Dysthymia is a type of depression that is characterized by persistent mood disturbances. At one time or another, many people had to deal with its manifestation. The article describes the main symptoms that can help identify dysthymia. In addition, we suggest taking a test that will help determine whether you have been exposed to this disease. So, what is dysthymia and is it possible to fight it?
Dysthymia: what is it?
What do psychologists say about the disease?
General information
Dysthymia is a chronic depressive disorder, also called minor depression. It occurs in a mild form, but is protracted - symptoms can appear over several years. The term was first used by psychiatrist R. Spitzer. Now this designation is being replaced by the terms psychasthenia and neurasthenia.
Who is at risk of getting sick?
It is believed that people with certain mental characteristics are more often predisposed to dysthymia. Sometimes the disorder occurs due to chemical disorders in the brain, due to insufficient production of serotonin, a hormone responsible for resistance to stressful situations.
How to help a patient with dysthymic disorder in time?
In most cases, the prognosis for treatment of dysthymic syndrome is favorable, subject to timely consultation with a specialist.
Not many patients come to see psychologists and psychotherapists on their own, considering the clinical manifestations of neurotic depression to be part of their character; a few seek help to alleviate severe symptoms of the disease that are no longer bearable on their own. Dysthymia is a syndrome that is dangerous for the development of complications in the absence of diagnosis and treatment. If symptoms of the disorder are observed in a friend, colleague, relative or spouse, it is imperative to convince him to see a specialist to jointly find a way out of a long-term stressful state.
Please leave your opinion on the content of the article, share a real-life incident related to the disease under discussion in the comments.
Dankina Nadezhda · Jun 10, 2020
Factors that provoke the disease
To date, there is no single expert theory about the factors that provoke this type of chronic depression. The most likely hypothesis suggests a direct connection between the onset of the disease and changes in the chemical composition of substances that affect brain activity. A key factor in the formation of depressive disorder is considered to be a deficiency of serotonin, which is the main neurotransmitter.
Factors that increase the chances of dysthymia
:
- Chronic somatic diseases.
- Regular exposure to stress factors.
- Individual properties of the nervous system and a number of personal characteristics.
- Difficult situations “from childhood” in the form of strict upbringing, loss of loved ones, social isolation.
- Incorrect rest and work schedule.
- Junk food, lack of diet.
Provoking factors
Dysthymic disorders can develop in the presence of one or a combination of several unfavorable factors:
- psychosocial factor
- dysthymic syndrome may first appear at puberty when faced with the first difficulties in life, in the absence of help and support from loved ones. The teenager’s self-esteem decreases, complexes are formed, immersion within oneself, and a depressive mood; - melancholy and susceptibility to depression
- according to Freud, dysthymia develops when a child has unsuccessful interpersonal relationships in childhood. Growing up, the patient demands from his partner constant recognition of his merits, boundless love on the verge of dependence. If the patient does not receive such an attitude or the partner breaks off contact with him, clinical symptoms of depression immediately appear.
The option of a genetic predisposition to dysthymic syndrome is being considered - rates of depressive disorders in families with this disease reach 50%.
The situation is aggravated by the lack of support from close circles and society, and constant stress. Ganser syndrome - What is it?
Symptoms of dysthymia
The main symptom of the disease is considered to be chronically low mood. The situation with a general basement condition can be observed for two years or more.
Check out the list below. If you have two or more symptoms, you may have a disorder
:
- Sleep problems, manifested in the form of insomnia, early awakenings, obvious drowsiness during the day.
- Disturbed eating behavior caused by decreased appetite or excessive overeating.
- Constant lack of energy and fatigue.
- Low self-esteem, feelings of personal worthlessness, tendency to self-criticism, self-flagellation.
- A systematic feeling of emptiness, reluctance to think about anything.
- Slow reaction, distracted attention, inability to make quick decisions.
- Loss of interest in usual hobbies and reluctance to do what you once liked.
- Periodic headaches, cardiovascular diseases, joint pain, and other ailments that cannot be eliminated with medications.
- Pessimism, doubts about one's future.
- Thoughts about suicide.
Main types of dysthymia
Let's take a closer look at the two types of dysthymia:
Somatized dysthymia (cathesthetic)
This type of disorder is characterized by general poor health, rapid heartbeat, constipation, shortness of breath in the absence of physical activity, intermittent sleep, and tearfulness. The patient feels irrational anxiety.
