Dysthymia

Dysthymia is a mood disorder that falls within the depression spectrum. It is typically characterized by a lack of enjoyment or pleasure, clinically referred to as anhedonia, that continues for an extended period. Dysthymia differs from major depression in that the former is both longer-lasting and less disabling. Dysthymia can prevent a person from functioning effectively, disrupt sleep patterns, and interfere with activities of daily living (ADLs). Many dysthymia sufferers have a more specific subtype called Atypical depression.^{[citation needed]} Dysthymia sufferers exhibit fairly mild symptoms on a day-to-day basis. Over a lifetime the disorder may have more severe effects, such as a high rate of suicide, work impairment, and social isolation. The psychiatric term describing a personality with opposite characteristics to dysthymia is hyperthymia.

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Diagnostic criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, characterizes Dysthymic disorder as a chronic depression, but with less severity than a major depression. The essential symptom involves the individual feeling depressed almost daily for at least two years, but without the criteria necessary for a major depression. Low energy, disturbances in sleep or in appetite, and low self-esteem typically contribute to the clinical picture as well. Sufferers have often experienced dysthymia for many years before it is diagnosed. People around them come to believe that the sufferer is 'just a moody person.' Note the following diagnostic criteria:

1. During a majority of days for 2 years or more, the patient reports depressed mood or appears depressed to others for most of the day.
2. When depressed, the patient has 2 or more of:
   1. Appetite decreased or increased
   2. Sleep decreased or increased
   3. Fatigue or low energy
   4. Poor self-image
   5. Reduced concentration or indecisiveness
   6. Feels hopeless or pessimistic
3. During this 2 year period, the above symptoms are never absent longer than 2 consecutive months.
4. During the first 2 years of this syndrome, the patient has not had a Major Depressive Episode.
5. The patient has had no Manic, Hypomanic or Mixed Episodes.
6. The patient has never fulfilled criteria for Cyclothymic Disorder.
7. The disorder does not exist solely in the context of a chronic psychosis (such as Schizophrenia or Delusional Disorder).
8. The symptoms are not directly caused by a general medical condition or the use of substances, including prescription medications.
9. The symptoms cause clinically important distress or impair work, social or personal functioning.

Treatment

As with other forms of depression, a number of treatments exist for dysthymia. Doctors most commonly use psychotherapy, including cognitive therapy, to help change the mind-set of the individual affected. Additionally doctors may prescribe a variety of antidepressant medications For mild or moderate depression, the American Psychiatric Association in its 2000 Treatment Guidelines for Patients with Major Depressive Disorder advises psychotherapy alone or in combination with an antidepressant as possibly appropriate.

See also

• Anhedonia, a similar symptom of schizophrenia and clinical depression involved absence of or decreased sense of pleasure
• Blunted affect, a symptom of PTSD, schizophrenia, and ASPD involving decreased or absent emotional response
• Atypical depression
• Clinical depression