Dysthymic Disorder

Dysthymic disorder is characterised by chronic feelings of depression without the severity of major depression, and it can sometimes start in childhood. It is one of the most prevalent types of depression yet it is probably one of the most undertreated.  The main symptom is an almost daily depressed mood for at least two years. Although sufferers of Dysthymia exhibit fairly mild symptoms on a day-to-day basis, over a lifetime these symptoms can have a dramatic effect.

The World Health Organisation classifies Dysthymic disorder as 'a period of at least two years of constant or constantly recurring depressed mood'. During at least some of the periods of depression at least three of the following characteristics are present:

1. A reduction in energy or activity
2. Insomnia
3. Loss of self-confidence or feelings of inadequacy
4. Difficulty concentrating
5. Often in tears
6. Loss of interest or enjoyment in sex and other pleasurable activities
7. Feeling of hopelessness or despair
8. A perceived inability to cope with the routine responsibilities of everyday life
9. Pessimistic about the future or brooding over the past
10. Social withdrawal
11. Less talkative than normal

Many people who experience Dysthymic disorder will often claim that they can't remember ever feeling not depressed.

Dysthymic disorder does not tend to debilitate the sufferer to the point where they cannot perform everyday routines, although the disorder is severe enough to cause distress and interference with important life role responsibilities.

Other signs and symptoms that health professionals have noted include: lowered self-esteem, problems with short term memory and forgetfulness, negative thoughts, guilt, self-criticism and blame, irritability or excessive anger, changes to eating habits (either eating more or less), aches and pains, and neglecting personal appearance or hygiene.  Fatigue appears to be a major issue. People with dysthymic disorder may go to bed earlier, or stay in bed longer, but they tend to feel that they don’t get enough sleep.

Treatments

There are a number of treatment method options available for people with Dysthymic disorder. Current treatment methods tend to use a combination of antidepressants and psychotherapy. Lifestyle changes and self-management techniques may also help. Please see our Treatment Methods section for more information.

References: 

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
American Psychiatric Association
1994

Dysthymic Disorder: Integrating Research Findings into Clinical Treatment
Journal of Psychiatric Practice - USA
David J. Hellerstein MD
September 2001

Harvard Medical School's Consumer Health Information

Understanding Depression
Maria Prendergast
2006