A Current Look at Chronic Depression
A chronic form of depression, dysthymia is characterized by depressed mood on most days for at least two years. On some days individuals may feel relatively fine or even have moments of joy. But the good mood usually lasts no longer than a few weeks to a few months. Other signs include low self-esteem, plummeting energy, poor concentration, hopelessness, irritability and insomnia.
Dysthymia — also known as dysthymic disorder — is typically described as a mild depression. But the data show a different story: Dysthymia is often a serious and severe disorder, said David J. Hellerstein, M.D., professor of clinical psychiatry at Columbia University and a research psychiatrist at New York State Psychiatric Institute. Experts refer to dysthymia as a paradoxical condition because it appears mild day to day but becomes brutal long-term, he said.
Epidemiological studies reveal that dysthymia frequently has a devastating impact on people’s lives. Individuals with dysthymia are more likely to receive government assistance, have high healthcare costs and have elevated rates of unemployment. If they do work, they typically work part-time or report under-achieving because of emotional problems. They also tend to be single because depression can make relationships more challenging.
People with dysthymia also are at increased risk for more severe episodes of depression. In fact, as many as 80 to 90 percent will get major depression, according to Dr. Hellerstein, who’s also author of the book Heal Your Brain: How the New Neuropsychiatry Can Help You Go from Better to Well. “It’s like if you have asthma, you are more likely to get bronchitis and pneumonia because you have this baseline condition all the time,” he said.
There’s evidence that dysthymia boosts the risk for suicidal behavior. One seven-year study found that the rates of suicidal behavior in dysthymia were similar to the rates in major depression.
Dysthymia still largely goes undiagnosed and untreated. As many as three percent of Americans struggle with dysthymia, while less than half ever seek treatment. Part of the problem is that many people mistake the symptoms for their personality, Hellerstein said. They may assume that they’re just pessimistic or self-conscious or moody. After struggling for so many years, people come to view the fog of depression as their normal functioning. If people do seek treatment, it’s usually for other concerns, such as vague physical aliments or relationship problems, he said. As a result, these individuals rarely get evaluated for a mood disorder.
Learn more: Dysthmic disorder symptoms