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Dysthymia

Dysthymia (dis-THIE-me-uh) is a mild but long-term (chronic) form of depression. Symptoms usually last for at least two years, and often for much longer than that. Dysthymia interferes with your ability to function and enjoy life.

With dysthymia, you may lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem and an overall feeling of inadequacy. People with dysthymia are often thought of as being overly critical, constantly complaining and incapable of having fun.

Symptoms Causes Risk factors Complications Prevention

Dysthymia symptoms in adults may include:

  • Loss of interest in daily activities
  • Sadness or feeling down
  • Hopelessness
  • Tiredness and lack of energy
  • Low self-esteem, self-criticism or feeling incapable
  • Trouble concentrating and trouble making decisions
  • Irritability or excessive anger
  • Decreased activity, effectiveness and productivity
  • Avoidance of social activities
  • Feelings of guilt and worries over the past
  • Poor appetite or overeating
  • Sleep problems

In children, dysthymia sometimes occurs along with attention-deficit/hyperactivity disorder (ADHD), behavioral or learning disorders, anxiety disorders, or developmental disabilities. Examples of dysthymia symptoms in children include:

  • Irritability
  • Behavior problems
  • Poor school performance
  • Pessimistic attitude
  • Poor social skills
  • Low self-esteem

Dysthymia symptoms usually come and go over a period of years, and their intensity can change over time. But typically symptoms don't disappear for more than two months at a time. In general, you may find it hard to be upbeat even on happy occasions — you may be described as having a gloomy personality.

When dysthymia starts before age 21, it's called early-onset dysthymia. When it starts after that, it's called late-onset dysthymia.

When to see a doctor

It's perfectly normal to feel sad or upset sometimes or to be unhappy with stressful situations in your life. But with dysthymia, these feelings last for years and interfere with your relationships, work and daily activities.

Because these feelings have gone on for such a long time, you may think they'll always be part of your life. But if you have any symptoms of dysthymia, seek medical help. If not effectively treated, dysthymia commonly progresses into major depression. Sometimes, a major depression episode occurs in addition to dysthymia — this is called double depression.

Talk to your primary care doctor about your symptoms. Or seek help directly from a mental health provider. If you're reluctant to see a mental health professional, reach out to someone else who may be able to help guide you to treatment, whether it's a friend or loved one, a teacher, a faith leader, or someone else you trust.

The exact cause of dysthymia isn't known. Dysthymia may have causes similar to major depression, including:

  • Biochemical. People with dysthymia may have physical changes in their brains. The significance of these changes is still uncertain, but they may eventually help pinpoint causes.
  • Genes. Dysthymia appears to be more common in people whose biological (blood) relatives also have the condition.
  • Environment. As with depression, environment may contribute to dysthymia. Environmental causes are situations in your life that are difficult to cope with, such as the loss of a loved one, financial problems or a high level of stress.

Certain factors appear to increase the risk of developing or triggering dysthymia, including:

  • Having a first-degree relative with dysthymia or major depression
  • Stressful life events, such as the loss of a loved one or financial problems
  • Interpersonal dependency where the person relies excessively on approval, reassurance and attention from others and then this approval is significantly reduced or no longer occurs

Complications that dysthymia may cause or be linked with include:

  • Reduced quality of life
  • Major depression
  • Substance abuse
  • Relationship difficulties and family conflicts
  • Social isolation
  • School and work problems
  • Decreased productivity
  • Anxiety
  • Eating disorders
  • Suicidal behavior

There's no sure way to prevent dysthymia. Because dysthymia often starts in childhood, identifying children at risk of the condition may help them get early treatment. Strategies that may help ward off dysthymia symptoms include the following.

  • Take steps to control stress, to increase your resilience and to boost your self-esteem.
  • Reach out to family and friends, especially in times of crisis, to help you weather rough spells.
  • Get treatment at the earliest sign of a problem to help prevent symptoms from worsening.
  • Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.
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