or '''dysthymic disorder''' is a form of the
Mood Disorder of
Depression characterized by a lack of enjoyment/pleasure in life that continues for at least two years. It differs from
Clinical Depression in the severity of the symptoms. While dysthymia usually does not prevent a person from functioning, it prevents full enjoyment of life.
Dysthymia can be considered a paradoxical disorder in that its symptoms are fairly mild on a day-to-day basis, however, over a life time it can be a severe disorder with high rates of
Suicide , work impairment, and social isolation. Dysthymia typically lasts much longer than an episode of major depression, and outsiders often perceive dysthymic individuals as dour and humorless. When a major depressive episode occurs on top of dysthymia, clinicians may refer to the resultant condition as .
The Diagnostic and Statistical Manual of Mental Disorders characterizes Dysthymic Disorder as a chronic depression, but with less severity than a major depression. The essential symptom is that the individual is depressed almost daily for at least two years, but without the criteria necessary for a major depression. Low energy, sleep or appetite disturbances, and low self-esteem are typically parts of the clinical picture as well. The diagnostic criteria are as follows:
# On the majority of days for 2 years or more, the patient reports depressed mood or appears depressed to others for most of the day.
#When depressed, the patient has 2 or more of:
##Appetite decreased or increased
##Sleep decreased or increased
##Fatigue or low energy
##Poor self-image
##Reduced concentration or indecisiveness
##Feels hopeless
#During this 2 year period, the above symptoms are never absent longer than 2 consecutive months.
#During the first 2 years of this syndrome, the patient has not had a Major Depressive Episode.
#The patient has had no
Manic ,
Hypomanic or Mixed Episodes.
#The patient has never fulfilled criteria for
Cyclothymic Disorder .
#The disorder does not exist solely in the context of a chronic psychosis (such as
Schizophrenia or Delusional Disorder).
#The symptoms are not directly caused by a general medical condition or the use of substances, including prescription medications.
#The symptoms cause clinically important distress or impair work, social or personal functioning.
As with other forms of depression there are a number of treatments available for dysthymia. The most common being
Psychotherapy or
Cognitive Therapy which are used to help change the mind set of the individual affected. Additionally there are a variety of
Antidepressant Medications , with most individuals with dysthymia responding to
Prozac and
Tofranil in a positive matter. For mild or moderate depression, the
American Psychiatric Association in its 2000 Treatment Guidelines for Patients with Major Depressive Disorder advises that psychotherapy alone or in combination with an antidepressant may be appropriate.
There is a limited amount of evidence that
St John's Wort extract might also be effective for treating mild to moderate forms of depression such as dysthymia. A 2002 study involving 375 patients with mild to moderate major depression found it to be effective with side effects similar to placebo . However, a 2006 study involving 150 patients with minor depressive symptoms or dysthymia found that St. John's Wort extract was not effective for the patients with dysthymia.
The term ''dysthymia'' originally referred to a sub-clinical behaviors.
Dysthymia dates back at least as far as ancient Greek and Roman civilization as recorded in the works of Sophocles and Virgil. Many societal occurrences of dysthymia occur within groups of individuals leading stressful lives. Clinical descriptions of dysthymia date from 1881, when Jean de Caseet-Maneut, a leading physician at that time, investigated the phenomemon in Paris. Records also appear sporadically in medical and psychological journals.
