Dysthymia: Persistent Depressive Disorder

Bea Boomer’s Vital Aging Project – Day 57– 5/13/15

I had no idea what to write about today ~ for some reason, I couldn’t sleep last night.  As I tossed and turned, I tried to come up with ideas for today’s post ~ my thoughts meandered around the labyrinth of my brain and kept coming to dead ends.  After getting home from work today at 5:15 p.m., I realized that the Healthy Aging course I registed for at Ed2go starts today, which means that I have no time to come up with a last minute idea! 

So instead, I’m re-posting an article I wrote for the Ezine Articles website about Dysthymia (Persistent Depressive Disorder). My co-worker, Fred (name changed to protect the innocent) would accuse me of “phoning it in” tonight; but sometimes, that’s just the way it goes. . . . 

Dysthymia Symptoms

Jenny, a 35 year old wife and mother, has little energy to play with her two young children.  She sleeps restlessly at night, and often feels the need to take a nap during the day.  She has difficulty in making even the most minor decisions, and finds it hard to concentrate.  Jenny often feels her family would be better off without her.  For short periods of time, she’s able to pull herself out of her mood, and she’ll feel like her “old self” again.  But these periods don’t last. 

This wife and mom is suffering from the common symptoms of dysthymia, also known as persistent depressive disorder.  Other symptoms include feelings of sadness almost every day, poor appetite or overeating, low self-esteem, and loss of enjoyment in formerly fun activities.  While the symptoms aren’t as severe as those of major depression, they last longer.  Dysthymia symptoms last at least two years. 

Causes of Dysthymia

The causes behind any form of depression can be complex.  People suffering from dysthymia usually have a family background of depression. Brain chemical imbalances can be another cause. Sometimes childhood trauma that causes chronic stress can lead to dysthymia in a teenager or young adult.  Additionally, some medical conditions can be linked to dysthymia.  These include neurological conditions, hypothyroidism, chronic fatigue syndrome, and fibromyalgia.* For elderly people, dysthymia may arise due to the challenging life changes they face as they age.  This may include chronic illnesses or physical disability, brain function decline, or the loss of a spouse.  

Diagnosis and Treatment

People who have dysthymia often don’t obtain treatment – the symptoms often develop slowly and then become integrated into a person’s life, causing them to believe it’s just a part of who they are. This is especially true for those people who develop this disorder early in their lives.  However, it’s important that persistent depression is treated. People who have dysthymia are at a higher risk of developing major depression. Experts have termed this condition “double depression.”*

If a person has been suffering from a depressed mood over the period of two years and has some of the other symptoms described above, a visit to their family doctor will help.  The person will need to provide their doctor with both the physical and mental ailments that have been plaguing them. If the doctor suspects persistent depressive disorder, he or she may start with a physical examination.  This is done because dysthymia may be caused by an underlying medical condition.  Laboratory and blood tests may also be given to provide further insight.  Finally, the doctor may conduct a psychological examination.

Treatment for dysthymia involves anti-depressants, psychotherapy, or a combination of both.  There are a few types of anti-depressants that are prescribed for this type of depression; however, the most common type used are selective serotonin reuptake inhibitors (SSRIs).  Experts point out that SSRIs tend to work well for most people and have more bearable side effects than other types of anti-depressants. These drugs don’t work overnight; it may take several weeks for them to make a difference in the affected person’s life.

Psychotherapy involves talking to a mental health professional.  This can give the person some insight about the condition, as well as their own emotions, thoughts and behaviour.  A good mental health professional can help teach the person how to deal with stress, negative thought patterns, and self-defeating behaviors. Psychotherapy can provide a person with the everyday skills they need to battle their persistent depression.  They can also suggest support groups, if needed. 

Jenny doesn’t have to live the rest of her life suffering with the “grays” of dysthymia that greatly limit her happiness and well-being.  If she takes that first step by visiting her doctor and describing her symptoms, there are treatments available to help her fight back against persistent depressive disorder and take back her life. 

Sources Cited List

*Swartz, Karen, MD. The Johns Hopkins White Papers. Depression and Anxiety. 2014. Remedy Health Media: New York, NY.  Print. 



When Worry Becomes Anxiety: Generalized Anxiety Disorder

Worry is a normal emotion which is experienced as anxiety. People worry about finances (or lack thereof), their kids, their health, their jobs. . . Or they worry about the state of the economy, the high cost of living, and so on.  The only people that don’t worry are people with no stressors in their lives, and do you actually know anyone like that?

Me neither.

When once-in-awhile or moderate worrying pops up in our lives, there are some self-help techniques that we can use to help rid us of that worrisome thinking.  But what about worry that develops into extreme anxiety?

When worrying becomes so pervasive in a person’s life that it keeps him or her from functioning well, it can develop into Generalized Anxiety Disorder.  HelpGuide talks about the difference between normal worries and GAD here.

According to the National Institute of Mental Health, symptoms of GAD include:

  • An inability to shake off anxieties
  • An inability to relax – a person with GAD is often easily startled
  • Difficulties with concentration
  • Insomnia:  Difficulty in not only falling asleep, but also staying asleep

GAD sufferers may also have problems with fatigue, headaches, muscle tension, aches and pains, trouble swallowing, trembling, twitching, irritability and a variety of other physical concerns.  There’s no question that this disorder wreaks havoc on people’s lives.

It should be noted that some physical conditions may cause symptoms of anxiety, including hypo- or hyperthyroidism, low blood sugar, heart disease, gastroesophageal reflux disease (GERD)  and even menopause (Mayo Clinic Staff, 2011). If those conditions can be ruled out by a doctor, a person may have Generalized Anxiety Disorder.

You can find out about the risk factors for GAD at the Mayo Clinic website.

So how is this mental health condition treated?  Prescription medications (certain types of anti-depressants and anti-anxiety drugs) are often used.  While medications may help for the short-term, many have side effects, and can be habit-forming.  It’s best to combine a limited used of medication along with therapy to deal with the root of the anxiety problem.

The most common psychotherapy used for GAD is:

Cognitive Behavioral Therapy – The patient learns about GAD in order to understand it better.  He/she is taught to monitor their anxiety levels and what triggers their anxiety. He/she is then taught relaxation techniques, thought-changing techniques, and behavioral techniques to deal with the anxiety.

Biofeedback is another treatment option. As described in Wikipedia, “Biofeedback is the process of gaining greater awareness of many physiological functions primarily using instruments that provide information on the activity of those same systems, with a goal of being able to manipulate them at will.” (http://en.wikipedia.org/wiki/Biofeedback) In the case of GAD, the biofeedback would be used to teach the patient how to become more relaxed.

WebMD also describes some lifestyle modifications that go along with therapy.


Mayo Clinic Staff. Sep. 2011. Generalized Anxiety Disorder.

Pertinent Websites:

Anxiety and Depression Association of America

Mayo Clinic: Generalized Anxiety Disorder

Tips for coping with GAD