Dysthymia (Persistent Depressive Disorder)

Lingering sadness that stretches on for prolonged periods of time without being extremely intense but also not something that’s easy to ignore. This is how people with dysthymia can feel. Dysthymia is now called persistent depressive disorder in the DSM-5. It’s not as well understood as major depressive disorder (MDD). MDD tends to come and go with episodes of depression alternating with periods of remission. With dysthymia, symptoms of depression can persist for years without much remission time. It can start in childhood, making someone feel like they have always been depressed. 

Causes

As with most mood disorders, dysthymia is believed to have a complex web of causes ranging from biological to social to environmental and psychological. Risk factors include family history, high stress, low self esteem, trauma and having other mental health diagnoses. It also appears to be more common in women. 

Symptoms

In order to meet the criteria, adults need to be experiencing a depressed mood that interferes with their life for at least two years. If there is any relief, it does not last longer than 2 months. Other symptoms need to be present such as fatigue, insomnia, increased or reduced appetite, or poor concentration but not all of these are required to be diagnosed with dysthymia. 

Treatment 

Dysthymia is treated much the same way as depression. Antidepressant medication and therapy is often recommended. In addition to these options, I support my patients by improving their diet in a way that improves their mental health, working on lifestyle changes and recommending nutritional supplements and herbal medicines that they can incorporate into their treatment plan without interacting with medications they may be taking. Treatments plans (including diet and lifestyle) need to meet a patient where they are at so that they are realistic and not overwhelming. 

Please remember to speak to your family doctor or psychiatrist to confirm any diagnoses rather than self-diagnosing. If you’re in a state of crisis, contact: 1-855-310-COPE (2673), Suicide Crisis Helpline (9-8-8) or 9-1-1.