Dysthymia is a condition characterized by a mood disorder characterized by depression, despondency, and sadness. The second name of the disease is chronic subdepression, marked by manifestations that are not enough to establish a diagnosis of depression. The concept of dysthymia was introduced by psychiatrist Robert Spitzer to replace the term neurotic depression.

Before the appearance of the term dysthymia, the disease was called neurasthenia or psychasthenia. The disease is characterized by permanent depressive mood, which does not reach the degree of severe depression. Within the framework of dysthymia, short-term improvements of the condition occur, but their duration does not exceed two months. If the remission lasts for more than two months, then it is already impossible to talk about dysthymia, and it should be noted that this is recurrent depression.

Dysthymia symptoms

Dysthymia and illness symptoms manifest themselves in low mood with the following manifestations: decreased or increased appetite, drowsiness or insomnia, lack of energy, fatigue, low self-esteem and concentration of attention, difficulty in making decisions, a sense of hopelessness, pessimism, inability to feel pleasure - anhedonia.

The diagnosis of dysthymia is made if the disorder lasts up to two years. The disease is characteristic of a young age, but a person often becomes informed about his diagnosis many years after the onset of the disease. If dysthymia reveals itself in childhood, the patient considers himself to be depressive, and all the symptoms refers to character traits. Therefore, its manifestations of doctors, relatives are not informed. Psychological disorders that overlap the symptoms of the disease interfere with the detection of the disease.

The diagnosis of dysthymia is established only if there are symptoms for two years with a short break (up to two months). Manifestations of the disease should not be associated with the use of drugs, drugs, alcohol.

Dysthymia is not diagnosed if the patient has episodes of mania, depression, hypomania, cyclothymia, schizophrenia, delusional disorder. For children, as well as adolescents, manifestation of symptoms within one year is sufficient, and not as an adult for two years. After three years of the disease, symptoms of severe depression can join. In these cases, talking about double depression.

Up to 75% of patients with dysthymia have chronic diseases of organic origin or psychological disorders. There are combinations of this disease with panic attack, social phobia, generalized anxiety, and somatic diseases. Dysthymic sufferers are at high risk for depression.

Dysthymia types

Somatisation (kadestetichesky) dysthymia is noted complaints of satisfactory health, shortness of breath, palpitations, constipation, poor sleep, tearfulness, depression, anxiety, sadness, burning sensation in the larynx, intestines, cold under the spoon. Gradually, external events no longer affect the dynamics of clinical manifestations.

Characterological (character) dysthymia is expressed in persistent, persistent disorders in the form of anhedonia, the blues, pessimism, arguments about the meaninglessness of life, the formation of a depressive world view. At the core lies the loser complex. The picture of the world appears before them in a mourning light, the sick see the dark sides in everything and are inborn pessimists. Every joyful event appears to them as a fragile joy, and they expect nothing from the future, except difficulties and unhappiness. Past memories give remorse when making mistakes. Patients are sensitive to trouble. They are in anxious expectation of misfortune. They are constantly in a gloomy, gloomy state, little talkative and sad. His behavior often repel people who are not indifferent to them. Facial expressions and all behavior transmit lethargy: weakly hung hands, lowered facial features, slow gait, flaccid gestures. Sick quickly tired and fall into despair. They are indecisive and inert, are intellectuals, but mental work is accompanied for them by a feeling of great tension.

Dysthymia and Cyclothymia

Dysthymia must be differentiated from cyclotymia, which is accompanied by manifestations of mental, affective disorder, in which mood swings are characteristic between manifestations close to dysthymia and hyperthymia with episodes of hypomania.

In cyclotemia, pathological changes occur as separate, as well as dual episodes, separated by states of mental health or alternating continuously. The concept of cyclothymia was originally used to describe bipolar disorder, and the traditional classification considers it as an easy and unexpressed version of general cyclofrenia.

Dysthymia treatment

The disease is treated very difficult, because it is strong resistance (resistance), which is characterized by the constant presence of signs of mood disorder, but not leading to a depressive state.

It happens that depressive manifestations in the framework of dysthymia are complicated and the clinical picture of severe depression is noted. This condition is called double depression.

There are reviews of patients that the disease in them is well treatable with Sertralin at a therapeutic dose of 50 mg per day. Often patients make mistakes when taking antidepressants from different groups or when non-systematic treatment was carried out in the early phases of treatment.

Dysthymia includes in the treatment of such antidepressants: Amelipramine, Imipramine, Amitriptyline, Anafranil, Clomipramine.

Good results are given by such drugs as Sulpiride, Amisulpriid. Sulpiride is an atypical neuroleptic that has a moderate antipsychotic effect with a weak anti-depression and psychostimulant effect. It is necessary under the supervision of doctors to carry out consistent and proper treatment according to specially selected schemes.

Amisulpriid is a neuroleptic that refers to atypical antipsychotics. The antipsychotic action is combined with a sedative (sedative) effect.

Cognitive psychotherapy is of great importance in the treatment of dysthymia. Successfully established individual psychotherapy, group therapy, and support groups, allowing the patient to develop interpersonal communication and assertiveness (open, direct behavior), increasing self-confidence.

Prevention of dysthymia includes the timely detection of signs of the disease and an increase in the level of self-esteem.