Characterological dysthymia (characterogenic)
This type of illness is characteristic of a constitutionally depressive personality type. Feelings that an individual constantly experiences: a tendency to the blues, pronounced pessimism, constant thoughts and reasoning about the meaninglessness of life.
Dysthymia in a child
Diseases for which a child may be diagnosed with chronic dysthymia
:
- Social phobia.
- Severe chronic diseases.
- Manic-depressive disorder.
- Problems with the endocrine system.
In children, symptoms of dysthymia appear not only due to illness, but also after emotional or physical stress, as well as taking certain medications that were not approved by the doctor. The character of the child and his mental state can play a certain role.
Dysthymia in children is treated only by qualified specialists. Talk to your doctor and come up with a dysthymia treatment plan together. He will tell you how to get rid of possible complications and what to do as a preventive measure.
Doctors who will help you cope with the problem: psychologist, pediatrician, toxicologist, psychiatrist. The doctor will be able to identify parameters that contribute to the appearance of signs of dysthymia. After this, a course of treatment will be prescribed. Depending on the severity of the disease, drug treatment, group or individual therapy may be chosen. Do not delay diagnosis and treatment.
Diagnostics
It was previously said that dysthymia can be judged if there are at least two of the above symptoms. When making a diagnosis, the specialist pays attention to several important criteria:
- Over a long period of time (2 years or more), a person experiences depression and remains in a depressed state.
- During the period specified in the first paragraph, signs of dysthymia disappeared for a maximum of two months.
- The patient had no history of cyclothymic disorder.
- The symptoms are not the result of excessive use of alcohol, drugs, or any medications.
And one more point - the first signs are noticed before the age of 21.
Cyclothymia and dysthymia: differences
Some people confuse cyclothymia and dysthymia. What are their differences?
Cyclothymia
Chronic instability of mental state, in which mild depression alternates with high spirits. Young people are usually susceptible to this instability. Subsequently, it becomes chronic, but at times the mood can be normal for several months. It is difficult to make a diagnosis if the patient is not seen by a specialist for a long period, and because of this, many people do not even suspect that they have an illness.
Dysthymia
With dysthymia, there are no long periods of elation or normalization of mood. At the same time, some patients may evaluate some periods as relatively good, but even during them they continue to feel tired and lack of energy. That is, the main difference is that a person almost constantly feels oppressed. Of course, such a condition is much easier for doctors to identify than cyclothymia.
Difference between dysthymia and depression
As stated above, the main difference is the ease of flow. If we compare dysthymia with depression, then in its case the symptoms are blurred. But at the same time, its manifestations oppress a person for many years. In life, he is a pessimist, feeling dissatisfied with what is happening to him.
Dysthymia is an insidious disorder. A person retains his full abilities; he still conducts mental, motor and mental activities. But he does it through force, without joy and pleasure. People around you see constant fatigue.
Seasonal dysthymia
Some people experience seasonal dysthymia without always noticing it. As the name implies, the disease comes with the change of season. Typically, during the autumn period, changes in mood, sleep patterns, appetite, and energy levels are observed. It is believed that about 2% of people are susceptible to deep seasonal depression. Milder forms are typical for 15% of people.
Signs of summer affective disorder (it is not so common): insomnia, anxiety, poor appetite.
Signs of winter affective disorder: overeating, drowsiness, cravings for foods high in carbohydrates, narrowing the circle of social contacts.
Treatment and prevention of pathology
Dysthymia is treated with psychotherapy and medication. Antidepressants are among the main group of medications that help combat the disorder. Many patients are wary of these drugs, but modern antidepressants for the most part do not carry the negative side effects that the drugs were characterized by before.
Shortly before the start of therapy, the doctor prepares the patient for the fact that the course will take a certain time - this is not a matter of two or three days. The main task is to eliminate the patient’s symptoms of the disease, as well as consolidate a positive result.
The doctor individually determines the dosage of the medicine and its immediate choice in each specific case. The specialist also determines the duration of treatment.
Dysthymia is a mental disorder that can be easily corrected. The sooner you decide to seek help, the faster you can achieve success in treatment.
