Dysthymia

What is dysthymia?

Dysthymia is a mild depression. Dysthymia is feeling sad, uninterested, or hopeless almost every day. You may lack interest in life and activities, or always feel down on yourself. In adults, it may last for 2 years or more. In children, it lasts more than 1 year.

How does it occur?

Dysthymia usually starts gradually. It can begin in childhood, but usually starts when you are a teenager or young adult. About 6% of Americans have it sometime in their lives. You are more likely to develop it if you have a family member who has had some form of depression. Women are 2 to 3 times more likely to get dysthymia than men.

What are the symptoms?

Besides feeling somewhat sad and uninterested in things, you may also:

• Be irritable.
• Have trouble falling asleep, wake up very early, or sleep too much.
• Have little or excessive appetite.
• Be easily tired and low in energy.
• Have low sexual desire and function.
• Feel worthless and guilty.
• Have trouble concentrating or remembering things.
• Feel hopeless or just not care about anything.
• Have unexplained physical symptoms.
• Worry that you will ever feel better.

How is it diagnosed?

Your healthcare provider or a mental health therapist will ask about your symptoms and any drug or alcohol use. You may have lab tests to rule out medical problems such as hormone imbalances.

How is it treated?

Do not try to overcome dysthymia by yourself. It can be successfully treated with psychotherapy, antidepressant medicine, or both. Talk with your healthcare provider or therapist about this.

Medicine

Antidepressant medicines can help treat dysthymia. Your healthcare provider will work with you to carefully select one for you.

You must take these medicines daily for 3 to 6 weeks to get full benefit from them. Most people benefit most from taking these medicines for at least 6 months.

No nonprescription medicines are available to treat depression.

Psychotherapy

Seeing a mental health therapist is helpful. You may need therapy for a very short time or for many months. Cognitive behavioral therapy (CBT) is a form of psychotherapy that helps you identify and change thought processes. Replacing negative thoughts with more positive ones can help your depression.

Complementary Treatments

Diets rich in fruits and vegetables are recommended for people with depression. A multivitamin and mineral supplement may also be recommended.

Studies suggest that eating fatty fish 2 to 3 times per week may reduce feelings of depression and anxiety. These fish contain omega-3 polyunsaturated fatty acids. Fatty fish include salmon, tuna, mackerel, herring, and sardines. Fish oil capsules are available. Flaxseed, pumpkin seed, walnuts, and olive oil are also sources of omega-3 fatty acids.

St. John's wort may help with some forms of mild depression. It does not help with severe depression, and may cause side effects, such as sun sensitivity, anxiety, or trouble sleeping.

Other supplements that may be helpful in treating depression include SAMe, DHEA, and 5-hydroxytryptophan.

Be careful which products you use. "Natural" products are not standardized. They may have different strengths and effects. Some may be contaminated. Herbs and supplements affect your body and may interact with prescription medicines. Talk to your healthcare provider or pharmacist about any supplements that you are using or considering.

Other treatments that may help dysthymia are:

• Biofeedback. Through biofeedback you learn to control body functions such as muscle tension or brain wave patterns. Biofeedback can help with tension, anxiety, and concentration. It may indirectly help dysthymia. Biofeedback and relaxation therapies are helpful when used along with psychotherapy and medicine.
• Relaxation Therapies. Learning ways to relax can help, along with medicine and psychotherapy. Yoga and meditation may also be helpful.
• Massage Therapy. Massage therapy may help lower stress, but it does not cure dysthymia.
• Art and Music Therapies. Some people find art and music therapy, along with medicine and psychotherapy, are helpful.

How long will the effects last?

Dysthymia can go on for years. Seek professional help to overcome or reduce the symptoms.

What can I do to help myself or my loved one?

Certain medicines such as Accutane, Lariam, Levaquin, benzodiazepines, digitalis, and beta blockers can add to the symptoms of depression. Tell all healthcare providers who treat you about all medicines you are taking, including nonprescription products, vitamins, and natural remedies.

Maintaining a healthy lifestyle is crucial. To help prevent dysthymia:

• Exercise for at least 20 minutes every day, for example, a brisk walk.
• Learn which activities make you feel better and do them often.
• Talk to your family and friends.
• Eat a healthy diet.
• Get 7 to 9 hours sleep per night.
• Do not abuse alcohol or drugs.
• Do not drink too much caffeine.
• Learn ways to lower stress, such as breathing and muscle relaxation exercises.

When should I seek help?

Do not try to overcome dysthymia by yourself. Seek professional help if you believe that you or a loved one has symptoms of depression.

Get emergency care if you or a loved one have serious thoughts of suicide or harming others.

For more information, see:
Depression: Its Symptoms and Treatment
Adjustment Disorders with Depressed Mood
Cognitive Therapy