What Is Dysthymic Disorder, And How Do I Manage The Symptoms?
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Depression in the media is often presented as struggling to complete daily tasks and get out of bed, severely losing the ability to care for oneself. While these symptoms characterize major depressive disorder (MDD), some people may live with a type of depression that allows them to function daily but involves long-term and persistent depression, low mood, and difficulty finding enjoyment. This form of depression is known as persistent depressive disorder, previously called dysthymic disorder.
In the Diagnostic and Statistical Manual of Mental Disorders there are various forms of depression, from major depression, to psychotic depression, and seasonal affective disorder. Dysthymic disorder is another subset depressive disorder with mild to moderate symptoms of depression lasting two years or more. If you believe you might be living with persistent depressive disorder, knowing how to manage symptoms and find support may be helpful.
What is dysthymic disorder?
According to the Diagnostic and Statistical Manual of Mental Disorders, persistent depressive disorder is characterized by a chronic form of mild to moderate depression that does not subside. People with dysthymic disorder may experience depressive symptoms like a prolonged loss of interest in previously enjoyed activities, hopelessness, a lack of energy, and low self-esteem. Dysthymic disorder, like other depressive disorders, can be associated with multiple comorbid conditions, including anxiety, substance use disorders, and others.
Recognizing persistent depressive disorder
Persistent depressive disorder (PDD) is a long-term mood disorder that lasts approximately two years or longer and features low-grade depressive symptoms. These depressive episodes may alternate with periods of an average mood lasting no more than two months. Although symptoms present in dysthymic disorder may not be as noticeable as symptoms associated with major depressive disorder, they can still impact an individual's ability to lead a happy, healthy lifestyle.
PDD may be challenging to diagnose because the individual living with it may not immediately identify the symptoms as part of depression. However, persistent depressive disorder and major depressive disorder have several symptoms in common, including:
A depressed mood experienced for most days in a week
Changes in sleep patterns
Changes in appetite or eating patterns
Low energy and fatigue
Difficulty concentrating
Low self-esteem
Feelings of hopelessness
Physical aches and pains
Substance use to cope
Suicidal thoughts or urges
Some individuals living with persistent depressive disorder may also be diagnosed with other mental illnesses, including chronic major depressive disorder. However, unlike major depressive disorder, those who have dysthymic disorder may still feel pleasure and experience periods of respite from their symptoms.
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. 988 also offers an online chat for those with an internet connection.
How to manage persistent depressive disorder
As with other depressive disorders, the treatment of persistent depressive disorder may consist of talk therapy, medication, or a combination of the two. However, because persistent depressive disorder is known to have long-lasting symptoms, longer, more acute treatments may be required to help you better manage your symptoms.
Traditional treatment options are not the only way to help you cope with or prevent persistent depressive disorder symptoms. Below are a few lifestyle changes you can make throughout the course of your disorder to reduce symptom severity.
Diet and exercise
Exercising regularly and eating a more balanced diet may support your mental and physical health. Eating a balanced diet offers you valuable nutrients that may balance mood, and exercise can release endorphins that increase your energy. Try to avoid substance use or processed foods, as they may negatively affect your body and brain's chemical balance.
Research reports that exercise can relieve symptoms of depression and, in some cases, prevent it. Exercise produces brain chemicals that block the perception of pain and increase feelings of well-being.
Regular physical activity also provides additional benefits if done outside, as nature can improve mental health and allow you to receive vitamin D from the sun. If you are new to exercise or can't exercise strenuously, a walk outside may decrease depressive symptoms.
Socializing and fun
Connect with those around you and engage in activities that make you happy. If you do not feel up to socializing or partaking in previously enjoyed activities, you might modify them or break them down into steps. However, consider your limits. If you believe going out would make you feel worse, give yourself time. You might also talk to a therapist about these feelings to develop solutions for your unique circumstances.
Relieving lifestyle stress
The more stress that you are experiencing, the more you may experience adverse emotional and physical symptoms. Consider which areas of your lifestyle produce the most stress and how you can successfully reduce that stress.
For example, you might try cutting down on non-essential, stress-producing activities. Setting realistic goals you can reach without overexerting yourself can be worthwhile. Also, putting off major decisions that don't need to be made immediately can be helpful, especially when you’re having difficulty making decisions. Although stress can be healthy, excessive stress is not beneficial for your mental health.
Finding positives
For people with PDD, finding positives in daily life can be challenging. However, with support and practice, optimism and gratitude may increase. If you can, on your own, try pointing out the positive aspects of life daily, reducing judgment of what those aspects are. For example, you might be thankful for how your hair smells or the growth of new flowers outside your apartment.
Building a support system
Being surrounded by trustworthy, supportive individuals who can act as your safety net when struggling with your mental health may be crucial to reducing depression. A support system can also involve pets, spiritual leaders, teachers, mentors, doctors, or therapists. For some, a therapist is one of the most effective ways to receive support during a depressive episode.
