychiatric Association, the characteristics of MDD include:
A low or depressed mood
Loss of interest in prior activities that brought enjoyment
Changes in appetite
Sleep disturbances
Fatigue or a lack of energy
Feelings of guilt or worthlessness
Difficulty concentrating
Slowed thought and reduced physical movement
Thoughts of death or suicide
If you are experiencing suicidal thoughts or urges, call the 988 Suicide & Crisis Lifeline at 988 or text 988 to talk to a crisis provider over SMS. They are available 24/7 to offer support. The lifeline also offers an online chat for those with an internet connection.
Persistent depressive disorder (PDD)
Persistent depressive disorder (PDD) is a relatively new term. Previously, this disorder had been called dysthymic disorder or dysthymia. The dysthymia definition used by Harvard Health Publishing (based on the American Psychiatric Association’s definition) is a “depressed mood most of the time for at least two years, along with at least two of the following symptoms: poor appetite or overeating; insomnia or excessive sleep; low energy or fatigue; low self-esteem; poor concentration or indecisiveness; and hopelessness.” The Diagnostic and Statistical Manual of Mental Disorders, DSM-5) now uses the term persistent depressive disorder.
This mental health condition is a long-term form of depression. An individual with persistent depressive disorder may feel persistent sadness, emptiness, or hopelessness and lose interest in daily activities. With persistent depressive disorder, these feelings can last for years.
Knowing dysthymia: Definition and difference of persistent depressive disorder vs major depressive disorder
Persistent depressive disorder differs from major depressive disorder in two main ways, including the duration and severity of depressive symptoms. Persistent depressive disorder is not as severe as MDD but lasts over two years. Meanwhile, MDD is more severe but may last a shorter period, like two weeks or two months.
The symptoms of persistent depressive disorder tend to be less severe and less intense than those experienced by individuals with MDD. However, persistent depressive disorder is a long-term disorder that can negatively impact the quality of life over an extended period. Additionally, someone with persistent depressive disorder can experience a major depressive episode while experiencing dysthymia. This diagnosis is referred to as double depression.
Dysthymia (persistent depressive disorder) symptoms
Below are a few of the potential causes of PPD and its symptoms.
What causes persistent depressive disorder?
One factor may not solely cause persistent depressive disorder for every person. However, some risk factors can contribute to an individual developing the condition, including but not limited to the following:
Brain chemistry
A family history of the condition
A personal history of other mental health conditions
Trauma or major stressors
Long-term physical illness
Physical trauma to the brain
Is it chronic depression and bad mood?: Symptoms of persistent depressive disorder
While there may not be one cause of this form of chronic depression, it may be easier to identify the symptoms characteristic of persistent depressive disorder. By exploring these symptoms, you may get an idea of whether you or someone you love might be living with PDD and find ways to manage your symptoms.
Cognitive symptoms may be more common in persistent depressive disorder. For example, low self-esteem and social withdrawal may be more prevalent than symptoms like irregular sleep and significant changes in appetite, which are more common in MDD.
Some of the symptoms of persistent depressive disorder can include:
Feelings of sadness or emptiness
Loss of interest in previously enjoyed activities
Changes in appetite
Difficulty sleeping
Fatigue
Feelings of low self-esteem
Difficulty focusing
Hopelessness
Avoidance of social activities
Difficulty completing tasks
Irritability or anger
Feeling guilty or worried about the past
Caring for your mental health: Dysthymia treatments
Having persistent depressive disorder can sometimes be frustrating, but treatment options exist, including the following.
Medication
Besides therapy, certain medications may be used to treat persistent depressive disorder. Antidepressant medications, such as selective serotonin reuptake inhibitors, are commonly used. If you want to explore medication options, it’s recommended that you find a doctor before starting, changing, or stopping medical treatments.
Lifestyle changes to improve your mood
In addition to medical treatment, there are lifestyle changes an individual can try to cope with this condition. These can include:
Getting regular exercise
Avoiding substance use
Eating a balanced diet
Cultivating a meditation practice
Therapy
Talk therapy is a commonly recommended form of treatment for persistent depressive disorder. Two of the most common types of therapy for dysthymia are interpersonal therapy and cognitive behavioral therapy (CBT), which is often used for many mental health conditions, including anxiety disorders, mood disorders, and bipolar disorder. In therapy, individuals can discuss their emotions, thoughts, and behaviors and learn ways to cope with negative emotions healthily and manage symptoms. Talk therapy can give the individual the opportunity to set goals and regain a sense of control.
