What is Chronic Depression (Dysthymia)

According to estimates made by mental health institutes, about 10.9 million people in America, aged 18 and above, suffer from chronic depression. Depression is defined as a mental condition wherein there is an overwhelming feeling of sadness. At some time or the other, most people experience feelings of sadness in response to a sad event or a loss, however, this is usually a temporary state of being. When the sadness lasts for a longer time, and the symptoms of depression may subside for a short period only to resurface again, it is referred to as chronic depression, also called dysthymia. Chronic depression is generally considered a milder form of depression, although it is characterized by lingering for a longer period of time, sometimes even years. Those who are afflicted by dysthymia usually are able to carry on their day-to-day activities adequately enough, but just are constantly unhappy.

What are the Causes of Dysthymia
While it is well-known that a traumatic or sad event can often lead to depression, it is not known yet what causes chronic depression. However, some of the factors associated with dysthymia are: fairly substantial levels of stress; an imbalance of chemicals in the brain; and heredity. Stressful situations in an individual's life, like years of neglect or abuse during their childhood, can lead to chronic depression later in life. The stress of chronic illness, like hormonal disorders, some chronic cardiac conditions, Parkinson's disease, and AIDS can also bring about chronic depression. According to studies done on the functioning of the brain, it has been observed that a complex system of neurotransmitters in the brain produce chemicals, which transmit signals between nerve cells. Serotonin, which is one of these neurotransmitters, creates a feeling of happiness or well-being. Drugs that are used for correcting the imbalances of neurotransmitters are very effective in the treatment of depression, which is why it is thought that depression may be triggered off by chemical imbalances in the brain. And as far as heredity is concerned, it has been observed that depression often runs in families.

It is often quite usual for people affected with chronic depression to also undergo bouts of major depression simultaneously. That is they can slip into an episode or two of major depression and then get back again to the milder form of dysthymia. This condition is referred to as double depression.

How can Dysthymia be Diagnosed
If you experience the symptoms of depression for over two weeks, it is important to consult a psychiatrist or your doctor. The medical professional will carry out a comprehensive medical evaluation, with particular attention being paid to the psychiatric history of your family's as well as your own. There are no laboratory tests such as X-rays or blood tests involved in the diagnosis of dysthymia. A specialist in mental health usually diagnoses chronic depression on the basis of the symptoms of the individual. With dysthymia, the symptoms of depression will generally be less severe and have lasted longer compared to people afflicted with major depression.

What are the Symptoms of Dysthymia
The symptoms of chronic depression are similar to that of major depression, only if observed for at least two years in adults and about one year in children. They include:

• Difficulty in falling asleep
• Fatigue or lack of energy
• Inordinate feelings of worthlessness or guilt
• A lack of interest as well as the loss of being able to enjoy oneself
• Discernible physical and mental sluggishness
• Changes in the appetite
• Difficulty in making decisions, thinking, and concentrating
• Constant thoughts of suicide or death

Treatment Options for Dysthymia
Although chronic depression is a serious condition, it can be treated. Dysthymia is usually treated by combining psychotherapy and drugs. Drugs help to correct chemical imbalances as well as to treat the symptoms of sadness. Psychotherapy helps in resolving personal issues that could be responsible for the depression.

There are many types of antidepressants that are used in the treatment of chronic depression such as: SSRIs or selective serotonin reuptake inhibitors, like sertraline and fluoxetine, which help by increasing serotonin levels; TCAs or tricyclic antidepressant, such as nortriptyline, imipramine, and amitriptyline; and MAOIs or monoamine oxidase inhibitors, which include phenelzine and anylcypromine, which work by inhibiting or blocking the action of monoamine oxidase, which is an enzyme, in the central nervous system. However, all these drugs have side effects and must be taken under medical supervision.

Young people who develop dysthymia often do not realize that they are ill. They believe their symptoms to be a part of their personality. This belief can create a situation where it becomes difficult to change and the negative outlook towards life and their surrounding world can lead to suicidal tendency. But there is hope, patients need not consider life to be a long stretch of pain and suffering as dysthymia is a treatable illness.