Depression's less famous cousin

You would probably have been living in solitary confinement all your life to have never heard of depression. But, not so famous is the related mood disorder called dysthymic disorder. To recap, 'major' depression is a severe drop in mood that last for at least a few weeks. It is accompanied by several additional symptoms/problems. Some of the more common symptoms include:

  • Loss of enjoyment in activities (also known as 'anhedonia')
  • Increase/decrease in sleep
  • Increase/decrease in appetite
  • Poor concentration and/or memory
  • Decreased motivation
  • Fatigue
  • Thoughts of guilt and/or hopelessness
  • Thoughts of suicide. 

We tend to distinguish major/clinical depression from normal ups-and-downs of life through consideration of duration, severity, and impairment. Low mood that lasts 2-3 days is not normally anything to be concerned about (provided there are no additional symptoms, especially self-harm/suicidal thoughts). Low mood that lasts several weeks or more is a different story and probably requires attention. Low mood must also be sufficiently severe. Impairment is important here because low mood needs to be so severe that it causes great distress to the person and/or seriously messes with a person's ability to carry out their normal day-to-day life. 

So, what about dysthymia? Essentially, dysthymia is a less severe than major depression, but is longer lasting (more chronic in other words). In fact, someone has to experience at least a couple of years of depressed mood to be in the dysthymia ball park. Dysthymia is associated with additional symptoms, many of which also occur in depression.

People will experience at least a couple of the following:

  • Poor appetite or overeating
  • Decrease or increase in sleep
  • Low energy or fatigue
  • Poor self-esteem
  • Poor concentration
  • Difficulties making decisions
  • Feelings of hopelessness

Just as in the case of major depression, low mood and associated symptoms need to cause distress and/or impairment in dysthymia. Figures from the US suggest that rates of dysthymia in the population are around 3-6%. Around twice as many females as men develop dysthymia. 

I have found dysthymia to be a problem that can be easily missed. Partly because of the less severe nature of symptoms. Another factor here I think is that, because symptoms can persist for years, they become something that is considered to be more a part of a person's underlying personality. For example, we all know a pessimist, someone who always seems to be indecisive, or a person who always needs a power nap (OK, I’m partially guilty on the power nap front).

I find this a particularly cruel mental health problem given that people can suffer for so long with an unrecognised problem. Dysthymia can sap the potential out of people in their work and personal lives. It can also be difficult to treat because you are dealing with entrenched symptoms and ways of thinking about life. Unfortunately, there is not the volume of research devoted to dysthymia that we see with major depression. 

On the positive side, people can make progress using well-established psychological approaches to treating low mood. Strategies such as engaging in enjoyable activities, getting in lots of social time, challenging negative thoughts, and physical exercise can all be helpful. We need to learn more about causes, and develop specific treatments for dysthymia to be more effective in dealing with this problem.

I think that increased awareness is really important with this mental health problem, hence writing a bit about it in this blog. Hope you find it useful. 

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