Neurotic depression (dysthymia); Dysthymic disorder; Chronic depression; Depression - chronic
Dysthymia is a chronic type of depression in which a person's moods are regularly low. However, symptoms are not as severe as with major depression.
The exact cause of dysthymia is unknown. It tends to run in families. Dysthymia occurs more often in women than in men and affects up to 5% of the general population.
Many people with dysthymia have a long-term medical problem or another mental health disorder, such as anxiety, alcohol abuse, or drug addiction. About half of people with dysthymia will also have an episode of major depression at some point in their lives.
Dysthymia in the elderly is often caused by:
The main symptom of dysthymia is a low, dark, or sad mood on most days for at least 2 years. In children and adolescents, the mood can be irritable instead of depressed and may last for at least 1 year.
In addition, two or more of the following symptoms will be present almost all of the time that the person has dysthymia:
People with dysthymia will often take a negative or discouraging view of themselves, their future, other people, and life events. Problems often seem more difficult to solve.
Your health care provider will take a history of your mood and other mental health symptoms. The health care provider may also check your blood and urine to rule out medical causes of depression.
Treatment for dysthymia includes antidepressant drug therapy, along with some type of talk therapy.
Medications often do not work as well for dysthymia as they do for major depression. It also may take longer after starting medication for you to feel better.
The following medications are used to treat dysthymia:
People with dysthymia often benefit from some type of talk therapy. Talk therapy is a good place to talk about feelings and thoughts, and most importantly, to learn ways to deal with them. Types of talk therapy include:
Dysthymia is a chronic condition that lasts many years. Though some people completely recover, others continue to have some symptoms, even with treatment.
Although it is not as severe as major depression, dysthymia symptoms can affect a person's ability to function in their family, and at work.
Dysthymia also increases the risk for suicide.
If it is not treated, dysthymia can turn into a major depressive episode. This is known as "double depression."
Call for an appointment with your health care provider if:
Call for help immediately if you or someone you know develops these symptoms, which are signs of a suicide risk:
Institute for Clinical Systems Improvement. Health Care Guidelines: Major Depression in Adults in Primary Care. 11th ed. 2008.
Stewart JW. Treating depression with atypical features. J Clin Psychiatry. 2007;68:25-29.
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