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Chronic depression (dysthymia)

Dysthymia, or chronic depression, is a form of low mood, but with less severe symptoms than major depression.

An adult with dysthymia will usually have a low, dark, or sad mood most days of the week over a two year period. The diagnosis period for children and teenagers is one year.

What causes dysthymia?

Experts are not sure what causes dysthymia. This form of chronic depression is thought to be related to brain changes that involve serotonin, a chemical or neurotransmitter that aids your brain in coping with emotions. Major life stresses, chronic illness, medications, and relationship or work problems may also increase the chances of dysthymia.

What are the signs and symptoms of dysthymia?

The symptoms of dysthymia are the same as those of major depression but not as intense and include the following:

  • Persistent sad or empty feeling
  • Difficulty sleeping (sleeping too much or too little)
  • Insomnia (early morning awakening)
  • Feelings of helplessness, hopelessness and worthlessness
  • Feelings of guilt
  • Loss of interest or the ability to enjoy oneself
  • Loss of energy or fatigue
  • Difficulty concentrating, thinking or making decisions
  • Changes in appetite ( overeating or loss of appetite)
  • Observable mental and physical sluggishness
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • Thoughts of death or suicide

While not disabling like major depression, dysthymia can keep you from feeling your best and functioning optimally. Dysthymia can begin in childhood or in adulthood and seems to be more common in women.

How is dysthymia diagnosed?

A doctor will generally make the diagnosis based on the person's symptoms. 

With dysthymia, your doctor will want to make sure that the symptoms are not a result of substance abuse or a medical condition, such as hypothyroidism. Also, the depression and other symptoms should cause clinically significant distress or impairment in social, occupational, or other important areas of your life.

If you are depressed and have had depressive symptoms for more than two weeks, make an appointment to see your doctor. He or she will perform a thorough medical evaluation, paying particular attention to your personal and family psychiatric history.

There is no blood, X-ray or other laboratory test that can be used to diagnose dysthymia.

How is dysthymia treated?

While dysthymia is a serious illness, it’s also very treatable. As with any chronic illness, early diagnosis and medical treatment may reduce the intensity and duration of depression symptoms and also reduce the likelihood of a relapse.

To treat dysthymia, doctors may use psychotherapy counselling, medications such as antidepressants, or a combination of these therapies.

What is psychotherapy?

Psychotherapy (or talk therapy) is used in dysthymia and other mood disorders to help the person develop appropriate coping skills to deal with everyday life. Psychotherapy can also help increase compliance with medication and healthy lifestyle habits, as well as help the patient and family understand the mood disorder. You may benefit from one-to-one therapy, family therapy, group therapy, or a support group with others who suffer with chronic depression.

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