Mild depression dysthymia


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Last Updated: 08/30/2022

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Symptoms of dysthymia, treatment of dysthymia at the Allianz Central Medical Health Center

Dysthymia is a long-term mild depression that, in terms of the severity of symptoms, does not reach the classic depression, but in terms of duration it exceeds it. At various times, this condition was called neurotic depression, endoreactive dysthymia, chronic depressive disorder. One thing remains constant, dysthymia is a disorder that can and should be treated.

Despite the "lightness" - low severity of manifestations, dysthymia significantly affects the life and performance of a person. Therefore, it must be treated by a psychotherapist. nine0003

Signs and symptoms of dysthymia

The diagnostic criteria for the disorder are difficult to recognize in practice, even for a specialist.

Dysthymia, the symptoms of which are similar to those of recurrent depression, can begin as early as adolescence. Compared to a recurrent disorder, its manifestations are less pronounced and stretched over time - for two years or more. If the maturation of the personality occurs under the distorting influence of dysthymia, then such a person, having matured, perceives the signs of the disorder as part of his "melancholy nature". And only a professional can separate the constitutional and personal characteristics of a person from the symptoms of the disease. nine0003

Below are the main signs that must be present for at least two years in a row (at adolescence - 1 year). There may be episodes of improvement lasting no more than a few weeks.

  • decreased ability to concentrate;
  • negative assessment of the future, present, and past. Alternatively, the past can, on the contrary, be idealized, and then the state acquires the features of a nostalgic depression;
  • nine0017 feeling of uselessness, hopelessness;
  • decreased or, rarely, increased appetite;
  • insomnia, daytime sleepiness;
  • decline in vitality;
  • reduced self-confidence, self-esteem;
  • decreased libido;
  • lack of pleasure from what used to bring joy.

The longer a person is sick, the worse his quality of life becomes - other diseases join (addiction to psychoactive substances, panic attacks, social phobia), the transition of the disease to bipolar affective disorder is also possible. nine0003

Important

If the disorder is not treated, against the background of the above described signs of dysthymia, severe depressive episodes occur - the so-called double depressions.

Dysthymia diagnostics

The diagnosis is made by a psychotherapist after a clinical and anamnestic examination. It includes an assessment of symptoms, the order in which they appear, and their connection with events in a person's life - stress, overload, trauma, infectious or other diseases. nine0003

To confirm the diagnosis, a clinical psychologist performs a pathopsychological examination. It gives a conclusion about the characteristics of the patient's personality and reveals deviations in cognitive processes (thinking, memory, attention).

For differential diagnosis, instrumental and laboratory studies are carried out:

  • EEG - with organic damage to the nervous system;
  • Neurophysiological test system and Neurotest with endogenous diseases (schizophrenia, schizotypal disorder). nine0018

Dysthymia - treatment

After confirming the diagnosis of "dysthymia", treatment is prescribed individually and includes three main areas:

  1. Psychotherapy.
  2. Medical support.
  3. Treatment of associated diseases.

Psychotherapy. From the point of view of evidence-based medicine, the direction of choice is cognitive-behavioral therapy, however, depending on the specific situation, personal characteristics, as well as the preferences of the client, rational, family, group psychotherapy, biofeedback therapy or psychoanalytic therapy are used. nine0003

Some researchers attribute dysthymia to personality disorders (congenital character traits). This confirms that the main method of treatment is psychotherapy, that is, the joint work of the patient and the doctor on attitudes, attitudes towards life, the ability to deal with symptoms and achieve goals.

Drug therapy is aimed at neutralizing the symptoms of dysthymia and maintaining the mood and emotional-volitional sphere of the individual within the normal range. Medical way out of the state of chronic depression allows the development of psychotherapeutic intervention. nine0003

Treatment of associated diseases - secondary diseases that have developed against the background of dysthymia: addiction to psychoactive substances, panic attacks and generalized anxiety disorder, social phobia. This group also includes general medical diseases, the course of which can renew dysthymia in a predisposed person. To exclude these diseases and ensure the adequacy of treatment, a full-fledged diagnosis by a psychotherapist is required.

What is dysthymia and how does it differ from depression

February 4, 2022 Likbez Health

Sad mood, low self-esteem, indecision and fear of the future may well be associated with this condition.

