Dysthymia - what is it? Causes and symptoms, treatment. Difference between chronic depression (dysthymia) and clinical type Dysthymia treatment according to international standards

Depressed mood, lack of systematization in social and personal plans, and a constant focus on negative details are symptoms of a chronic form of depressive syndrome, which does not tend to develop into a clinical form of this mental disorder. This condition is called dysthymia. Currently, the incidence of pathology among the population of the countries of the former Soviet Union is increasing. Women who constantly feel psychological pressure from many circumstances are more susceptible. First of all, this is facilitated by the imbalance in the distribution of gender responsibilities of the individual.

The need to independently resolve all domestic, material and social issues does not allow a woman to fully realize the instinct of motherhood. Imposed constant anxiety for the future of their offspring. Often, patients do not have a stable position of internal security on the part of their husband, father, and other members of the stronger sex. Thus, experts come to the conclusion that dysthymia in the modern world is a direct consequence of emancipation.

However, men can also be affected by this disease. Their dysthymia overtakes as a result of the realization of their failure in various social spheres. In men, dysthymia often develops against the background of a midlife crisis. Pathology in view of the absence of obvious signs can proceed unnoticed for several years. Resolution occurs in the classic form of depression or ends in suicide attempts.

The main clinical sign of dysthymia is the absence of pronounced symptoms of a depressive state. It can develop in adolescence in the form of various inferiority complexes in the presence of a hereditary component.

The vast majority of diagnosed cases of dysthymia have a hereditary and family background. The influence of the lifestyle of the parental family and the attitude of its members to their own lives and the events taking place around is undeniable. Patients have a persistent negative assessment of any facts, surrounding things and people. With a high degree of probability, they can be attributed to the group of pessimistic introverts.

However, no reliable cause has yet been identified. The situation is aggravated by the systematic use of alcoholic beverages and drugs. Also, a psychologically difficult life situation can become a provocative factor, for example, the death of a loved one, betrayal, unrequited love, loss of a job or social status, a midlife crisis.

Approximately 30% of patients diagnosed with dysthymia have a latent or not clearly expressed mental pathology with a chronic course. This may be an increased anxiety status, a mild form of schizophrenia, oligophrenia.

In adolescence, dysthymia is more often transient and is a direct consequence of hormonal changes in the body. Low self-esteem and a lack of personal education can have a negative impact.

Elderly people suffer from chronic depression against the background of social loneliness and the development of hydrocyanic dementia (dementia). It is not necessary to exclude organic damage to brain structures and the influence of a somatic disease that worsens the quality of life (chronic heart, kidney, liver failure, diabetes mellitus, the consequences of ischemic or hemorrhagic strokes).

Symptoms of dysthymia

The characteristic symptoms of dysthymia can only be detected by constant communication with the intended patient. Symptoms usually develop gradually over several months. In this regard, the manifestation of dysthymia is often written off as a consequence of various life problems and difficulties, which in their essence are, on the contrary, the result of a depressed mental state.

It is worth paying attention to the following symptoms of dysthymia:

decreased interest in the events taking place around;
a gloomy daily mood, in which eating, walking, communicating with loved ones does not bring joy;
painful feeling from the need to perform professional and social duties;
a feeling of the presence of hopelessness and hopelessness in the reasoning of a person;
regular disturbances of night sleep, in which insomnia may alternate with constant drowsiness;
feeling of constant weakness, fatigue, loss of strength;
a decrease in the level of assessment of one's abilities and capabilities (a person constantly begins to say that all this is beyond his power);
eating disorders, which can be expressed both in an increase and in a decrease in appetite;
lack of ability to focus on important matters and facts.

With a detailed diagnosis, the specialist reveals complete personal infantilism, in which for the individual there is not even a hypothetical possibility of solving his problems.

There are certain differences in the symptoms of dysthymia in adolescents and adults. In juvenile age, this form of chronic often provokes an increased level of irritability, anger, and a negative attitude towards any attempts to interfere in personal space from the outside. But one should carefully differentiate this state from the manifestations of the transitional period in which the formation of personal qualities takes place.

