Online sessions now available.Kristian S. Nibe - clinical psychologist and ISTDP practitioner.
What is dysthymia?
Dysthymia, presently referred to as persistent depressive disorder (PDD), is a depressive disorder with similar characteristics as clinical depression. Dysthymia has milder symptoms, but a longer timespan, and can therefore be considered as a mild form of chronic depression.
Dysthymia has through the years been referred to as depressive personality disorder, depressive neurosis, and neurotic depression, until it in the latest diagnostic manual, DSM-V, got called PDD. The disorder typically lasts longer than two years, but is less inhibiting than clinical depression. Those afflicted are usually able to keep a full-time job.
Around 3 % of the population will be afflicted by dysthymia sometime in their life. Twice as many women as men are afflicted by it, and so are people from a lower socio-economic class, singles, and unmarried people. The symptoms normally have their onset between 15-19 years of age.
A dysthymic is characterized by someone who has lived being chronically unhappy most of his life. The downtrodden mood doesn’t let go for more than a day or two, and real happiness and enthusiasm are basically non-existent. It can go several years before the depressed mood temporarily lifts for a month or two, only to return again to its depressed state later.
Common symptoms of dysthymia are; reduced work capacity, sleep and appetite disturbances, reduced energy, tiredness, indecisiveness, difficulty concentrating, social withdrawal, shyness, dissatisfaction with most aspects of life, irritability, conflicts with family and friends, somatic health issues, parents suffering from depression, assumptions of worthlessness and the pointlessness of existence, dependence on approval from others to confirm own self-esteem, exaggerated reactions towards disappointments, helplessness, tendency to blame others and take a victim role, a lack of humility, and a passive-aggressive behavioral pattern.
The symptoms of dysthymia are quite similar to the symptoms of depression, the main difference being that they are less intense.
75 % of dysthymics also suffer from other psychological disorders such as phobias, anxiety disorders, eating disorders, or personality disorders. 50 % of dysthymics have an alcohol problem. Many that developed dysthymia in adult age did so as a result of not fully recovering from an earlier depressive episode.
Dysthymia as a clinical diagnosis.
The symptoms for dysthymia must according to DSM-IV be present for at least two years, where no more than a two month symptom-free period was present. Two or more of the following six symptoms must have been present for minimum two years in order to qualify for the clinical diagnosis dysthymia:
- Low appetite or overeating.
- Insomnia (sleep deprivation) or hypersomnia (oversleeping).
- Low energy level or tiredness.
- Low self-esteem.
- Difficulty concentrating or difficulty making decisions.
- Feelings of hopelessness.
As for depression, manic episodes can’t also have been present, as one then would be diagnosed within the bipolar spectrum. If the onset of dysthymia occurs before age 21, then it is labeled as early onset, while onset over age 21 is labeled as late onset.
Treatment of dysthymia.
Only one in five suffering from dysthymia or other forms of depression ever seek help. This despite that dysthymia is a curable disorder. With the right treatment many that have suffered from dysthymia show a relatively good progression over the course of a psychological treatment. Traditional treatment of dysthymia has been a combination of anti-depressants and psychotherapy.
As for depression, the main focus of the treatment is to help the person get more energy by getting in touch with their feelings, rather than having the depressive mechanism continue to put a lid on their feelings.
Dysthymics often lack self-confidence and the ability for self-assertion. Therefore they need to learn more effective ways to relate to and communicate with others.
If dysthymia remains untreated it unfortunately has a great chance of lasting the whole lifetime and it may also develop into a clinically depressed state. This leads to unfortunate consequences both personally and occupationally. Dysthymics perform worse in the work place, and they struggle to maintain close relationships over time.
Since the symptoms aren’t as severe as clinical depression they’re able to maintain an effective appearance on short-term projects, but they struggle to be effective and to relate closely with others in the long run.
Some grow up so used to be slightly depressed and downtrodden that they believe that this state is just part of who they are, rather than understanding that the depressive mechanism is something that can be overcome.
Many clinicians believe that dysthymia is a difficult diagnosis to cure, but the prognosis is quite good for those who have a strong motivation to change and a sense of humility to accept their limited perceptions. But the healing process requires, as everything else, dedicated effort and a willingness to change. This isn’t always easy when the energy is low and pessimistic thoughts are allowed to dominate.
Online consultations available.
Use the contact form below for any inquiries. Please state briefly the nature of your problem, when and how you are available, and how you prefer to conduct payment (Credit Card or PayPal).
Consultations are available for either 45 minutes or 90 minutes, and are conducted by video either through Skype or appear.in. Alternatively I also offer sessions through chat/e-mail.
The price per 45 minute consultation is 160 Euro. The price for a 90 minute consultation is 300 Euro.