Dysthymia (depression)

The three main categories of depression are major depression, bipolar depression (sometimes referred to as manic depression) and dysthymia.

Symptoms of depression include sad mood, loss of interest or pleasure in activities that were once enjoyed, change in appetite or weight, difficulty sleeping or oversleeping, physical slowing or agitation, energy loss, feelings of worthlessness or inappropriate guilt, difficulty thinking or concentrating, and recurrent thoughts of death or suicide.

A diagnosis of major depressive disorder is made if a person has 5 or more of these symptoms and impairment in usual functioning nearly every day during the same two-week period. Major depression often begins between ages 15 to 30 but also can appear in children. Episodes typically recur.

Bipolar disorder cycles between episodes of major depression and highs known as mania. Bipolar disorder is much less common than the other types, afflicting about 1 percent of the U.S. population. Symptoms of mania include irritability, an abnormally elevated mood with a decreased need for sleep, an exaggerated belief in one's own ability, excessive talking, and impulsive and often dangerous behavior.

Dysthymia doesn't strike in episodes, unlike major depression, but is instead characterized by milder, persistent symptoms that may last for years. Although it usually doesn't interfere with everyday tasks, victims rarely feel like they are functioning at there full capacity. According to the National Alliance for the Mentally Ill, almost 10 million Americans may experience dysthymia each year.

Dysthymic disorder is diagnosed when depressed mood persists for at least 2 years (1 year in children) and is accompanied by at least 2 other symptoms of depression. Many people with dysthymia develop major depressive episodes.

Recognizing Depression: How Will I Know?
In general, diagnosing depression in an individual is an inexact science because everyone’s experience of sadness and other symptoms of depression are highly subjective and variable. Perhaps the most important symptoms to watch out for are excessive feelings of sadness (different for each individual), persistent inability to derive pleasure from those things that one used to enjoy, and difficulty in performing one’s usual daily activities. All too frequently in older individuals, these symptoms are simply attributed to the aging process. It is important to remember that depression is not a normal part of aging. It is a disease that can strike at any age, and it is usually treatable no matter what the age of the patient.

Symptoms

For more than two years (one year or more for children and adolescents) or more on the majority of days, depressed mood is reported or observed and two or more of the following symptoms occur:

• low self-esteem
• poor concentration
• difficulty with decision-making
• over-eating or poor appetite
• low energy
• insomnia or hypersomnia (too much sleep)
• feelings of hopelessness

During the first two years of the condition, the individual has not had a Major Depressive Episode; nor any Manic, Hypomanic or Mixed Manic episodes. They have never reached criteria for Cyclothymic Disorder. The disorder does not exist only in the context of a chronic psychosis; symptoms are not directly a result of a general medical condition or use of substances; symptoms result in severely impaired functioning in work, social or personal areas.