Some individuals with persistent depressive disorder may frequently feel fatigued and experience low energy, so the thought of leaving the house to seek therapy in an office setting may feel exhausting. In these cases, online therapy may be a convenient option. With online therapy through a platform like BetterHelp, you can speak with a licensed therapist from the comfort of your home without worrying about a commute or finding parking. In addition, you can choose between phone, video, or chat sessions based on your preferences.
Research has shown that online therapy can be an effective option for reducing symptoms of depression. One study examined the effectiveness of an online therapy program for improving symptoms of depression and anxiety, and it found that the program delivered significant reductions in symptoms, comparable to those experienced by individuals in traditional in-office therapy.
Takeaway
Dysthymia vs. depression
It is a long-term form of depression.
Knowing dysthymia: Definition of what “dysthymia” means
Dysthymia is another name for persistent depressive disorder, which is a chronic form of depression with symptoms that are considered “less severe” than those of major depression.
Symptoms of chronic depression such as persistent depressive disorder include:
- Loss of interest in daily life and activities
- Feelings of sadness and hopelessness
- Social avoidance or withdrawal
- Lack of energy and decreased activity
- Difficulty getting healthy sleep
- Poor concentration or difficulty making decisions
- Poor appetite or overeating
The National Institute of Mental Health describes dysthymic disorder on their website.
How long does dysthymia last?
To be diagnosed with persistent depressive disorder, an adult must have signs and symptoms for at least two years. During this time frame, people with persistent depressive disorder will not be without an episode of depression for more than two months at a time. Without treatment, these signs and symptoms can continue for years.
Treatment for any kind of depression is important. A combination treatment with both antidepressants and therapy can be effective. In fact, a systematic review showed that medication can be helpful for dysthymia in the short term. For people whose relationships have suffered due to dysthymia, interpersonal psychotherapy may be appropriate.
Is dysthymia a serious mental health illness?
Persistent depressive disorder is a long-term form of depression and a real mental illness. Persistent depressive disorder can last years and interfere with a person’s daily life and responsibilities.
What happens if dysthymia is left untreated?
If dysthymia is left untreated, it can lead to problems with work, school, and relationships. It can also put someone at risk of experiencing more severe symptoms, along with developing other depressive disorders. It can have physical effects, as well, such as making heart disease more likely. If you suspect dysthymia, you should definitely reach out to a mental health professional to get support. And if you experience suicidal thoughts, call a crisis lifeline or your local emergency number immediately.
No one knows the exact cause of dysthymia. It could be a side effect of medical illnesses, chronic stress, or isolated stressful life events. Personality disorders are also sometimes accompanied by dysthymia. Some people also may have genetic susceptibility.
There may be no way to prevent persistent depressive disorder (another term for dysthymia), but there are things you can do to lessen its likelihood and its impact. Managing depression involves practicing self-care by eating nutritious food and getting regular physical activity. Substance misuse can also exacerbate depression, so it’s best to avoid alcohol and recreational drugs. And there is some evidence that shows that dietary supplements can be helpful for depression, although you should talk to your doctor before taking supplements for mental health issues. All these things to do in order to prevent symptoms are not a replacement for therapy, however. If you are experiencing physical symptoms like headaches or or emotional symptoms like apathy and persistent sadness, or other symptoms of depression, reach out to a therapist immediately. The sooner that patients confront the root causes of their depression, the better the therapeutic outcomes.
What defines dysthymia?
Dysthymia is defined as having a low mood for a period of at least two years with milder symptoms than major depressive disorder. It’s more serious than when people feel sad for a few days or even weeks.
How does dysthymia affect relationships?
The fatigue and apathy often occurring in dysthymia can make people withdraw socially and make them uninterested in engaging with friends. This can lead to problems with relationships and/or isolation from others, which can make dysthymia even worse, even leading to clinical depression or double depression.
Is dysthymia a form of bipolar?
No, dysthymia is not the same, or another form, of bipolar disorder.
How do people with dysthymia behave?
Dysthymia has a number of clinical implications. Dysthymia’s main symptom is the appearance of apathy. People with dysthymia are often quiet, lethargic, or moody. They may have trouble concentrating or making decisions and may be highly self critical. They may also have trouble sleeping. They may choose not to engage in a social situation, or even will choose to withdraw and stay home. Medical director Beth Salcedo asserts that dysthymia is treatable.
What is worse than dysthymia?
For someone experiencing dysthymia, it can feel pretty awful, but the symptoms of major depressive disorder are more severe than for dysthymia.
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