How is dysthymia different from depression?
A major depressive episode is a severe condition that usually develops relatively quickly and significantly disrupts normal life. Dysthymia occurs differently: mood is moderately depressed, but almost constantly and for years. A person copes with his responsibilities, but inside he feels emptiness, fatigue and irritation. Sometimes real depression develops on top of dysthymia - then they talk about double depression, and more active treatment is required. It is important to distinguish between these conditions because the duration of therapy depends on it.
- Dysthymia lasts at least two years in adults and a year in adolescents
- Symptoms are milder but more stable
- Light periods are short, usually less than two months
- Often begins in adolescence and is perceived as a personality trait
- May be associated with episodes of major depression
How it manifests itself
The main sign is a depressed or joyless mood most of the day. It is accompanied by decreased energy, difficulty concentrating, indecisiveness, low self-esteem, and a feeling of hopelessness. Sleep and appetite change: some people sleep too much, others have trouble falling asleep, and some people develop cravings for food. It is typical that a person cannot remember when he felt truly good. The body also reacts - headaches, heaviness in the muscles, discomfort in the stomach for no clear reason.
- Persistently depressed mood
- Fatigue and lack of strength even after rest
- Low self-esteem, guilt
- Difficulty concentrating and making decisions
- Sleep and appetite disorders
- Feeling hopeless
Why does it occur
Like other mood disorders, dysthymia develops from a combination of biological, psychological and social factors. What matters is hereditary predisposition, the functioning of brain systems responsible for mood, as well as long-term stress: difficult living conditions, conflicts, loss of loved ones, emotional neglect in childhood. Chronic physical illnesses, pain, lack of sleep, physical inactivity and social isolation also contribute. Separately, the doctor takes into account the influence of alcohol and certain medications that can maintain a depressed mood.
- Family history of mood disorders
- Chronic stress, overload, burnout
- Traumatic childhood experiences
- Chronic illnesses and constant pain
- Alcohol, certain medications
- Loneliness and lack of support
How to make a diagnosis
There is no special test for dysthymia: the diagnosis is made by a doctor based on the criteria of duration and set of symptoms. At the appointment, they clarify when the condition began, whether there were periods of normal mood, whether there are episodes of increased activity, how things are with sleep, appetite, and alcohol. Questionnaires and scales are used to assess severity. At the same time, somatic causes are excluded, which give a similar picture: decreased thyroid function, anemia, deficiency of vitamin B12 and vitamin D, chronic infections.
- Detailed clinical interview and history taking
- Depression and Anxiety Rating Scales
- TSH to rule out hypothyroidism
- Complete blood count, ferritin
- Vitamin B12 and Vitamin D
- Assessing alcohol and drug use
Treatment and self-help
The basis of treatment is psychotherapy, primarily cognitive-behavioral and interpersonal: they help change persistent negative beliefs and restore activity. If symptoms are severe, your doctor may add an antidepressant; The drugs do not act immediately, so the course is continued for several months and discontinued gradually, only in consultation with the doctor. Additionally, regular sleep, physical activity, daylight, avoiding alcohol and restoring social connections are important. Self-selection of medications and dietary supplements instead of treatment is harmful and delays recovery.
- Cognitive-behavioral and interpersonal psychotherapy
- Antidepressants as prescribed by a doctor, course
- Stable sleep and wake-up routine
- Regular physical activity
- Quitting alcohol
- Gradual return of enjoyable activities