Subsequent prevention of the disorder will also be determined by the doctor depending on the individual characteristics of the course of the disease. Usually it is aimed at a healthy lifestyle, increasing self-esteem, maintaining a sleep, work and rest schedule, and a balanced diet.
Prevention and prognosis
Knowing what dysthymia is, we can conclude: it is difficult to predict what will happen to the patient next. However, it is worth noting that the treatment methods described above significantly improve his condition. Therefore, the prognosis is generally favorable.
It should be mentioned here that in some cases there is resistance to treatment of dysthymia. That is, the person seems to be following all the doctor’s instructions, but there is no improvement. Why is this happening? There are several reasons:
- inaccurate diagnosis;
- incorrect dosage of medications;
- insufficiently long course of treatment;
- the patient’s reluctance to continue treatment, independent dosage reduction, etc.;
- anxiety, constant stress;
- insufficient effectiveness of drugs;
- side effects from treatment.
Concomitant psychiatric disorders and too early an age at onset of dysthymia may also slow recovery.
As for prevention, it is difficult to say whether the onset of dysthymic disorder can be prevented. The only thing psychologists can advise is to devote enough time to rest and relaxation. It is recommended to do yoga, meditate, and, if possible, devote time to sports.
Dysthymia test
We suggest taking a fairly simple test that will help you determine whether you have dysthymia. So, read the questions and give yourself one point for each positive answer.
Questions
:
- Does it take a lot of effort to make you happy?
- Do you often notice that you are in a depressed mood?
- When you smile, don't you always actually feel happy?
- Do you find it difficult to switch off from all your worries and start having fun?
- Do your everyday life go by without expecting any joys from life?
- Do you tend to be pessimistic about your own life?
- Do you often think about something unpleasant?
- Do you think your life is very difficult?
- Do you consider your own life to be meaningless?
- Do you lose your temper easily and despair when you fail?
- Do you often feel guilty?
- Is your conscience tormenting you because of past mistakes?
- Can you be called an insecure person?
- When talking about your failures, do you feel ashamed and uncomfortable?
- Do you not really like to talk a lot and prefer to remain silent in conversations?
- Are you cool with telling jokes?
- Do you feel discomfort when being in the company of confident and happy people?
- Is sunny weather not having any positive effect on your overall mood?
Now count up all positive answers in points
:
- 0-11
– you don’t have to worry about having dysthymia. - 11-14
– you are close to dysthymia or its initial stage. - 15-18
– you undoubtedly have dysthymia, which can turn into serious depression, so be sure to take action.
DYSTHYMIC PERSONALITIES
Dysthymic temperament (with a more severe manifestation, subdepressive) is the opposite of hyperthymic. Personalities of this type are serious by nature and usually focus on the gloomy, sad aspects of life to a much greater extent than on the joyful ones. Events that have deeply shaken them can bring this serious pessimistic mood to a state of reactive depression, especially in cases where there are pronounced subdepressive features. Stimulation of vital activity in dysthymic temperament is weakened, thought works slowly. In society, dysthymic people hardly participate in conversation, only occasionally inserting remarks after long pauses.
A serious mood brings to the fore subtle, sublime feelings that are incompatible with human egoism. A serious attitude leads to the formation of a serious ethical position. It is already significant that in both cases we use the definition “serious”. This indicates an internal closeness between these manifestations. It is in them that we see the positive side of dysthymic temperament. Passivity in actions and slow thinking, in cases where they go beyond the norm, are among the negative properties of this temperament.
Subdepressive temperament is easy to connect with depressive mental illness, but, as with hyperthymia, this connection is by no means necessary. This temperament very often corresponds to the mental norm.
I give one of the descriptions from our collective work (doctor Unger).
Horst H., born 1931 The father is a calm, reserved person. The mother is more lively by nature, but is constantly sick. X. has two brothers, both of whom are more relaxed than X.
Already as a child, X. was very reserved. Studying was not easy, but conscientiousness helped; X. was not a repeater. He did not have a close friend at school, as, indeed, in subsequent years. X. considered his fellow students to be hooligans and was indignant when they did not take the teachers’ demands seriously. At home he loved to tinker and dreamed of becoming a cabinetmaker, but after graduating from school he received a place as a turner's apprentice. A year later he left this job, after which he worked as a laborer until 1949. In 1949 he began working in the mining industry and became a foreman. On weekends, he preferred solitary long walks to the entertainment enjoyed by his workmates; in winter he went skiing alone. After a year and a half, they wanted to transfer him to another mine, but he refused, because this mine had a bad reputation, and went to work as an auxiliary worker. Two friends convinced him to apply to police school.
