Research studies have suggested a significant reduction in dysthymia symptoms with antidepressants. But this is not a straightforward matter – other studies have found no improvement, so the pros and cons must be weighed up on an individual basis.
A review in 2003 found tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) to be equally effective for dysthymia. While cheaper, TCAs such as imipramine (Tofranil) were more likely to cause side-effects than SSRIs like fluoxetine (Prozac) and sertraline (Zoloft).
What alternatives are available?
A range of alternative treatments exist which may benefit dysthymia. Extracts of St John’s wort have been found as effective as antidepressants for treating mild to moderate depression. Overall, though, the evidence is “inconsistent and confusing”, according to a 2005 review.
Some favourable results have been found for omega-3 fatty acids, either consumed as oily fish or as a supplement. It’s possible that future studies will show a definitive benefit, and in the meantime, oily fish has no known side-effects and can certainly be recommended for physical health.
Other dietary supplements which may help include the B vitamins, potassium, and zinc. Of course, a healthy balanced diet is always a good idea, and making food look and smell appealing may encourage a suppressed appetite. Cutting down on, or avoiding, caffeine, alcohol and nicotine is a step in the right direction as they all have a bearing on physical and mental well-being. Seek professional help if necessary.
The herb valerian may be useful to combat the insomnia sometimes caused by dysthymia, and ginseng may benefit low energy levels. Aromatherapy, acupuncture, and other complementary therapies could also be tried.
Regular exercise is important for everyone, but can be particularly beneficial to people with dysthymia. Exercising releases the ‘happy’ chemicals called endorphins, and increases self-esteem. It will also help counteract overeating and promote good sleep.
For many people, the support of friends and family is invaluable in learning to cope with their dysthymia. Nevertheless, help and support from strangers can sometimes be easier to receive, and this is where support groups come in. Community-based support groups help many people to share their feelings, find friendship, and develop coping skills. Belonging to a dysthymia support group, together with psychotherapy, can substantially improve the chances of recovery.
Can dysthymia affect children?
Dysthymia is present in up to five per cent of children and eight per cent of adolescents. While the main symptom in adults is sadness, children and adolescents often display anger or irritable mood. It can have consequences on children’s social skills and education, later impacting on professional life and setting in place a vicious circle which may later trigger major depression.
As children with dysthymia often have multiple problems, treatment should involve a range of measures together with adequate support for the parents or caregivers.
Hopes for recovery
A full recovery from dysthymia is slow and not guaranteed, but around 70 per cent of patients do recover after four years. Of these, 50 per cent are likely to have a recurrence, so it may be sensible to continue with the successful measures which led to recovery.
A final word
Although depression can be devastating to all areas of a person’s everyday life, many people still believe that they should be able to shake off the symptoms by themselves. Because of this, people with dysthymia may not recognize that they have a treatable disorder or may avoid seeking treatment because of feeling shame or stigma. But, even if it takes several months, the majority of people can be helped to feel better.
Lastly, do call your doctor if your symptoms worsen or don’t improve despite treatment, or if you have thoughts of death or suicide.
Depression and Bipolar Support Alliance
800-826-3632 (toll free)
Depression Awareness, Recognition, and Treatment Program of the National Institute of Mental Health
MacArthur Foundation Initiative on Depression and Primary Care
National Alliance for the Mentally Ill
800-969-6642 (toll free)
American Psychiatric Association