What is dysthymia

This is a chronic disorder in which mood is depressed for at least several years. And although dysthymia is similar to depression, its manifestations are not so severe that it can be diagnosed as a depressive episode or recurrent depression. nine0003

The main reference book for American psychiatrists, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), focuses on the duration of the condition. In DSM-5, dysthymia has a separate name - persistent, or permanent, depressive disorder.

How dysthymia differs from depression

This is a rather slippery question, especially considering that true depression can also be different - both severe and mild.

Both disorders have many similar symptoms: depressed mood, sleep problems, loss of energy, poor concentration. Dysthymia and depression are so similar that many psychiatrists believe that the disorders should be combined. nine0003

But there are differences between depression and dysthymia. Experts at Harvard Medical School list a few of the most obvious.

  1. With dysthymia, a person is able to enjoy life. In contrast to the victim of depression, he can enjoy communication with loved ones, get involved in hobbies.
  2. Dysthymia does not have pronounced psychomotor signs. For example, excessive excitement or obvious lethargy. If behavior changes quite dramatically during depression, then in the case of dysthymia, a person may appear calm, diligently go to work and go about daily activities. nine0018
  3. Dysthymia is sometimes felt as part of the personality. Depressed people are able to realize that something is wrong with them. With dysthymia, a person becomes so used to a dreary state that he begins to consider depression as part of his character.

How to recognize dysthymia and when to see a doctor

To draw a clearer line between disorders, psychiatrists suggest focusing primarily on mood and self-awareness, rather than on specific physical symptoms. Therefore, you should take a look at yourself. nine0003

Dysthymia is suspected when at least two of the following are present:

  • weight changes;
  • sleep problems;
  • lack of energy;
  • low self-esteem;
  • difficulty concentrating and making decisions;
  • feeling of hopelessness.

If this condition persists for more than two years (more than a year in a child), this is a serious reason to consult a doctor: a therapist or psychotherapist.

The doctor will conduct an examination, ask about the state of health, lifestyle, chronic diseases. Perhaps he will offer to take tests. This is necessary to exclude other problems that may manifest themselves as symptoms of a depressive disorder. For example, lack of energy and weight changes are often associated with hypothyroidism, an underproduction of thyroid hormones. In this case, it is necessary to correct this violation so that the symptoms go away by themselves. nine0003

Persistent depressive disorder is diagnosed when chronically depressed mood is not explained by physiological causes.

How dysthymia is treated

With psychotherapy and antidepressants. The latter have a lot of side effects, so doctors start treating children and adolescents, as well as people whose dysthymia is not too pronounced, without using these drugs.

Antidepressants are prescribed when the dysthymia is so severe that it can develop into a real "major" depression, or when the symptoms of the disorder are seriously making a person's life miserable. nine0003

It is important to remember that antidepressants are not a magic pill. There are many types of them, and it is far from always possible to find a really effective medicine the first time. And in order for the drugs to begin to work, you need to take them for at least a few weeks. In addition, you cannot simply stop taking antidepressants: when treatment is stopped abruptly or a few doses are missed, symptoms usually return with renewed vigor.

How to relieve the condition at home

Experts from the American research center Mayo Clinic recommend supplementing the treatment prescribed by a doctor with self-care.

  1. Remember your goal. One day you will again become a happy and active person. Necessarily.
  2. Make your life more manageable. Plan your day, make to-do lists, use sticky notes as reminders, try to stick to a predetermined schedule. This will give you back a sense of control over what is happening. nine0018
  3. Keep a diary. In it you will be able to express your emotions and thus reduce the level of stress.
  4. Read books on psychology. They will help you understand yourself and what is happening. If you don't know where to start, ask your doctor for advice.
  5. Do not withdraw into yourself. It is important to continue to meet with loved ones and keep working in order to feel needed.
  6. Learn to control stress. For example, learn deep breathing or meditation techniques and use them in difficult moments. nine0018
  7. Do not make any decisions about your future during times of anguish. This approach will protect against the temptation to quit therapy if it suddenly seems that it does not work.

How to avoid dysthymia

Unfortunately, there are no reliable methods of prevention: scientists have not yet fully understood the nature of dysthymia.


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