What is Dysthymia

Dysthymia or PDD —  The Mental Problem that Slowly Kills You Inside

In these trying times, depression is already a huge mental health issue in India. Did you know that there is a big brother of depression? Well, not exactly a big brother, kind of more like a nasty cousin. It is called dysthymia  —  and it’s a rather new one in the list of mental health problems.

It is a relatively new diagnosis in the field of psychiatry. Previously, mental health patients with similar types of issues were diagnosed as having a chronic major depressive disorder. But these cases are becoming so common and somewhat different from standard depression, that psychologists had to separate it into its own new category of mental health disorder.

What is Dysthymia

Dysthymia is a kind of depression that may not be very strong, but that remains with you constantly, for a long, long time. It becomes your very nature to feel down at all times, feel hopeless, not having any interest in the activities of life, not having the mood to do anything substantial, feel hopeless, etc. 

Previously, this issue was called Persistent Depressive Disorder (PDD) and doctors used to think it was a part of normal depression. Well, turns out, it can be something bigger, actually. 

Unlike depression, dysthymia hits women twice as much as men. It affects your whole life continuously and is not just a phase that you go through. PDD changes what you intrinsically like or dislike (dislike, in most cases). It affects how you eat or sleep, it affects how your general health is, and it affects the whole of who you are.

Because dysthymia grows so slowly and gradually and stays on for years and years, it is very hard to detect. It becomes a part of your very nature, it becomes who you are.  That’s a scary thought if you ask me. Being imprisoned in your own mind for a decade or more? I wouldn’t wish on an enemy. 

Symptoms of Dysthymia

At first look, dysthymia or PDD does look a lot similar to standard depression. You have all the standard depressive disorder symptoms; i.e. having constantly low mood, low self-esteem, feeling sad or hopeless for no apparent reason, not being able to enjoy any life activities, not being able to have fun, being indecisive and lazy, low social contact, etc. 

But the major way dysthymia differs from depression is TIME. regular depression, while a long-term mental health issue by itself, doesn’t last too long. It comes for a good reason and as the cause is removed, it goes away. This makes depression easier to treat. Generally, you will find most people having depressive phases for up to 10 months, not much more.

However, the symptoms of dysthymia as mentioned above can last years and years, without any reason you can find. It develops gradually in late childhood or adolescence, continuing well through the youth, and lasting even into adulthood. Of course, 30-year old dysthymia is not that common, but the nature of the issue is like that.

Because it starts growing in teenagers in most cases, many teen psychological behaviors are symptomatic of dysthymia. Often you can see some kids who get angry easily, are pessimistic in their worldview, moody, and lonely. They may cry alone. They may have difficulty in achieving good grades at school despite having an intelligent and powerful brain. And they will almost certainly have problems socializing with other kids their age. Take care, these can be early symptoms of an onset of dysthymia.

Changes in eating habits are also associated with depression, and so you will find that in dysthymia. Only, with dysthymia, it would not be so much as a change but as a lifestyle. People with PDD often have odd kinds of appetites like impulsive eating or hating food altogether. They may even have odd tastes or odd timing of hunger.

What Causes Dysthymia

Unlike depression, it is hard to figure out what causes PDD or dysthymia. Again, the reason behind this is time. Since a lot of things happen over years of life, it would be hard to tie something single to this problem.

However, since dysthymia seems to start on its own without much external reason, many doctors theorize that it is tied to some physical issue. The patient may have the following causes of dysthymia: 

• Chemical imbalance in the brain or nervous system
• Genetic reason  —  family history of chronic depression
• Other mental health issues (bipolar disorder, for example)
• Continuously stressful adolescent life (we will talk more about causes of depression in children due to parental behavior another day)
• Unresolved grief  —  not getting over the loss of a loved one
• Some kind of long-lasting physical disease is almost guaranteed to cause PDD
• Brain injury from accident or sports
• Close association to another depression patient in the childhood, because children copy behavioral patterns

Treatment of Dysthymia

First of all, it is hard to know that you have dysthymia or PDD at all, due to the length and nature of the mental health problem. Because it starts so early in life and continues without much break, you are absolutely doomed to think that it’s just your normal life. 

If the issue is not too apparent, then you may not need to see a doctor. If you are still able to carry out a normal life in spite of having a generally low mood, then it isn’t a problem and indeed is just your nature. Don’t fix what isn’t broken, that is to say.

But unfortunately, mental health disorders have the nature of going bad to worse if left untreated. Depression itself and dysthymia can bring about certain complications and further degradation of life, such as:

• Anxiety disorder  —  being worried about nothing, all the time
• Substance abuse  —  depending on drugs to be artificially happy
• Relationship issues  —  not being able to have a successful, healthy relationship
• Sexual issues  —  low or no sexual urges, erectile dysfunction, etc.
• Work issues  —  low productivity, extreme laziness, unable to concentrate
• Multiple personalities —  escape through being another person, not remembering what you did for a few hours at a time
• Crying quietly when alone
• Suicidal thoughts and behavior
• Self inflicted injuries
• Development of other psychological disorders

When you see even one of the above in your life, run to the nearest qualified psychologist in India. They would be able to help you.

There are two ways dysthymia can be treated  —  prevention and cure. Let’s see about them one by one.

Prevention of dysthymia

Since it starts in children the most, you can take certain steps to try and prevent the onset of dysthymia in your child.

1. Control stress  —  create a stress-free environment and viable outlets for venting.
2. Communicate  —  talk more with people to reduce the tensions within the mind.
3. Stay alert  —  get to a doctor at the first sign of a problem.
4. Regular checkups  —  the mind requires regular maintenance just as the body does.

Cure of Dysthymia

In most cases of depression including PDD, CBT (Cognitive Behavioral Therapy) is the best way to fix it. It is a wonderful way of talking your problems out. However, in most cases in our society, when the patient finally goes to the doctor they are not much willing to open up. For that reason, most doctors give some medications first.

Medicines

To get medicines for depression, you have to consult a psychiatrist or a neurologist, because only they are licensed to give medicines that work on the brain. Depending on your condition, they would start you with a light or heavy anti-depressant drug, and they may also combine it with some anxiety medicine if required. Some heavy antidepressants have side effects, so you can expect some balancing medication as well. 

One thing you need to remember  —  since the disease didn’t happen in a day, don’t expect to see improvements in a day either. Whatever medicine you were given, you have to keep taking them regularly and routinely for a good amount of time before you feel anything changing. And even that will happen gradually as well, so, patience is the biggest factor in curing dysthymia.

Therapy

Unless your depression was a result of purely physical or genetic reasons, don’t expect the medicines to cure your dysthymia completely. You cannot take meds indefinitely and it is actually dangerous to do so if the root of the issue is something else (you will develop a tolerance for the medicine and require larger and larger doses).

When the cause of a mental health disorder is rooted in your mind, in your past, in your life, then therapy is the best and sometimes only way to fix it. As we have mentioned before, CBT is one of the best ways to cure anything related to depression and anxiety. It will find out how you see things around yourself, and how you feel about the past life events; and then it will change those distorted views.

CBT is a wonderful process of discovering yourself and changing yourself. Even if you think you are fine, you should sometimes go and talk to a therapist in India. You will find out so much about yourself, and gain more control over yourself.