Treatment methods for dysthymia

Currently, there are no drugs that would be able to completely cure dysthymia. In severe cases, antidepressants are prescribed. However, it is worth knowing that their impact on patients with this form of depression is much lower than with the classical form.

Possible groups of pharmacological agents:

serotonin (feel good hormone) inhibitors (sertraline, prozac, cipralex);
inhibitors of norepinephrine (a hormone that is responsible for the activity of all chemical metabolism processes in the human body) with direct action (wellbutrin or belpropion);
antidepressants of the tricyclic group (they are distinguished by a quick addiction process and negative consequences after the sudden withdrawal of the drug);
monooxidase activators (used only in clinical forms accompanied by suicide attempts).

Regular, well-constructed psychotherapy gives maximum efficiency. The main task of the psychologist is to teach the patient to control his thought process with the exclusion of the negative associative series from it. Methods of cognitive behavioral correction and psychological dynamics are used with consideration of cause-and-effect relationships between events and their negative perception.

Prognosis for dysthymia

The main danger of dysthymia in the prognosis for human life lies in systematic suicide attempts, which sooner or later may be crowned with “success”. Therefore, when symptoms worsen, relatives or close people need to show the patient to a psychiatrist as soon as possible, since the person himself may no longer be accountable for his actions.

In the absence of adequate treatment of dysthymia, psychological social adaptation is gradually violated. Patients cannot perform their professional duties qualitatively, pay attention to the family. As a result, they lose their jobs, close people and plunge into loneliness. In no case should this be allowed, since the prognosis of dysthymia is pronounced negative.

The concept of dysthymia (minor depression) is in many ways similar to the concept of neurotic depression (or), in the ICD-10 these disorders are included in the group of persistent affective disorders and have one coding (F34.1). To better understand the essence of the disease, imagine chronic depression that lasts for years, but is never deep enough for a depressive diagnosis. This will be the state of dysthymia. Due to the erased nature of the symptoms, people often neglect to seek medical help and do not receive the necessary treatment, even if chronic fatigue syndrome and other manifestations of the disease cause them a lot of trouble in their daily and professional activities. Dysthymic disorder is dangerous in that it greatly increases the risk of subsequently getting severe clinical depression.

What are the causes of dysthymia?

The development of dysthymia, like any affective disorder, can be influenced by both endogenous and external factors. Chronic depressive mood is more associated with the biochemical processes of the brain, namely with the production and transmission of serotonin. The reasons for the work of neurotransmitter systems that are different from the norm can be purely genetic or situational in origin. In the first case, dysthymic disorder can begin even in early childhood, while its symptoms are often mistaken for the characteristics of the child's character. But the onset of the disease in adulthood is usually due to psychogenic situations, for example, the loss of someone close or severe stress. Such a form of the disorder as endoreactive dysthymia develops due to the interaction of endogenous and psychogenic causes. The following factors increase the risk of developing dysthymia:

violation or absence of a normal regime of rest and work;
poor nutrition, lack of vitamins and minerals for the normal functioning of the body;
childhood psychological trauma (lack of parental love, family conflicts, upbringing in an incomplete family, cruel attitude and increased demands);
special personality traits (pedantry, a tendency to pessimism, low activity and energy), the nature of the neurotic warehouse, the features of the functioning of the nervous system;
chronic physiological diseases;
life in a stressful environment.

Features of the course of the disease

Dysthymic disorder most often begins in youth, sometimes even in childhood. Although some forms of the disease, for example, endoreactive dysthymia, can begin even during the period of involution. This chronic depressive mood usually lasts more than two years, sometimes much longer. In its course, dysthymia resembles, however, it does not reach it in terms of clinical signs. Low mood and other subdepressive symptoms last for months, and relatively positive periods are much shorter (a few days or weeks). With an early onset of dysthymia, relapses with vivid symptoms occur more often. After three years of the course of the disorder, most patients develop single or recurring major depressive episodes. It is noteworthy that about 75% of patients suffer additionally from another mental or chronic physical illness, such as alcohol or drug addiction, dissociation, social phobia, anxiety or panic disorder. For dysthymia, as well as for, it is characteristic that the person as a whole maintains a normal level of functioning in the family and society.

