What Is Dysthymia (Dysthymic Disorder)?

Dysthymia
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The word dysthymia comes from the Greek roots dys, meaning "ill" or "bad," and thymia, meaning "mind" or "emotions." The terms dysthymia and dysthymic disorder refer to a mild, chronic state of depression.

Under the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), this condition now falls under the umbrella of persistent depressive disorder, which includes any chronic depression running on a spectrum from mild to severe.

  These diagnostic changes were made to reflect the fact that there is no scientifically-meaningful distinction between chronic major depressive disorder and what was previously known in the DSM-IV as dysthmic disorder.

The rest of this article will deal with dysthymia as it was diagnosed under the DSM-IV.

Symptoms

The symptoms of dysthymia listed in the DSM-IV were similar to major depression, but less severe. These symptoms included:

  • either poor appetite or eating too much
  • sleep difficulties
  • fatigue
  • low self-esteem
  • difficuly concentrating or making decisions
  • feelings of hopelessness

Diagnosis

There was and still is no laboratory test available for diagnosing dysthymia or any other form of depression. A diagnosis of dysthymic disorder under the DSM-IV had to be made by a mental health professional after reviewing a patient's symptoms and medical history. In order to be diagnosed with dysthymic disorder, the patient had to meet the criteria listed in the manual as far as symptoms.

  Also, the individual's symptoms could not be better accounted for by drug or alcohol abuse, a medical condition, or another psychological disorder. In addition, It was required that the patient had felt symptoms of depression more often than not for at least two years prior.  For children, the requirement was lowered to one year.

Treatment

While the DSM-IV was in use, the treatments for depression were similar to how depression is currently treated:  psychotherapy and medications.  Generally, a combination of these two is the most effective.  St. John's Wort, which has been reported to be helpful with cases of mild to moderate depression, might also have been offered as a self-help remedy.

What Dysthymia Felt Like

A person diagnosed with dysthymia would have been able to function in his day-to-day life, but never felt quite right. He would have reported feeling like he had been depressed all of his life or said he felt like he was just barely managing to keep his head above water.

What Was Double Depression?

A person with mild depression meeting the diagnostic criteria for dysthymic disorder could at some point have also experienced a major depressive episode. When the major depressive episode ended, however, he would have returned to his previous state of chronic, low-level depression. When an episode of major depression was superimposed on dysthymia it was referred to as double depression.

Sources:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994.

Boehnlein, B. and L.D. Oakley. "Implications of self-administered St. John's wort for depression symptom management." J Am Acad Nurse Pract 14.10 (2002): 443-8.

"Hightlights of Change From DSM-IV-TR to DSM-5".  American Psychiatric Association.   American Psychiatric Publishing.  Published:  2013.  Accessed:  December 7, 2015.

Robertson's Words for a Modern Age: A Dictionary of Latin and Greek Words used in Modern-English Vocabulary. Rev. September 2, 2006. http://www.wordinfo.info/ (September 6, 2006).

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