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Dysthymia (Dysthymic Disorder)

Dysthymia, or Dysthymic Disorder, is a type of Depressive Disorder where the episodes are less intense but last much longer than in Major Depressive Disorder.  

Dysthymia (Dysthymic Disorder)

Dysthymia, or Dysthymic Disorder, is a type of Depressive Disorder where the episodes are less intense but last much longer than in Major Depressive Disorder.  

According to the DSM-IV-TR, the depressed mood that occurs in Dysthymia must last at least 2 years to qualify (though in children and adolescents the mood can also be irritable, and needs to last only 1 year to qualify), and needs to be present throughout most of the day and for more days than not.  In addition, there must also be two or more of the following symptoms occurring continuously over the two-year period:

  • Poor appetite, or overeating
  • Trouble sleeping, or oversleeping
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness

If a Major Depressive Episode preceded the Dysthymic Disorder by two months or less, or occurs during the first two years of the Dysthymia (or first year in children and adolescents), then a diagnosis of Dysthymic Disorder is not made, and instead the disorder is considered to be a Major Depressive Episode that is either chronic or incompletely resolved.  Also, if there is a period of two months or more during the first two years of the supposed Dysthymic Episode when the person is free of the above symptoms, then the diagnosis of Dysthymia cannot be made.

If a Manic or Mixed Episode occurs, then the diagnosis changes to Bipolar I Disorder.  If a Hypomanic Episode occurs, then the diagnosis changes to Cyclothymia.

If the depressive symptoms are caused by a particular drug or medication, or are due to a general medical condition, then a diagnosis of a Dysthymic Disorder is not made, though this person will still require medical attention. 

It is possible for Atypical features to characterize a person's Dysthymia. 

Although Dysthymia may be less intense than a Major Depressive Episode, it nevertheless causes a considerable amount of suffering and significantly impairs a person's quality of life and their ability to function to their full potential in work, school, and in social settings and relationships.   Dysthymia in many cases can continue for longer than two years, and it may be difficult to distinguish what is the disorder from the person's basic personality.  Personality Disorders can be diagnosed in half or more individuals with Dysthymia.  If the Dysthymia begins before the age of 21, then there is also a good chance that the person will eventually develop and Major Depressive Disorder.

 

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