Dysthymia (Persistent Depressive Disorder) – Interesting Facts, Causes, Symptoms, Diagnosis, Treatment

Interesting Facts About Dysthymia (Persistent Depressive Disorder)

Dysthymia, also called persistent depressive disorder (PDD), is a continuous long-term form of depression. The word ”dysthymia” comes from the Ancient Greek word ”δυσθυμία,” which translates as ”a bad state of mind.”

With PDD, the depression symptoms can linger for a long period of time, commonly two years or longer. It can begin in childhood or in adulthood. But, unlike major depression, PDD symptoms are more likely to start during childhood or adolescence.

PDD represents a consolidation of DSM-IV defined dysthymic disorder and chronic major depressive disorder, according to the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition, (DSM-5).

Statistics

More African-Americans than Caucasians are afflicted. Also, women suffer from dysthymia more than men. The condition can afflict around 3 percent of the US population.

It is more common in unmarried persons. Major depression will affect approximately fifty percent of people who struggle with PDD.

Symptoms

Common symptoms include:

  • avoidance of social activities;
  • persistent feelings of hopelessness and sadness;
  • a negative attitude;
  • sleep problems, such as excessive sleep or insomnia almost every day;
  • poor self-esteem;
  • low energy;
  • decreased productivity;
  • a lack of interest in daily activities;
  • indecisiveness;
  • being physically restless in a way which is noticeable by others;
  • a major change in body weight;
  • difficulty concentrating;
  • a change in appetite.

Complications

Health problems which may be associated with PDD include:

  • personality disorders, such as – histrionic personality disorder (excessively emotional and seeking constant attention), narcissistic personality disorder, avoidant personality disorder, and borderline personality disorder;
  • suicidal thoughts or behavior;
  • reduced quality of life;
  • general medical illnesses;
  • chronic pain;
  • anxiety disorders;
  • major depression;
  • decreased productivity;
  • work and school problems;
  • family conflicts;
  • relationship difficulties;
  • substance abuse;
  • schizotypal (having few or no intimate relationships and turning inward);
  • antisocial (disregard for others and aggressive behavior).
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Causes

Image credit – https://commons.wikimedia.org/wiki/File:Depression.jpg

No one knows for sure what causes the condition. However, it is thoughted that it may be related to some changes in the brain which involve chemicals, like:

  • serotonin – a chemical that is sometimes called the happy chemical;
  • norepinephrine – a catecholamine which is produced primarily by the adrenal medulla;
  • dopamine – a neurotransmitter that inhibits the transmission of nerve impulses.

Risk Factors

Certain factors may contribute to the development of PDD, including:

  • physical brain trauma, like – a concussion;
  • chronic physical illness, like – diabetes or heart disease;
  • traumatic life events, including – financial problems or the loss of a loved one;
  • stress – it is believed to impair the patient’s ability to regulate mood;
  • a history of bipolar disorder or anxiety;
  • poor sleeping habits;
  • a regular diet rich in junk food;
  • a family history of PDD;
  • a chemical imbalance in the brain.

Diagnosis

In order to meet criteria for the diagnosis of PDD, a person must have symptoms of sadness on a daily basis, for at least 1 year for children and teens and 2 years in a row in adults.

A healthcare provider will also want to confirm that your symptoms are not a result of anemia, thyroid problems (they occur when this gland produces either too much or too little hormones), or anxiety.

Treatment

The two main treatments for PDD include:

  1. Psychotherapy

There are different kinds of psychotherapy available, including:

  • process-oriented talk therapy;
  • group therapy;
  • family therapy (typically provided by a clinical social worker, a psychologist, or a licensed therapist);
  • cognitive behavioral therapy.

2. Medications

The types of medications most commonly used to treat PDD include the following:

  • SNRIs (serotonin and norepinephrine reuptake inhibitors) – these medications work by modifying the levels of neurotransmitters norepinephrine and serotonin;
  • TCAs (tricyclic antidepressants) – common TCAs include – trimipramine, protriptyline, amitriptyline, nortriptyline, imipramine, doxepin, desipramine, and amoxapine;
  • SSRIs (selective serotonin reuptake inhibitors) – common SSRIs include – sertraline, escitalopram, fluoxetine, paroxetine, and citalopram.
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Note – a few studies have concluded that combining medication and psychotherapy together works best for treating individuals with PDD. But, in most cases, learning how to look at things differently is the best way to improve the quality of life of the patient.

Prevention

There is some evidence that treating PDD in parents can help prevent the development of the condition in their children. Other prevention methods include:

Stay Active

run exercise
Image credit – https://www.flickr.com/photos/giuseppemilo/18553677950

Not only is regular physical exercise good for the physical health, it can also improve anxiety, depression, and overall mood.

According to research, any physical activity can help in the prevention and treatment of PDD in a few ways:

  • it reduces immune system chemicals which may worsen depression;
  • it releases chemicals, such as – endorphins, that can boost mood;
  • it increases your body temperature, that can have a calming effect on the CNS.

You can try any type of exercise you like, such as – pilates, yoga, running, cycling, swimming, and calisthenics. Aim to exercise 3 to 5 days a week for half an hour or more.

Turn off the TV

Exposure to artificial lights at night (from the TV or smartphones) has been strongly associated with all kinds of problems, many of them resulting from disrupting the body’s production of melatonin, a natural hormone made by the pineal gland which regulates sleep.

Moreover, studies have established that individuals who watch a lot of television typically have intensified feelings of isolation.

Get Enough Sleepsleep

Disturbances in circadian rhythms have been linked to depression. Aim to sleep 7 to 8 hours per night.

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Eat a Healthy Dietcarrots and skin

Foods rich in omega-3 fatty acids and folate (also known as vitamin B9) may ease depression since they may help your mind feel relaxed. Moreover, these foods provide you with essential minerals and vitamins. Good food sources include:

  • lentils;
  • chickpeas;
  • broccoli;
  • red kidney beans;
  • carrots;
  • walnuts;
  • almonds;
  • sesame seeds;
  • sunflower seeds;
  • flax seeds;
  • chia seeds;
  • apples;
  • bananas;
  • mangoes;
  • pineapples;
  • papayas;
  • pecans.

Mindfulness Meditation

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There is strong evidence that mindfulness meditation helps to reduce clinical depression and prevent relapses.

This meditation involves observing emotions and thoughts from moment to moment without becoming caught up in them or judging. Aim for a daily meditation session of about 40 minutes.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719439/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3095185/
https://www.ncbi.nlm.nih.gov/pubmed/18164766

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