What is dysthymia?
Dysthymia, persistent depression disorder, or constant depression disorder is a type of depression characterized by its chronic nature, lasting longer than two years, but with a severity ranging from mild to moderate.
A patient with Dysthymia may suffer from constant fatigue, lack of energy, low self-esteem, difficulty thinking through decisions before making them, as well as sleep disturbances, along with impaired appetite and persistent pessimism.
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Who is affected by persistent depressive disorder?
Constant Depressive Disorder can affect anyone, but the chances of developing it increase in the following groups:
- Positive family history: The more family members (especially first-degree relatives) who have this disorder, the higher the likelihood of developing it.
- Previous trauma: Individuals who have experienced psychological trauma are more likely to develop this disorder.
- Females: This disorder is more common in females than in males.
- People with mental health disorders: They are among the most susceptible to this disorder.
- Children: The chances of developing it increase between the ages of 13 and 18 y.o.
- Personality Traits: Low self-esteem or chronic negativity.
- Chronic Illness: Physical health problems like pain.
- Substance Use: Alcohol or drug misuse.
How common is constant depression disorder?
The prevalence of Constant Depressive Disorder can be expressed as follows:
- Adults: Affects 1.5% to 3% of adults in any age group.
- Gender: Affects females more often than males.
- Children: Affects children between the ages of 13 and 18, accounting for 11% of this age group.
- Severity: Less severe than major depression.
- Onset Age: Often before age 21.
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What are the symptoms of persistent depressive disorder?
This patient is experiencing a range of symptoms, including:
- Consistently low mood.
- Persistent fatigue and low energy.
- Sleep disturbances, including insomnia or excessive sleep.
- Appetite disturbances, including overeating or loss of appetite.
- Low self-esteem and feelings of worthlessness.
- Difficulty concentrating.
- Loss of interest.
- Feelings of hopelessness or pessimism.
- Irritability or excessive anger.
- Indecisiveness or difficulty making decisions.
What causes constant depression disorder?
Several factors can contribute to an increased risk of developing this disorder, including:
- Brain chemistry and structure: Constant Depression Disorder may arise from the structure of the brain or from a change that has occurred in it. It has also been proven that there is a strong relationship between this disorder and the occurrence of an imbalance in some neurotransmitters, the most famous of which are serotonin, dopamine, and norepinephrine.
- Environmental factors and trauma: This disorder actually arises as a result of a person going through difficult events in the early stages, such as neglect, deprivation, loss of a loved one, or addiction. This disorder may also become violent when going through a period of financial difficulties or chronic illnesses.
- Genetics: Genes can indeed contribute to the transmission of such diseases within families.
- Chronic illness: A chronic illness can cause a patient to suffer from Constant Depressive Disorder.
- Personal reasons: It is very possible that a person may develop this type of disorder as a result of his constant desire to achieve perfection in everything, or his constant tendency to undervalue himself.
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What are the risk factors for persistent depressive disorder?
Several factors can increase the likelihood of developing this disorder, including:
- Genetics: The chances of developing this disorder increase if a close relative, especially a first-degree relative, has it.
- Chronic stress: Living under constant psychological and emotional stress can increase the likelihood of developing Constant Depressive Disorder, such as living in difficult financial circumstances or lacking social support.
- Psychological factors: A person may suffer from depression as a result of consistently negative thinking, a persistent tendency towards pessimism, and a failure to see positive aspects.
- Gender: Women are more likely to suffer from this disorder than men.
- Age: Such disorders often begin during a young age.
How is persistent depressive disorder diagnosed?
Initially, to diagnose Constant Depressive Disorder, a person must be experiencing depression and exhibiting two or more of the previously mentioned symptoms.
In addition, several factors are considered, including:
- Duration: Symptoms must be present for two years or more in adults, or at least one year in children.
- Persistence: Each episode must be continuous and last for at least two months.
- Exclusion: Any other disorder that may be contributing to these symptoms must be excluded.
- Impairment: This refers to the significant and negative impact these symptoms have on a person’s personal and professional life.
The assessment process consists of three steps:
- Clinical interview: The specialist thoroughly evaluates the patient and determines the severity of their symptoms.
- Mental status exam: This assesses the patient’s psychological, mental, and emotional state, as well as their appearance and overall well-being.
- Medical tests: A series of tests, such as blood and urine analyses, are conducted to rule out any other underlying conditions that may be contributing to the symptoms, such as thyroid problems or vitamin deficiencies.
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What is the difference between persistent depressive disorder in children and in adults?
The symptoms of this disorder differ between children and adults in several ways, including:
- Duration: Symptoms need to persist for two years in adults and one year in children.
- Mood: Children tend to be irritable, impulsive, and restless, while adults tend to experience persistent sadness.
- Impact: In children, the disorder affects academic performance, exams, and social relationships. In adults, depression can be so long-lasting that others become accustomed to it as a normal part of the patient’s personality.
How is persistent depressive disorder treated?
Constant Depression Disorder is treated with a combination of psychotherapy and medication, along with a range of lifestyle changes.
Psychotherapy includes:
- CBT: This involves identifying and modifying negative beliefs and behaviors to create positive ones.
- IPT: This focuses on resolving problems related to social relationships.
- IOP: This involves investigating the main factors and causes contributing to the development of depression in order to address and eliminate them.
Regarding medications, SSRIs and SNRIs are used in most cases, but other medications may also be used, such as TCAs and MAOIs. Each of these medications may take several weeks to show noticeable results, and the medication or its dosage should not be changed randomly without consulting a doctor.
There are also some lifestyle changes needed to achieve the best possible outcome, including:
- Regular exercise to improve mood.
- Establishing a routine for daily activities.
- Enlisting the support of friends and family to prevent isolation.
- Nutrition/Sleep: Balanced diet and sleep hygiene.
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Side Effects of persistent depressive disorder treatments
There are some side effects that may appear while using medications for Constant Depression Disorder. For example, SSRIs can cause stomach upset, insomnia, fatigue, and decreased libido.
SNRIs have very similar side effects to SSRIs, with the addition of some blood pressure increases and dizziness. TCAs can cause dry mouth, constipation, or blurred vision.
Does persistent depressive disorder ever go away?
Constant Depression Disorder is difficult to consider curable, but it is considered highly manageable.
It is a chronic disorder, but its symptoms are not severe, and it can be controlled with available treatments; spontaneous recovery is rare.
Relapse Risk: 60-80% recur after stopping medication.
Early Treatment: Better long-term outcomes with prompt intervention.
How can I prevent persistent depressive disorder?
There is no direct way to prevent this disorder, but there are some practices that can be followed to reduce the likelihood of experiencing it, including:
- Regular exercise.
- Learning to manage daily stress.
- Avoiding any addiction.
- Understanding various forms of psychotherapy.
- Strengthening relationships with friends, family, and relatives.
- Healthy sleep: 7-9 hours nightly maintains mood stability.
- Balanced nutrition: Omega-3s، vitamin D، avoid processed foods.
- Early intervention: Treatment at first signs prevents chronicity.
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When to Contact a Doctor?
You should contact a doctor if your mood is consistently low throughout the day, if symptoms occur daily for more than two weeks, or if these symptoms are debilitating and interfere with your daily life and activities.
You should also consult a doctor urgently if you experience recurrent suicidal thoughts or an increased tendency to harm yourself.
At BritMed Healthcare, we provide the necessary support for patients with Constant Depression Disorder through our team of highly qualified and experienced psychiatrists.