Dysthymia is a condition characterized bymood disturbance, characterized by depression, despondency, sadness. The second name of the disease is chronic subdepression, marked by manifestations that are not enough to establish a diagnosis of depression. The concept of dysthymia was introduced by psychiatrist Robert Spitzer to replace the term neurotic depression.
Before the appearance of the term dysthymia, diseasecalled neurasthenia or psychasthenia. For the disease is characterized by a permanent depressive mood, not reaching degrees of severe depression. Within the framework of dysthymia, short-term improvement of the condition occurs, however, their duration does not exceed two months. If the remission lasts more than two months, then one can not talk about dysthymia, but it should be noted that this is a recurrent depression.
Dysthymia and symptoms of the disease are manifested ina decrease in mood with the following manifestations: a decrease or increase in appetite, drowsiness or insomnia, lack of energy, fatigue, low self-esteem and concentration of attention, difficulty in making decisions, feelings of hopelessness, pessimism, inability to feel pleasure - anhedonia.
Diagnosis of dysthymia is made if the disorderlasts up to two years. The disease is typical for a young age, but a person often becomes informed about his diagnosis many years after the onset of the disease. In the event that dysthymia reveals itself in childhood, the patient deems himself depressed, and attributes all symptoms to character traits. Therefore, about their manifestations to doctors, relatives does not report. The detection of the disease is also hindered by psychological disorders that cover the symptoms of the disease.
The diagnosis of dysthymia is established only under conditionthe presence of symptoms for two years with a short break (up to two months). Manifestations of the disease should not be associated with the use of drugs, drugs, alcohol.
Dysthymia is not diagnosed if the patientThere are episodes of mania, depression, hypomania, cyclothymia, schizophrenia, delusional disorder. For children, as well as adolescents, symptoms are sufficient for one year, and not as adults for two years. After three years of the disease course, the symptoms of severe depression can join. In these cases, they speak of a double depression.
Up to 75% of patients with dysthymia have chronicdiseases of organic origin or psychological disorders. There are combinations of this disease with a panic attack, social phobia, generalized anxiety, somatic diseases. Those suffering from dysthymia are at great risk of developing depression.
Somatized (catesthetic) dysthymianoted complaints of satisfactory health, dyspnea, palpitations, constipation, poor sleep, tearfulness, depression, anxiety, sadness, burning in the larynx, intestines, cold in the pit of stomach. Gradually, external events no longer affect the dynamics of clinical manifestations. Characteristic (characteristic) dysthymia is expressed in persistent, persistent disorders in the form of anhedonia, melancholy, pessimism, reasoning about the meaninglessness of life, the formation of a depressive worldview. The basis is a set of losers. The picture of the world appears before them in a mourning light, the sick in everything see the gloomy sides and are born pessimists. Every joyous event appears to them like a fragile joy, and from the future they expect nothing but difficulties and misfortune. Past memories deliver remorse when making mistakes. Patients are sensitive to trouble. They are in anxious expectation of unhappiness. Constantly in a gloomy, gloomy state, they are little talkative and dull. Their behavior often repels people who are not indifferent to them. Facial expressions and all behavior imparts inhibition: impotently dangling arms, lowered facial features, slow gait, sluggish gestures. The sick quickly get tired and fall into despair. They are indecisive and ignorant, they are intellectuals, but mental work is accompanied by a feeling of great tension for them.
Dysthymia and Cyclothemia
Dysthymia must be differentiated fromcyclothymia, which is accompanied by manifestations of a mental, affective disorder in which mood jumps between close to dysthymia manifestations and hypertension with episodes of hypomania are inherent.
In cyclotemia, pathological changesoccur as separate, as well as double episodes, separated by mental health states or alternating continuously. The concept of cyclothymia was originally used to describe bipolar disorder, and the traditional classification considers it as an easy and not expressed variant of general cyclophrenia.
The disease is treated very difficult, because toit is strong resistance (resistance), which is characterized by a constant presence of signs of mood disturbance, but not leading to a depressed state.
It happens that depressive manifestations within dysthymia become more complicated and a clinical picture of severe depression is noted. This condition is called double depression.
There are patient testimonials that thisthe disease in them is well treatable with sertraline in a therapeutic dose of 50 mg per day. Often, patients make mistakes when taking antidepressants from different groups or when they performed non-systematic treatment in the early phases of treatment.
Dysthymia includes in the treatment of such antidepressants: Amelipramine, Imipramine, Amitriptyline, Anafranil, Clomipramine.
Good results are given by such drugs asSulpiride, Amisulpride. Sulpiride is an atypical antipsychotic with a moderate antipsychotic effect with a weak antidepressant and also a psychostimulating effect. It is necessary, under the supervision of physicians, to carry out consistent and correct treatment according to specially selected regimens.
Amisulpride is an antipsychotic related to atypical antipsychotics. Antipsychotic action combines with a sedative (sedative) effect.
Great importance in the treatment of dysthymia renderscognitive psychotherapy. Individual psychotherapy, group therapy, and support groups that allow the patient to develop interpersonal communication and assertiveness (open, direct behavior) have successfully established themselves, increasing self-confidence.
Prevention of dysthymia includes the timely detection of signs of the disease and increasing the level of self-esteem rights.