X. graduated from the school of police officers (albeit with C grades) and became the head of the unit. His work did not satisfy him in any way, he did not like to command, did not like to overcome someone's resistance. “There was no joy in the work,” he said, “and life itself seemed meaningless.” At X.'s request, he was transferred to a unit with fewer people. However, the opinion at work about him was good. X.'s greatest desire was to move to another job, but police discipline did not allow this.
The first intimate relationship with the girl lasted 2 years. He left her for the reason that she used to tell him about invitations from other men. “What especially hurt me was that she was so flattered by it, that she was so proud of it,” said X.
In 1962, he married someone the same age, but he and his wife “didn’t get along.” His wife always dragged him to dances and group outings in the countryside, but he preferred to stay at home with the children. If his wife invited guests, he remained silent the entire evening. He preferred solitude and a book to any reception. “But I don’t blame her, her nature is different.” In 1965, “by mutual consent,” they filed for divorce. His wife invited him to live in the same apartment after the divorce (“it’s easier to look after the children together”), X. agreed. He explained it this way: “The hopes still did not come true, whether I leave or stay - this, in essence, does not change things.” He decided that he would move out of this apartment if his wife found a new life friend.
X. peppered his story about himself with the following remarks: “I always see the bad in everything,” “I’ve never had a really good life,” “I can’t communicate with anyone, I’m somehow inferior.” At first he refused to talk about himself at all: “What is this for?”
This person undoubtedly has positive traits. He takes his responsibilities seriously, no matter where he works, they are always happy with him. He is tactful and fair. But lack of activity prevented him from organizing his life in such a way as to feel satisfaction. A constant pessimistic attitude aggravates the situation; the subject tries to “start something else”, to join a new profession, but does not find joy or even balance.
Characteristics of temperament can, as a rule, be established already in childhood. Hyperthymic temperament in children is easy to determine, perhaps easier than in adults, since the natural liveliness of children is accompanied by liveliness of temperament. In my work “Children's Neuroses and Children's Personality” I described such “super-active”, “super-fast” children. Dysthymic temperament in children is also easy to recognize. Such children stand out from others by their timidity and indecisiveness. This is evidenced by the case described by Zeller in our book.
Karl S., 12 years old. He came to us to undergo a course of inpatient treatment. The mother is an unbalanced woman, “she sometimes cries and sometimes laughs,” and is sometimes strict and self-possessed. My father is a baker, a lively person by nature, a conscientious worker. The mother constantly helps in the bakery, the father goes to bed very early (due to working conditions), so the children are essentially left to their own devices.
Of the six children, Karl is the quietest and slowest, although he can hardly be called timid. The boy is always very serious, never laughs heartily. With strangers, Karl is timid, shy, and begins to stutter. He is afraid to go shopping: “you have to talk to the sellers there.” Neat in clothes. He often quarrels with his older brother, whom his parents love more than him, and then his brother and his friends beat him.
Karl had a hard time at school; he even repeated the second year once. He studied conscientiously, but it took twice as much time to prepare his lessons as other children. In class everyone made fun of him, no one ever defended him. He was friends with elementary school students: “they are not so impudent and do not fight.”
In the department, Karl was timid, inhibited, constantly depressed, and tears often came to his eyes. There was no trace of childish laughter or cheerfulness; he spoke very quietly. He was often offended by children, but easily came to reconciliation. I was sincerely grateful for any kind of attention. Questions about his older brother made him very excited. Our children's team did not “accept” him. Karl was happy when he found a boy who became friends with him. He submitted to this boy in everything, for his sake he even committed offenses that he himself condemned (missing classes at the school at the clinic). Age-related intelligence indicators, determined by special tests, are normal.
Karl exhibits the whole complex of subdepressive temperament. He does not have childish carelessness or gaiety; he rather gives the impression of a depressed child. Added to this is slowness and clumsiness. His thinking is probably slow, as evidenced by his poor performance at school. Despite his normal intelligence, depression and slowness of reactions caused him to lag behind his peers. Therefore, Karl’s peers made fun of him, but he was angry and offended by them.
