What is Dysthymia (Depressed Mood)?
Dysthymia is a persistent mood disorder characterized by a chronic depressive mood that currently does not meet the description of a recurrent depressive disorder of mild or moderate severity, either in severity or duration of individual episodes (although in the past there could be individual episodes that meet the criteria for a mild depressive episode, especially at the onset of the disorder). The balance between the individual episodes of mild depression and periods of relatively normal state is very variable. These people have periods (days or weeks) that they themselves regard as good. However, most of the time (often months) they feel tired and depressed. Everything becomes difficult and nothing is fun. They are prone to dark reflections and complain that they do not sleep well and feel uncomfortable, but generally cope with the basic requirements of everyday life, therefore dysthymia has much in common with the concept of depressive neurosis or neurotic depression.
Causes of Dysthymia (Depressive Mood)
The types of personalities that have dysthymia, it would be correct to call constitutional depressive. These features in them are manifested in childhood and puberty as a reaction to any difficulty, and later on endogenously.
Pathogenesis during Dysthymia (Depressive Mood)
Usually, this disorder begins at a young age (at a teenager or up to 30 years old) and lasts for several years, sometimes indefinitely. When such a condition occurs later, it is most often a consequence of a depressive episode and is associated with the loss of a loved one or other obvious stressful situations.
Symptoms of Dysthymia (Depressive Mood)
Patients are tearful, pensive and not too sociable, pessimistic. Under the influence of insignificant stresses in postpuberty, for at least two years, they have periods of constant or periodic depressive mood. Intermediate periods of normal mood rarely last longer than several weeks, the whole mood of the person is colored by subdepression. However, the level of depression is lower than with mild recurrent disorder. It is possible to identify the following symptoms of subdepression:
- reduced energy or activity;
- sleep disturbance and insomnia;
- decreased self-confidence or inferiority;
- difficulty concentrating, and hence subjectively perceived loss of memory;
- frequent tearfulness and hypersensitivity;
- decrease in interest or pleasure from previously pleasant and instinctive forms of activity;
- a sense of hopelessness or despair due to an awareness of helplessness;
- inability to cope with the routine duties of everyday life;
- pessimistic attitude towards the future and a negative assessment of the past;
- social exclusion;
- decreased talkativeness and secondary deprivation.<
Diagnosis of Dysthymia (Depressive Mood)
- At least two years of persistent or recurring depressive mood. Periods of normal mood rarely last longer than a few weeks.
- The criteria do not correspond to a mild depressive episode, since suicidal thoughts are absent.
- During periods of depression, at least three of the above symptoms of subdepression should be present.
Differential diagnosis. It should be differentiated from a mild depressive episode, the initial stage of Alzheimer’s disease. In a mild depressive episode, suicidal thoughts and ideas are present. In the initial stages of Alzheimer’s disease and other organic disorders of depression become protracted, organics can be identified neuropsychologically and with the help of other objective research methods.
Treatment of Dysthymia (Depressive Mood)
With a reduced mood, Prozac, sleep deprivation treatment and enotherapy are indicated. Sometimes 2-3 sessions of nitrous oxide, amytal-caffeine disinhibition and intravenous administration of novocaine, as well as nootropic therapy, give the effect.