Diagnosis and Treatment of Dysthymia
The most common mood disorder is depression. A person who is depressed often feels overwhelmed with sadness. He or she will lose interest in the things that they normally enjoy doing. He or she might experience intense feelings of worthlessness and guilt that makes them unable to feel pleasure. He or she might feel tired or apathetic, unable to make even a simple decision. Many depressed people blame themselves for their problems and feel that they have failed at life. According to Morris and Maisto (2010) “Seriously depressed people often have insomnia and lose interest in food and sex. They may have trouble thinking or concentrating—even to the extent of finding it difficult to read a newspaper. In fact, difficulty in concentrating and subtle changes in short-term memory are sometimes the first signs of the onset of depression.” In the most extreme cases, a depressed person might have thoughts of suicide or attempt to commit suicide.
Clinical depression is different from occasionally feeling blue. It is long lasting, and goes far beyond the typical reaction that most people have to stress in their lives. Only then can it be classified as a mood disorder. Major depressive disorder is a prolonged episode of intense sadness lasting a few months. In contrast, dysthymia has less intense symptoms such as sadness, however it lasts for as much as two years or more. Women are more likely to experience depression than men. Children and adolescents can also suffer from depression, but it is much harder to diagnose.
According to the US National Library of Medicine website, the exact cause of dysthymia is unknown. It has a tendency to run in families and can effect up to 5% of the general population. The main symptom of dysthymia is a prolonged period of sadness or a dark mood on most days for at least two years. Two or more of the following symptoms must be present almost all of the time in order for a person to be diagnosed with dysthymia;
Feelings of hopelessness, too little or too much sleep, low energy or fatigue, low self-esteem, poor appetite or overeating, or poor concentration. People with dysthymia have difficulty solving problems, and will often have a negative view of themselves, their future, other people and life events.
Medications do not work as well for people who have dysthymia as compared to people taking medication for a major depressive episode. It can take longer after starting a medication for people with dysthymia to begin to feel better. It is also common for people with dysthymia to engage in some type of talk therapy. Talk therapy is a good place for people with dysthymia to talk about their feelings and their thoughts, and learn positive and pro-active ways to deal with them.
The following medications are commonly used to treat dysthymia: Selective serotonin reuptake inhibitors (SSRIs). They include: fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro). Other antidepressants used to treat dysthymia include: serotonin norepinephrine reuptake inhibitors (SNRIs), bupropion (Wellbutrin), tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs).
A combination of medication and talk therapy are often beneficial for people with dysthymia. Types of talk therapy include Cognitive behavioral therapy (CBT) which teaches depressed people ways of correcting negative thoughts. People can learn to be more aware of their symptoms, learn what seems to make depression worse, and learn problem-solving skills.
Insight-oriented or psychodynamic psychotherapy can help someone with depression understand the psychological factors that may be behind their depressive behaviors, thoughts, and feelings.
It is often recommended that a person with dysthymia join a support group of people with similar problems. Dysthymia is what is called a chronic condition, meaning that it can last for many years, perhaps even throughout a person’s entire life. Some people completely recover from dysthymia, while other’s still experience symptoms even while taking medication or participating in therapy. While dysthymia is not as severe as major depression, dysthymia can stiff affect a person’s ability to function normally in their everyday life with their family or at work. It is important to seek treatment for dysthymia because people with this diagnosis are at an increased risk of suicide. Call for help immediately if you or someone you know develops these symptoms, which are signs of a suicide risk:

o Giving away belongings, or talking about going away and the need to get "affairs in order"

o Performing self-destructive behaviors, such as injuring themselves

o Suddenly changing behaviors, especially being calm after a period of anxiety

o Talking about death or suicide, or even stating the desire to harm themselves

o Withdrawing from friends or being unwilling to go out anywhere

(US National Library of Medicine)
There are websites and suicide hotlines available for people who have no one else to turn to in a time of crisis. http://suicidehotlines.com/national.html Call 1-800-SUICIDE / 1-800-784-2433
Call 1-800-273-TALK / 1-800-273-8255

References

Understanding Psychology, Ninth Edition, by Charles G. Morris and Albert A. Maisto. (2010) Chapter 12 Psychological Disorders
Retrieved from University of Phoenix eBook database

US National Library of Medicine, PubMed Health (2010)
Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001916/ Dysthymia