Symptoms | Causes | Diagnostic Criteria | Treatments

Persistent depressive disorder (aka Dysthymia) is a mood disorder characterized by a depressed mood that occurs for most of the day, for more days than not, for at least 2 years, or at least 1 year for children and adolescents, according to the DSM-5.

Essentially, it is a long-term or chronic version of major depressive disorder, often seen as an amalgamation of DSM-IV dysthymic disorder and chronic major depressive episode.

The 12-month prevalence in the US is approx. 0.5% for dysthymia. Additionally, early-onset persistent depressive disorder is strongly associated with DSM-IV Cluster B and C personality disorders.

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Symptoms of Persistent Depressive Disorder (Dysthymia)

Some common symptoms of dysthymia include loss of interest in things once loved, loss of appetite, and a lack of energy. They may feel as though their life has no purpose and that everything is meaningless.

Besides the more observable symptoms of this disorder (i.e. isolation, moodiness, weight loss, etc.), suicidal ideation is another very prevalent occurrence with those suffering from this illness. In fact, suicide is the second leading cause of death in young people. A major cause of suicide is mental illness, very commonly depression.

If you have attempted suicide or you think about suicide, then you can reach out for help by contacting the Suicide Prevention Lifeline or by calling 800-273-8255.

Below, you will see some of the most common symptoms of this mental disorder:

• Deep sadness
• Lack of energy
• Loss of interest in things once loved
• Hopelessness
• Apathetic toward most things
• Suicidal ideation
• Loss of appetite
• Lack of motivation

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Causes of Persistent Depressive Disorder (Dysthymia)

Temperamental, environmental, genetic, and physiological factors are all likely to play key roles in the development of this mental illness. Individuals with a family history of depression may be at a higher risk for developing it themselves.

According to the DSM-5, there are no clear differences in illness development, course, or family history between DSM-IV dysthymic disorder and chronic major depressive disorder. Childhood risk factors include parental loss or separation.

Additionally, a number of brain regions (e.g., prefrontal cortex, anterior cingulate, amygdala, hippocampus) have been implicated in persistent depressive disorder.

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Diagnostic Criteria

To get diagnosed with persistent depressive disorder, one must undergo a psychiatric evaluation by a licensed mental health professional. This will often entail asking the patient numerous questions to better understand their family history, current symptoms, as well as the severity of those symptoms.

Below, you’ll see some of the diagnostic criteria for persistent depressive disorder, according to the DSM-5:

1. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years.
2. Presence, while depressed of two (or more) of the following:
   1. Poor appetite or overeating
   2. Insomnia or hypersomnia
   3. Low energy or fatigue
   4. Low self-esteem
   5. Poor concentration or difficulty making decisions
   6. Feelings of hopelessness.
3. There has never been a manic episode or a hypomanic episode, and criteria has never been met for cyclothymic disorder.

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Treatments for Persistent Depressive Disorder (Dysthymia)

Treatment for this condition is essentially the same for major depression. Talk therapy and psychiatric medication are often used in unison for someone suffering with dysthymia as they can help to reduce the intensity of symptoms associated with this condition. Group therapy, psychotherapy, and medication therapy may be very helpful at treating symptoms. The same can be said for regular exercise and healthy eating habits.

According to the National Institute of Mental Health (NIMH), antidepressants such as Paxil, Zoloft, Prozac, and Wellbutrin are just a handful of many drugs that may be able to help treat depression. Antidepressants take time to work before you will feel the true benefits of them. Usually, it will take around 2 to 4 weeks before you can expect to feel the full effects of the medication.

Remember, always talk to your doctor first before taking any medication to ensure it is safe and effective to do so.

If you think you may be suffering from some of the symptoms of this condition, then you may benefit from therapy. Feel free to reach out to your doctor or local mental health clinic to see what your available options are and to see if there is any sort of discount or promo code available to help you with the costs of treatment, as well as if your health insurance will cover treatment costs.

References:

• https://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/symptoms-causes/syc-20350929

• https://www.nami.org/Blogs/NAMI-Blog/January-2018/Understanding-Dysthymia

• https://www.health.harvard.edu/a_to_z/dysthymia-a-to-z

• https://www.hopkinsmedicine.org/health/conditions-and-diseases/dysthymia

• https://www.nimh.nih.gov/health/statistics/persistent-depressive-disorder-dysthymic-disorder

• Diagnostic and Statistical Manual of Mental Disorders (DSM-5) https://www.psychiatry.org/psychiatrists/practice/dsm

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