What is dysthymia disorder?

About dysthymia depression

Dysthymia is chronic, mild depression. The person suffering from dysthymia can function, but not at full capacity. Dysthymia is generally associated with a long-standing tendency to be gloomy, sensitive, anxious, worried, and irritable.

If you are dysthymic, you may still have brief periods of happiness. You do not have to be down in the dumps all the time to be dysthymic. You may feel okay at times, but everyday stresses and disappointments may easily push you back into a gloomy or irritable mood. You will tend to feel easily overwhelmed, stressed, and worn out by life’s problems. Friends and family may find it hard to sympathize with you since, to them, it seems that you are overreacting to pressures they take in stride. This may lead you to feel both angry and ashamed for being so “weak.”

Dysthymia disorderIs dysthmia disorder an illness?

Dysthymia is a serious illness. Yet, if you suffer from it, your symptoms are not so overwhelming as to make it clear that you are ill. As a result, dysthymia often goes unrecognized. It is frequently mistaken for a bad disposition or a personality problem. Up until 1980, even the official position of the American Psychiatric Association (APA) was that dysthymia was a personality problem. (The APA is the national organization of medical doctors specializing in the diagnosis and treatment of illnesses such as depression.) As a result of this confusion, dysthymia is frequently not treated or is inadequately treated, most often with minor tranquilizers or psychotherapy.

I cannot emphasize enough how easily overlooked and misdiagnosed dysthymia is. The manifestations are often so subtle and so much a part of a person’s way of being that it seems to be “just the way he is.”

Symptoms of dysthymia disorder

Part of the problem in recognizing dysthymia is that the standard list of symptoms for major depression does not capture the subtle manifestations of dysthymia. Three psychiatrists at the University of California, San Diego (Stephen Schuchter, Nancy Downs, and Sidney Zisook), call the subtle manifestations “the language of depression,” rather than symptoms. The language is expressed in relationship and work problems and sense of self, rather than in the symptoms we more typically associate with depression – that is, loss of appetite, sleep disturbance, and suicidal thoughts.

For instance, a woman suffering from dysthymia complains repeatedly about her husband’s shortcomings. These shortcomings may be real to some extent, but the wife exaggerates them or reacts to them with disproportionate hurt and anger. For a while, her husband tries to accommodate her and attempts to change. After some time, however, he starts to feel as if nothing will please her. If he has shaky self-esteem and a tendency to feel excessively guilty, he may begin to lose perspective. He begins to have trouble discerning where his problem ends and his wife’s begins. He may begin to withdraw out of guilt, frustration, a desire to punish, or a sense of helplessness and inability to make things work. Or if he is sensitive to criticism and has poor impulse control, he may end up losing his temper or becoming abusive. Their relationship can spiral down into ugly arguments or, at best, a “cold war” where they rarely talk to each other.

Most couples I see with this pattern have absolutely no idea that one or both of them may have a mood disorder that contributes to their problem. They may believe they have problems communicating or that their spouse has a serious personality problem. They begin to dislike and blame each other for their problems rather than blaming the common enemy: a depressive illness.

Dysthymia has been shown to have clear biological and genetic links to full-blown depressive illness. It is not a personality problem. Proper treatment with a combination of antidepressant medication and appropriate forms of psychotherapy or marriage and family counseling often produces profound improvements in a patient’s and family’s quality of life.