How to determine the presence of dysthymia? The most characteristic symptoms are identical to the classic depressive ones - anhedonia (inability to enjoy pleasure), low self-esteem and depressed mood. However, they are not so pronounced, so dysthymia sometimes, like masked depression, hides behind somatic manifestations and general malaise, which complicates diagnosis and treatment. During the course of the disease, the following somatic, mental and cognitive symptoms are most often observed:

taciturnity, avoidance of social contacts;
a tendency to reflect and regret about the past, a pessimistic assessment of prospects;
decreased ability to perform daily tasks;
despair, self-doubt, feeling of hopelessness;
loss of interest in previously favorite activities;
decreased concentration, activity and energy levels;
sleep and appetite disturbance, tearfulness, chronic fatigue syndrome.

Varieties of the disorder

Dysthymia is divided into primary, not associated with a previous mental illness, and secondary, which usually develops against the background of another somatic or mental illness. The primary form of the disease is characterized by an earlier onset. A secondary disorder is often associated with external traumatic circumstances. The secondary category also includes endoreactive dysthymia, isolated due to the vital nature of the clinical picture with hypochondriacal and anxious experiences. According to the symptoms, such forms of dysthymia are distinguished: characterological and somatized. The somatized form of the disorder is characterized by the fact that the patient mainly complains of feeling unwell, unpleasant physical sensations in the region of the heart or gastrointestinal tract. Somatic symptoms come to the fore: interruption of sleep, tearfulness, tachycardia, intestinal obstruction, shortness of breath. The characteristic type of dysthymia is characterized by the predominance of a depressive outlook on life in a person. Such people are convinced pessimists, they do not know how to have fun and constantly mope. Previously, such traits were considered a feature of temperament. Today, this point of view is questioned, most psychiatrists consider such manifestations to be a consequence of early dysthymia.

Diagnosis and treatment of dysthymia

The fact that the symptoms of depression are expressed implicitly often leads to the fact that the patient is silent about them, so the diagnosis is not immediately made. In order to prescribe the correct treatment for the diagnosis of minor depression, in addition to assessing all clinical criteria, it is necessary to exclude anxiety-depressive syndrome, some variants of schizophrenia, exposure to toxic substances and other psychotic diseases. Diagnosis is difficult if the patient mainly complains of physical malaise, and hides depressive symptoms. In such cases, dysthymia, like masked depression, is not detected, and treatment becomes meaningless. Therefore, be sure to tell a psychologist or psychotherapist before prescribing treatment about a bad mood, despondency, fatigue and pessimistic views, even if you consider this a feature of character. How to overcome such a chronic low mood syndrome as dysthymia? Treatment begins with the selection of antidepressants, most often SSRIs are used. Hospitalization is required in rare cases when dysthymia has an extremely negative impact on social adaptation and the quality of life of a person. Not the last place in the treatment is occupied by methods of psychotherapy. Support groups are especially effective, they allow you to overcome the “loser syndrome” and learn how to build interpersonal relationships.

A lot of people are prone to depression of various kinds. And some of them are faced with a mental disorder against the backdrop of a regular decrease in mood. Being in a state of sadness, despondency and depression, a person does not notice how he falls ill with dysthymia.

What is dysthymia

A mild form of depression (chronic) is dysthymia. It is characterized by periodic mood swings from normal to depressed. The duration of each of the periods is influenced by individual factors. Without effective treatment, dysthymia can develop into a more severe mental illness.

Most often, dysthymia occurs in people at a young age. The risk of developing pathology is higher in women than men. The impetus for the development of the disease can be a lack of attention, disappointment, harassment of any kind and emotional shock.

Over time, the disease corrodes the personality of a person. There is a decrease in self-esteem, pessimism, avoidance of positive moments, tearfulness and a persistent decrease in mood, alternating with a normal state. For the most part, dysthymic carriers experience lethargy and fatigue, a lack of pleasure (an inability to rejoice).

Patients with dysthymia are characterized by a lack of critical attitude to their disease, denial of pathological symptoms and unwillingness to see a doctor.

