Chronic Depression (Dysthymia)

January 8, 2009 at 12:01 am · Filed under Psychiatric section

The author: Professor Yasser Metwally

http://yassermetwally.com

INTRODUCTION

January 8, 2009 — Dysthymia, sometimes referred to as chronic depression, is a less severe form of depression. With dysthymia, the depression symptoms can linger for a long period of time, perhaps two years or longer. Those who suffer from dysthymia are usually able to function adequately but might seem consistently unhappy.

  • Causes of Dysthymia

Experts are not sure what causes dysthymia. This form of chronic depression is thought to be related to brain changes that involve serotonin, a chemical or neurotransmitter that aids your brain in coping with emotions. Major life stressors, chronic illness, medications, and relationship or work problems may also increase the chances of dysthymia.

  • What Are the Signs and Symptoms of Dysthymia?

The symptoms of dysthymia are the same as those of major depression but not as intense and include the following:

  • Persistent sad or empty feeling
  • Difficulty sleeping (sleeping too much or too little)
  • Insomnia (early morning awakening)
  • Feelings of helplessness, hopelessness, and worthlessness
  • Feelings of guilt
  • Loss of interest or the ability to enjoy oneself
  • Loss of energy or fatigue
  • Difficulty concentrating, thinking or making decisions
  • Changes in appetite (overeating or loss of appetite)
  • Observable mental and physical sluggishness
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • Thoughts of death or suicide

  • Management of Dysthymia

While dysthymia is a serious illness, it’s also very treatable. As with any chronic illness, early diagnosis and medical treatment may reduce the intensity and duration of depression symptoms and also reduce the likelihood of a relapse.

To treat dysthymia, doctors may use psychotherapy (counseling), medications such as antidepressants, or a combination of these therapies. Often, dysthymia can be treated by a primary care physician.

  • What Is Psychotherapy?

Psychotherapy (or talk therapy) is used in dysthymia and other mood disorders to help the person develop appropriate coping skills to deal with everyday life. Psychotherapy can also help increase compliance to medication and healthy lifestyle habits, as well as help the patient and family understand the mood disorder. You may benefit from one-on-one therapy, family therapy, group therapy, or a support group with others who suffer with chronic depression.

  • How Do Antidepressants Help Ease Dysthymia?

There are different classes of antidepressants available to treat dysthymia. Your doctor will assess your physical and mental health, including any other medical condition, and then find the antidepressant that is most effective with the least side effects.

Antidepressants may take several weeks to work optimally. They should be taken for at least six to nine months after an episode of chronic depression. In addition, it takes several weeks to go off an antidepressant, so let your doctor guide you if you choose to stop the drug.

Some commonly used antidepressants include:

  • Selective serotonin reuptake inhibitors (SSRIs) — Celexa, Lexapro, Prozac, Luvox, Paxil, Zoloft
  • Serotonin norepinephrine reuptake inhibitors — Effexor, Cymbalta
  • Tricyclic antidepressants — Elavil, Asendin, Anafranil, Norpramin, Adapin, Sinequan, Tofranil
  • Monoamine oxidase (MAO) inhibitors — Marplan, Nardil, Parnate, EMSAM
  • Trazodone — Desyrel
  • Other antidepressants — Mirtazapine, Bupropion

References

  1. Metwally, MYM: Textbook of neuroimaging, A CD-ROM publication, (Metwally, MYM editor) WEB-CD agency for electronic publication, version 10.1a January 2009 [Click to have a look at the home page]

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