Dysthymia: Persistent depressive disorder
- Causes of dysthymia
- Risk factors of persistent depressive disorder
- Diagnosis and investigations
- Prognosis of mental illness
- Complications of form of depression
EpidemiologyDysthymia occurs worldwide in around 105 million patients per year. A persistent depressive disorder is slightly more common in women than in men.
Causes of dysthymiaThere are no known causes of a persistent depressive disorder. Possibly there is a genetic predisposition for this form of depression. Changes in certain brain structures may also play a role in the development of the mental disorder. These brain regions work in a different way. Other factors related to dysthymia are stress, social isolation and a lack of social support.
Alcohol abuse is linked to a persistent depressive disorder / Source: Jarmoluk, Pixabay
Risk factors of persistent depressive disorderAt least three-quarters of patients with dysthymia also have a chronic physical illness or other psychiatric disorder such as:
- cyclothymia (fluctuations in hypomania and mild depression)
- an anxiety disorder
- a major depression
- a personality disorder
- a somatoform disorder
- substance abuse such as alcoholism and drug addiction
Early onset (diagnosis before the age of 21) is often associated with more frequent recurrences, psychiatric hospital admissions, and more common conditions. In the elderly who suffer from dysthymia, the psychological symptoms are often associated with medical conditions and / or stressful events and losses in life and. Patients with dysthymia usually also experience an episode of major depression at some point in life.
SymptomsA persistent depressive disorder may start early in life, even in childhood. There may be ups and downs in the mood, but lower moods dominate and persist. Patients with dysthymia therefore experience a longer period of depressive mood combined with at least two other symptoms, such as:
- concentration problems
- a negative self-image
- food changes (eat less or eat more)
- hopelessness or pessimism
- difficult to make decisions / indecision
- insomnia or sleepiness
- tiredness or little energy
- low self esteem
With mild symptoms of a persistent depressive disorder, patients withdraw from situations of stress and situations where there is a chance that they will fail. In more severe cases of dysthymia, patients withdraw from daily activities. They will usually have little pleasure with the usual activities and activities. Suicidal behavior is also a special problem in patients with dysthymia.
Diagnosis and investigationsThe diagnosis of dysthymia is difficult because the symptoms are subtle and patients can often hide them in social situations, making it a challenge for others to detect symptoms and patients have been walking around with the disease for years. In addition, dysthymia often appears together with other mental disorders, making it difficult for the physician to identify dysthymia, especially as there is often an overlap in the symptoms of the disorders. It is vital that a doctor looks for signs of major depression, panic disorder, generalized anxiety disorder (constant, irrational anxiety and worry), alcohol and substance abuse, and personality disorder. The 'Diagnostic and Statistical Manual of Mental Disorders IV' (DSM-IV) contains the diagnostic criteria of a dysthymic disorder. The essential symptom is that the patient feels depressed for most days and parts of the day for at least two years (this is one year for children and adolescents). Low energy, sleep disorders, changes in appetite and low self-esteem generally also contribute to the clinical picture.
TherapyPatients often seek treatment because they experience more stress or have personal problems that may be related to the situation. The patient often suspects that the chronic symptoms belong to his character and usually does not seek help for this. A combination treatment of antidepressants and psychotherapy is the most effective treatment for patients diagnosed with dysthymia. This combination is often the preferred treatment method for patients with dysthymia.
Medications relieve the symptoms / Source: Stevepb, Pixabay