Chronic depression is called dysthymia, and it is a less severe form of depression. The depression symptoms of dysthymia can linger for a long period of time, even two years or longer. Those who suffer from dysthymia are usually able to function adequately but may seem consistently unhappy. No one knows what causes dysthymia, but it is thought to be related to brain changes that involve serotonin, a chemical or neurotransmitter that aids the brain in coping with emotions. Serious life stresses, chronic illness, medications, and relationship or work problems may also increase the chances of dysthymia.

The symptoms of dysthymia are about the same as those of major depression, but are not as intense. The symptoms can include: persistent sad or empty feeling, sleep irregularities (sleeping too much or too little), feelings of helplessness, hopelessness, and worthlessness, feelings of guilt, the inability to enjoy pleasurable activities, loss of energy or fatigue, inability to concentrate or make decisions, changes in appetite (overeating or loss of appetite), mental and physical sluggishness, persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment, and thoughts of death or suicide.

Approximately 10.9 million Americans (aged 18 and older) are affected by dysthymia. While not as serious as major depression, dysthymia can keep a person from functioning normally. Dysthymia can begin in childhood or in adulthood and is more common in women than men.

When diagnosing dysthymia, a doctor must make sure that the symptoms are not a result of substance abuse or a medical condition, such as hypothyroidism. The depression and other symptoms must last longer than two weeks, and cause clinically significant distress or impairment in social, occupational, or other important areas of life in order to be considered dysthymia. There is no blood test or laboratory test that can be used to diagnose dysthymia, so doctors must rely on their own judgment.

A person with dysthymia may also experience major depression at the same time, swinging into a major depressive episode and then back to a more mild state of dysthymia. The addition of major depression to dysthymia is called double depression.

Dysthymia is a common and serious illness, but it responds well to treatment. Treatment of dysthymia can be psychotherapy (counseling), medications such as antidepressants, electroconvulsive therapy, or a combination of these therapies.

Psychotherapy (or talk therapy) is used in dysthymia and other mood disorders to help the person develop the coping skills necessary to deal with everyday life. Psychotherapy can also help increase adherence to medication, implement healthy lifestyle habits, and help the patient and family understand the mood disorder.

Antidepressants are available to treat dysthymia. The program of treatment must be tailored by a doctor to the patient.s needs, considering the best effectiveness with the fewest side effects. Antidepressants may take several weeks to begin working. Some common antidepressants include selective serotonin reuptake inhibitors (SSRIs) like Celexa, Lexapro, Prozac, Luvox, Paxil, and Zoloft; other drugs used are Effexor, Cymbalta, Elavil, Asendin, Anafranil, Norpramin, Adapin, Sinequan, Tofranil, Marplan, Nardil, Parnate,EMSAMTrazodone . Desyrel, Mirtazapine, and Bupropion. Reported side effects include mild insomnia and reduced sex drive, but the dosage can be altered or other drugs can be combined to limit side effects.

Electroconvulsive therapy (ECT) is another treatment that may be used if major depression or dysthymia doesn.t respond to antidepressant medications. However, psychotherapy and antidepressant drugs are usually used before any decision is made to try ECT therapy.

Being diagnosed and getting effective treatment is a major step in feeling better with dysthymia. Healthy lifestyle habits such as eating a well-balanced diet, getting regular exercise, avoiding alcohol and smoking, and being with close friends and family members for strong social support have also been shown to help those with dysthymia.

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