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Dysthymia (a type of chronic depression with neurotic origin) is one of the mental diseases in which patients experience a depressed mood. Dysthymia is a chronic problem that often makes it difficult for patients to live for many years. It happens that the existence of dysthymia is downplayed and unnoticed by both the patient and his surroundings. However, it is worth considering the problem because there are methods that allow you to effectively treat dysthymia, thanks to which the daily functioning of patients can be significantly improved.

In the course ofdysthymiathe predominant symptoms are those related to depressed mood - the disease belongs to the group of affective disorders. The problem is also known as chronic depression - but this term may seem not entirely correct due to the fact that in the course of pure dysthymia the symptoms do not reach such intensity that could constitute the basis for a diagnosis of depression.

The problem with dysthymia is that it lasts for a long time. Due to this, a significant number of patients, unfortunately, do not seek specialist help. The first symptoms of dysthymia appear most often in adolescence and early adulthood, so patients are considered to be naturally less cheerful.

Dysthymia is far more common than you might think. The lifetime risk of developing it is estimated at about 6%. Women predominate among people struggling with the problem - dysthymia occurs 2 to 3 times more often in this sex than in men. Depending on the age at which the first symptoms of dysthymia appeared in the patient, there are two forms of the disease: early dysthymia (with the onset of symptoms before the age of 21) and late dysthymia (with the first symptoms after the age of 21).

Causes of dysthymia

Regarding the pathogenesis of dysthymia, many issues remain unclear, but scientists have already made some assumptions about the factors involved in the development of the disease. Genetic determinants are taken into account among the causes of dysthymia. Their role in the development of chronic depression may be evidenced by the fact that it occurs more often in people who have a memberfamily suffered from affective disorders (e.g. depression or dysthymia).

Disorders of the neurotransmitter system in the nervous system are considered to be the biological basis of dysthymia. Particularly taken into account is the reduction of serotonin and norepinephrine concentrations - a confirmation of this assumption may be, for example, the fact that the improvement of the condition of patients with dysthymia is possible thanks to the use of drugs that increase the amount of these neurotransmitters in the brain. Endocrine dysfunction is another factor potentially involved in the pathogenesis of dysthymia. Among them, there are problems with the functioning of the thyroid gland and disturbances in the activity of the hypothalamic-pituitary-adrenal axis.

In some patients with a tendency to develop dysthymia, the disease appears spontaneously, while in others the onset of the problem is associated with certain events. Trigger factors that may lead to dysthymia in predisposed persons are professional, family or financial problems, but also a change of place of residence or the death of a loved one.

In addition to the already mentioned risk factors for dysthymia, there are also other mental problems in patients - personality disorders can be mentioned as an example of disorders that may predispose to the development of chronic depression.

Symptoms of dysthymia

Patients with chronic depression struggle with a number of problems related to mood, however, they may also experience other ailments. Symptoms of dysthymia include:

  • constantly depressed mood,
  • reduced ability to feel happiness (anhedonia),
  • constant feeling of fatigue,
  • thoughts about the nonsense of the world and your own functioning,
  • low self-esteem,
  • somatic problems such as sleep disturbances (both increasing the number of hours spent in bed and insomnia), eating disorders (eating more food or vice versa - lack of appetite),
  • irritability (this symptom especially applies to children with dysthymia, it may even dominate the depressed mood),
  • decreased activity,
  • avoiding social contacts,
  • slowness of thinking and problems with concentration.

The aforementioned ailments may be related to depression - in order to be able to diagnose a patient with dysthymia, the symptoms must not be of such intensity that it is possible to recognize depression (dysthymia can therefore be presented as a disorder with a less turbulent course than depression).

There is more to the diagnosis of dysthymia than thatthe presence of the symptoms listed in the patient, but also the length of time they are present. In the case of adults, the diagnosis of chronic depression can be made when the symptoms persist for a minimum of two years. A slightly different period of symptoms persistence is required when diagnosing dysthymia in children and adolescents - in this group the symptoms must last more than a year.

Dysthymia is a chronic problem that may last for many years. During this time, the patient may also experience other medical conditions - one possibility is depression. In such a situation, it is said that there is a "double depression" in the patient.

Treatment of dysthymia

Although the symptoms associated with this problem are much less severe than those associated with depression, the condition should still be treated. This is due to, inter alia, with the fact that:

  • the patient's ailments may significantly disturb his functioning in virtually every environment, be it family or professional,
  • people suffering from dysthymia are at an increased risk of depression and suicide,
  • patients may become addicted to various psychoactive substances - it happens that they use alcohol or drugs to (in fact only seemingly) alleviate their symptoms.

There are two methods of treating dysthymia: pharmacotherapy and psychotherapy. Drugs that are used in chronic depression are:

  • serotonin reuptake inhibitors (SSRIs),
  • tricyclic antidepressants,
  • serotonin and norepinephrine reuptake inhibitors (SNRIs).

Drug treatment of dysthymia lasts from several to several months. Patients should be advised that the drug's effects develop slowly - it usually takes about two weeks for the first effects to appear. Possible side effects of therapy are usually greatest during this period - their intensity gradually fades away, but if they are very strong, consult your doctor before discontinuing the drug.

The second method used in dysthymia is psychotherapy. Different psychotherapists recommend different techniques for the treatment of dysthymia, one of the most often used in patients with this problem is cognitive-behavioral psychotherapy.

The choice of a specific method of chronic depression treatment depends on the severity of the symptoms of the disease, but also on the general he alth of a given patient. Psychotherapy as a first-line method is especially recommended for children and adolescents with dysthymia. Sometimesa combination of pharmacotherapy and psychotherapy may prove beneficial.

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