” a sort of death-in-life existence and the blessed relief of flopping into our unmade beds.” John McManamy in (Mental Water Torture-Mild to Moderate Depression.) What he is describing is Dysthymia. Dysthmyia or Dysthymic Disorder is a type of mild depression (AAP, Diagnostic and Statistical manual of mental disorders). It is chronic, pervasive, and a disabling illness affecting up to 5% of the population (About Dysthymia).
People with Dysthymia suffer from a sustained, chronically depressed mood that lasts for most of the day, more days than not, for two years or longer. Sufferers often describe their mood as sad or “down in the dumps.” This is common in a lot of teenagers, especially female (DSM).
According to the article, About Dysthymia, during periods of depressed mood, most sufferers have, poor appetite or over eating, a sleep disorder (insomnia or over-sleeping), low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness and despair.
Not much is known about Dysthymia. Often when an adolescent or a child suffers from it, they have poor self-esteem and have poor social skills.
John McManamy explains that some sufferers turn to alcohol or drugs. Others (about 3-12 percent) commit suicides. But, sooner or later, major depression happens. Dysthymics fall too deep into a mild depression that they find themselves in a major one. This happens when sufferers of Dysthymia are untreated and keep going through a depression, every time falling deeper and deeper until they can no longer get out. When this occurs, it is known as “double depression.”
There are many ways to treat Dysthymia. According to the internet article, Dysthymic Disorder: Treatment, 62% of patients benefit from antidepressant medication. The guidelines for assessing the potential utility of drug therapy are a contributory family history and a past history and a past history of poor response to their forms of treatments. Some antidepressant drugs such as fluoxentine and imipramine can be used with both major and mild depression patients. Antianxiety drugs however don’t have as much effect on Dysthymia patients as do antidepressants.
Another form of treatment is psychosocial treatment. Psychotherapy is the principal treatment resource for patients with dysthymic disorder. Reassurance that the psychotherapist understands the depth of the patient’s pain, assessment of suicidal and other self-destructive potential, and optimism for the future are all useful. There is also “short term” psychotherapy. This stresses changes in interpersonal relationships and cognitive self-awareness are becoming more popular. Some of that is due to the fact that long-term analytic approaches to personality change are economically unfeasible. There is also group therapy that sufferers can take. Many sufferers benefit from group therapy and form active investigation and restructuring of maladaptive social functioning. The last type of therapy a Dysthymic can use is family therapy which is less common. This approach focuses on the “role of the sick member” in the family system rather than on the symptoms of the patient.
Bibliography
American Psychiatric Association.(1994). Diagnostic and Statistical manual of mental disorders, 4th edition. Washington, DC; American Psychiatric Association.
www.mentalhealth.com_Dysthymic Disorder: Treatment.
www.camh.net The Clarke Institute: About Dysthymia.
www.suite101.com/article.cfm. John McManamy; Mental Water Torture-Mild to Moderate Depression.
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