Program & Services

Dysthymia

What is Dysthymia?

The word dysthymia means bad state of mind or ill humor. It is similar to depression, but with milder symptoms. It is longer lasting. It lasts at least two years. Most people who have it are usually able to go on working and do not need to be in the hospital.

How Common Is It?

About three percent of people will have it at some time. That's lower than the rate of depression. It occurs more often in women than men. It is more common among poor and single people. The signs usually appear in young adults. Sometimes it doesn't appear until middle age.

Warning Signs

The warning signs of dysthymia are:

• poor school or work performance
• social withdrawal
• shyness
• irritability, hostility
• conflicts with family and friends
• sleep problems
• parents have had depression

Over half of people have some other mental or medical problem as well.

Current Care for Dysthymia:

• Talk therapy can help people learn how be more "positive" in life.
• Talk therapy can help them get along better with people.
• Medicine may be useful.

The signs may be hard to see. Most people with this problem only see their family doctor. The doctor may think something else is wrong. Especially if a lot of the signs are physical. Many people do not like to think they are depressed. They are relieved to be told they have a physical illness.

Signs of a problem

Adults with this problem are in a low, sad mood for least two years. They are unhappy most of the day. They are sad more days than not. A child or teen is unhappy or irritable for at least a year.

People with this problem don't enjoy life. They tend to put themselves down. Being down is common. Many people with this problem have poor personal relationships, because:

• These people are seen as always being grouchy or moody
• Close relationships don't bring great joy
• They tend to withdraw from others
• They find it difficult to function well on the job and in their personal lives

During periods of depressed mood, people have least two of these signs:

• Not eating or eating too much
• Not sleeping or sleeping too much
• No energy
• Low self esteem
• Poor concentration
• Problems making decisions
• Feelings of hopelessness

People with dysthymia may think they have are just gloomy people. They try to learn to live with always feeling down. They mat not realize they have a treatable problem.

Some people may have an "I don't care" attitude about living or dying. While not suicidal, they may say they wouldn't mind if they just didn't wake up one morning.

Kinds of Care

The first step is to talk to your doctor. Is the problem being caused by a medical problem? Or a medicine you're taking? If physical causes are ruled out, a psychiatrist or psychologist can assist in finding out what's wrong.

Therapy

Two types of therapy work well for dysthymia:

Interpersonal therapy . This short term therapy focuses on the person's relationships. It may uncover clues about the source of depression. It may show how the problem is getting in the way of relationships. The person's spouse and other family members sometimes are involved.

Cognitive behavior therapy. This focuses more on the person. This type of therapy looks at how the person thinks and acts. The therapy helps the person look at why they are so down. It helps the person gain confidence.

Medicines

Most people with dysthymia can be helped with medicine. It can take a few weeks for medicine to build up and take effect. It's typical to continue taking medicine for up to six months after your mood improves. Let your doctor know if you're feeling better or worse while taking medicine. The doctor may change the amount or try something else.

Self-help

In addition to speaking with your doctor and following the plan of care, you can take these steps to feel better:

• Keep your appointments and take your medicine, even if you feel it won't help. With time, it will.
• Plan to do fun things. See a funny movie. Read a funny book. Visit friends. Garden or work on a craft that you enjoy.
• Don't drink alcohol or use drugs. Both can worsen a bad mood. They may have bad side effects with the medicine you're taking.
• Take care of your health. Eat good foods. Get enough sleep.
• Exercise three times a week for at least 20 minutes. Things like walking or biking will help boost your mood.

FAQs

What's the difference between dysthymia and major depression?

Major depression comes and goes. When the person is depressed the sadness is overwhelming. They may be so low they stop feeling anything. A person with dysthymia doesn't experience deep depression. Their illness is always long term. It lasts for at least two years. It is considered a mild disorder when compared with major depression. But it is serious and should be treated.

I'm 25 years old and think I have dysthymia, but I've had symptoms for only one year.

To be dysthymia, you need to have it for at least two years. You may have depression. Or it could be the beginning of dysthymia. You'd need to wait a year to find that out. But you should see your doctor now.

How do I know that this not just a part of my personality? Maybe I'm just a gloomy person. There's nothing that can change that, right?

Researchers think that some people may have a depressed personality, so you might be some what right. But if you want to change your life for the better, you can improve your mood, attitude and habits. It has been said we are works in progress. We can change for the better if we work at it and have the support of those close to us.

Do people with dysthymia have to go to the hospital?

Almost never. People with this problem live their lives fairly normally, without feeling happy. If the feelings are serious enough to go to the hospital, the person has probably developed major depression on top of dysthymia.

Resources

Associations

National Alliance for the Mentally Ill
Colonial Place Three
2107 Wilson Blvd., Suite 300
Arlington, VA 22201-3042
(800) 950-NAMI (6264)
www.nami.org

Depression and Bipolar Support Alliance
730 N. Franklin St., Suite 501
Chicago, IL 60610
(800) 826-3632
www.ndmda.org

National Foundation for Depressive Illness
P.O. Box 2257
New York, NY 10016
(800) 239-1265
www.depression.org

The National Institute of Mental Health
NIMH Public Inquiries
6001 Executive Blvd., Room 8184, MSC 9663
Bethesda, MD 20892-9663
(301) 443-4513
(800) 647-2642 (toll-free information line)
www.nimh.nih.gov

National Mental Health Association
2001 N. Beauregard St., 12th Floor
Alexandria, VA 22311
(703) 684-7722
(800) 969-NMHA (6642) (toll-free automated information line)
www.nmha.org

Books

Burns, David D., M.D., The Feeling Good Handbook. Plume Publishers, 1999.

Markowitz, John C., M.D., Interpersonal Psychotherapy for Dysthymic Disorder. American Psychiatric Press, 1998.

Whybrow, Peter C., M.D., A Mood Apart: The Thinker's Guide to Emotion and Its Disorders. HarperCollins, 1998.

Greenberger, Dennis, and Christine A. Padesky, Mind Over Mood: Change How You Feel by Changing the Way You Think. Guilford Press, 1995.

Support Group

Mood Disorders Support Group of New York City offers help at:
www.mdsg.org