Dysthymia also known as Persistent Depressive Disorder is when a person suffers from a mild case of depression. Unlike Major Depressive Disorder (MDD), Dysthymia occurs as a chronic form of depression. Episodes of dysthymia can last longer than weeks and sometimes into years. However, people also afflicted with Dysthymia can also suffer from major depressive episodes forming what is also known as double depression.
But before we understand Dysthymia, we have to first understand what depression is.
Depression as a form of Psychosis
Depression is not always about having crying spells as most Pop Psychology would put out. It is highly multi-faceted. It’s being a psychiatric disorder can cause more than just crying spells. And with the rise of mental health awareness, people have been discovering that there are many unlikely and likely people suffering depression.
Depression can be seen in different ways. Different symptoms include:
- Anhedonia: People with depression are unable to feel any pleasure or elicit any form of happiness even when exposed to something that should trigger that feeling.
- Irritability: This is a sub-form of moodiness which often times swings towards anger.
- Moodiness: Moodiness is a general form of emotional instability. This can swing from sadness to having a flat affect.
- Incongruent Affect: This is a common symptom of mood disorders. Incongruent affect would include one’s statements about feeling certain things.
- Suicide Ideation: This is a common symptom for those who are afflicted with depression. They develop thoughts about ending their life although not many push through with it. What makes them push through with these said thoughts is a certain level of impulsiveness.
Dysthymia: The Mild Form of Chronic Depression
Sometimes, it’s a battle of choosing two of the lesser evils. There’s the chronic depression in the form of Dysthymia which can take long periods of time to vanish. It also can lead to another form of depression creating a “double depression”. This can amplify the effects of the depression, making the episodes worse. However, this only occurs when a major depressive episode occurs. It’s also during these episodes that psychiatrists and psychologists need to be aware of their patient. As sometimes, during these episodes, rationale is no longer completely accessible by the patient.
Depression can manifest in a variety of ways. It can create a loss of appetite, in which a person would even refuse their favorite foods. It can also deprive them of sleep as the suicidal and depressive thoughts will linger in their mind. Other times, depression can have them prefer staying in the bed and refuse to leave the bed. The instability of Dysthymia makes it hard for people to also hold down ordinary jobs as Dysthymia can sometimes cause people to be absent for long periods of time. And because some companies may fail to understand the effects of mental health on their productivity, these may cause companies to either place these people on probation or fire them outright.
Dysthymia can do the exact same thing but in milder cases. People inflicted with this disorder often suffer the same symptoms that are milder. But, the symptoms persist for longer periods of time. It also makes them vulnerable to a major depressive episode. Which is why examining a person’s psychological health needs to be comprehensive. If it has any other psychotic disorder that is co-morbid (co-existing) with it, it needs to be treated carefully. Dysthymia can serve as a precursor to another psychotic disorder and can amplify the effects if not examined carefully.
Treatment for Dysthymia
After being clinically diagnosed with Dysthymia, psychiatrists may prescribe a variety of mood stabilizers and antidepressants. However, should none of those work and the symptoms become worse, they would then begin to prescribe antipsychotics. This only should happen if the person starts suffering from other psychotic symptoms such as auditory or visual hallucinations.
Often times, treatment for Dysthymia is paired with the medicine and therapy. Therapy can go through a form of ways such as mindfulness therapy or CBT (Cognitive Behavioral Therapy). Cognitive Behavioral Therapy involves the therapist changing the schemas that are present in the individual. In a sense, it alters the kind of discourse they have towards certain things in order to give the person a coping mechanism they can use to cope with Dysthymia.
Psychiatric First Aid: What should I do if someone is suffering from Dysthymia?
When you have a friend suffering from Dysthymia, make sure to take note of what can make the depressive episodes worse. These are often called “triggers” which can make the episodes or the symptoms during Dysthymia worse. Once you find out what those triggers are, you can also start finding ways on how to calm that friend down. However, this doesn’t mean that you have to neglect yourself. After calming your friend down, try to examine yourself soon after. Try to find something to help you relax and bring back your psychological health to a balance.
Or, if you yourself have Dysthymia, try to catch what triggers it. And if the depression starts to overwhelm you, write down the triggers in the notebook so that you’ll be able to think straight even with the depression starting to overwhelm you. At times like these, it will take a lot of effort. However, it’s better than completely succumbing to Dysthymia. Also, make sure that there’s at least one person who knows about your triggers. That way, they know what to do should something go wrong.
- Williams Jr, J. W., Barrett, J., Oxman, T., Frank, E., Katon, W., Sullivan, M., … & Sengupta, A. (2000). Treatment of dysthymia and minor depression in primary care: a randomized controlled trial in older adults. Jama, 284(12), 1519-1526.
- Takeuchi, D. T., Chung, R. C. Y., Lin, K. M., Shen, H., Kurasaki, K., Chun, C. A., & Sue, S. (1998). Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. American Journal of Psychiatry, 155(10), 1407-1414.
- Anisman, H., Ravindran, A. V., Griffiths, J., & Merali, Z. (1999). Endocrine and cytokine correlates of major depression and dysthymia with typical or atypical features. Molecular psychiatry, 4(2), 182.
- Cuijpers, P., van Straten, A., Schuurmans, J., van Oppen, P., Hollon, S. D., & Andersson, G. (2010). Psychotherapy for chronic major depression and dysthymia: a meta-analysis. Clinical psychology review, 30(1), 51-62.
- Imel, Z. E., Malterer, M. B., McKay, K. M., & Wampold, B. E. (2008). A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia. Journal of affective disorders, 110(3), 197-206.
- Griffiths, J., Ravindran, A. V., Merali, Z., & Anisman, H. (2000). Dysthymia: a review of pharmacological and behavioral factors. Molecular Psychiatry, 5(3), 242.