Beginning medication
According to the Diagnostic and Statistical Manual of Mental Disorders, there are various forms of depression, from major depressive disorder to chronic depression and persistent depressive disorder. Certain antidepressants like selective serotonin reuptake inhibitors are widely used in the treatment of depression. Selective serotonin reuptake inhibitors work by “inhibiting” serotonin reuptake in the brain. This means there is more serotonin available, which leads to improved mood. Selective serotonin reuptake inhibitors can relieve various symptoms such as a depressed mood, lack of motivation, and low self-esteem.
Talking to a therapist
Some people experience barriers to reaching out for therapeutic support, such as financial constraints, a lack of transportation, or challenges with social interaction. Due to a demand for remote care, many online resources exist to help clients see a therapist from home. Through platforms like BetterHelp, individuals can choose between phone, video, or chat sessions and receive cost-effective quotes for treatment. In addition, they may be able to chat with their therapist throughout the day, receiving responses when the professional is available.
Research published in the Journal of Affective Disorder examines the efficacy of iCBT (internet-based cognitive-behavioral therapy) used by over 6,000 Australians in managing symptoms of depression and anxiety during the pandemic. Participants reported a significant reduction in the severity of their anxiety and depression symptoms and decreased psychological stress.
Takeaway
Is dysthymic disorder a bipolar disorder?
Dysthymic disorder is not a form of bipolar disorder, though the two conditions share certain depressive symptoms. Like bipolar disorder, dysthymic disorder is a mood disorder that is marked by feelings of sadness, tiredness, and hopelessness. Unlike bipolar disorder, however, dysthymia is typically not characterized by episodes of mania, in which an individual might experience an elevated mood, increased energy, and racing thoughts.
How long is dysthymic disorder?
For dysthymia to be diagnosed, symptoms generally must be present for two years. But the duration of dysthymic disorder typically depends on the individual, their symptoms, and the treatment they undergo. It can also vary based on the source of the condition. For example, dysthymia may last longer in an individual who has a chronic physical illness than someone who is experiencing depression following stressful life events.
Is dysthymia a serious mental illness?
Dysthymia is a serious mental health condition that can have significant impacts on an individual. The disorder can cause low mood, fatigue, feelings of worthlessness, and lack of motivation. In addition to the above symptoms, it can lead to poor appetite, loss of sleep, and other physical health impacts. If you believe you’re living with dysthymia, consider consulting with a healthcare provider, who can provide you with screenings and determine whether further testing, a diagnosis, and treatment are necessary.
What is another name for dysthymia?
Dysthymia is also called persistent depressive disorder or dysthymic disorder.
What is the difference between dysthymic disorder and major depression?
The most notable differences between dysthymic disorder and major depression are the duration and severity of the two conditions. Persistent depressive disorder is typically a longer-lasting—but less severe—form of depression. Despite these differences, the two depressive disorders share many similarities, including their primary symptoms. Additionally, major depression is often, like dysthymia, treated with medication, psychotherapy, or a combination of both. However, because dysthymia is typically a more persistent condition, it may require more long-term treatment methods.
Is Dysthymic a personality disorder?
Dysthymic disorder is a mood disorder, not a personality disorder. Dysthymic disorder does, however, often co-occur with personality disorders (e.g., borderline personality disorder). It can also impact an individual’s life in similar ways, potentially their affecting relationships, career/academic performance, and physical health.
What is a person with dysthymia like?
A person with dysthymia may exhibit signs of sadness, fatigue, low self-esteem, and a lack of interest. Dysthymic disorder can also cause an individual to lose or gain weight, become irritable, or move slowly. You may also notice that someone with this depressive disorder has trouble concentrating for extended periods. A person with dysthymia may also experience negative thoughts that cause suicidal ideation.
If you or someone you love is experiencing suicidal thoughts, help is available. The 988 Suicide & Crisis Lifeline is available 24/7 and can be reached by calling or texting 988 or chatting with a representative.
Can dysthymia be cured?
While there is no cure for dysthymia presently, early diagnosis and treatment can prevent symptoms from impacting an individual’s life negatively. Dysthymia is usually treated with therapy, medication, or both. Common forms of psychotherapy for depression include cognitive behavioral therapy, psychodynamic therapy, and interpersonal therapy. Medication used to manage depressive symptoms include selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and tricyclic antidepressants. Always consult with a healthcare professional prior to starting or stopping any medication.
Who is prone to dysthymia?
There are several risk factors that make certain individuals more prone to dysthymic disorder. These include chronic stress, physical health concerns (e.g., heart disease), a family history of depression, and existing mental health challenges (e.g., anxiety disorders, chronic stress). Additionally, dysthymic disorder is more prevalent among women than men.
Can dysthymia be permanent?
While dysthymia can be a lifelong condition, it is typically not permanent. To have dysthymia diagnosed, an adult must have experienced symptoms for two years (one year for children and adolescents). But the duration of the disorder will depend on the individual, the severity of their symptoms, and any treatment they’re undergoing.
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