Dysthymia: causes

Among the causes of dysthymia, only 3 are distinguished:

hereditary(genetic predisposition).
Personal(difficulties in personal life and at work).
Serotonin deficiency(happy hormone).
According to research, there is a hereditary factor in the development of dysthymia. There is a risk of a mental disorder in the presence of relatives who were carriers of the disease. Predisposition and a number of provoking circumstances can lead to dysthymia.
Often the formation of dysthymia is facilitated by restless childhood years. Parental suppression and lack of attention on their part, as well as violence, give rise to pessimism, persistent feelings, low self-esteem and an inability to perceive positively. All this is a provoking factor in the development of the disease.
There are frequent cases of the formation of dysthymia in adults. Constant frustration, stress, disappointment and other negative effects of the mental plane deplete the nervous system. This can lead to the development of dysthymia.
Serotonin is the main link in nerve cells. Its synthesis requires natural light. Thanks to the hormone of happiness, mood regulation, the manifestation of emotions, the emergence of sleep and appetite, as well as other processes no less important for human life, occur. With a lack of serotonin, chemical processes in the brain can lead to the development of dysthymia.

The formation of dysthymia can also contribute to the environmental factor, chronic diseases of a physical and mental nature, family history and various negative influences that suppress the psyche.

Dysthymia and mood (video)

The video explains what dysthymia is. Symptoms of this pathological disease. Reasons for bad mood. Recommendations for improving the mental state of the patient.

Symptoms. Characterological and somatized dysthymia

The course of a mental illness may be accompanied by the following symptoms:

Sluggish state (slowness in performing tasks).
Rapid fatigue (the appearance of a feeling of fatigue, a decrease in energy potential and performance).
Pessimistic attitude (criticality to own failures, lack of enterprise, negative expectations).
Decreased self-esteem (doubt in yourself and your abilities, distrust of yourself).
Feeling of hopelessness (constant stay in sadness, lack of faith in the best).
Sleep problems (or,).
Severe indecision (problems with choice, increased caution, scrupulousness).
Poor concentration (problems with perception and memory, inattention).
Loss of appetite (starvation or overeating).
Decrease in efficiency (choosing a difficult path and making it more difficult to solve the tasks).
Somatic pathologies (violation of the work of internal organs and systems).

The disease can manifest itself in different ways. Therefore, there are 2 types of dysthymia:

Somatized.
Characterological.

For somatized dysthymia the following symptoms are typical:

bad feeling;
increased heart rate;
dyspnea;
sweating;
frequent awakenings during sleep;
tearfulness;
tremor of the limbs;
vestibular disorders;

In the initial stages of somatized dysthymia, periods of low mood and anxiety can fluctuate under the influence of surrounding circumstances. Subsequently, the dynamics becomes permanent, when a feeling of anxiety and anxiety is replaced by physical impotence and a decrease in activity. And the place of tension is taken by lethargy or self-observation is activated.

Characterological dysthymia due to the following symptoms:

loss of the meaning of life;
blues;
decrease in self-esteem;
guilt;
pessimism;
expectation of failures and misfortunes;
joyless and dull perception;
failure to attach importance to bright life events, their quick forgetfulness.

Over the years, characterological dysthymia forms a depressive worldview in the patient, cultivates a loser complex. Not excluded. Women are more prone to dysthymia.

Diagnostics

For effective treatment of dysthymia, correct and timely diagnosis is necessary. For a diagnosis to be made, the following conditions must be met:

Use of a special set of questions to identify mental illness.
Identification of several symptoms at once.
The presence of a persistent decrease in mood for at least 2 years.
The presence of symptoms for two consecutive months or more.
Differentiation from major depression and mixed states, episodes of mania (hypomania).
Lack of association with delusional disorders and.
Exclusion of the diagnosis of cyclothymia.
Exclusion of the influence of alcohol, drugs and medications.

For children, the minimum period of symptomatic manifestation is 1 year (in adults - 2).

Treatment, antidepressants for dysthymia

Therapeutic measures aimed at eliminating dysthymia imply an integrated approach that is considered more effective. It includes medication and psychotherapy.

Medications:

antidepressants ("Amitriptyline", "Imipramine", "Clomipramine", "Sinequan");
selective serotonin reuptake inhibitors (SSRIs), including Zoloft, Lexapro, Prozac, Cellex, Luvox and Paxil;
SSRIs and norepinephrine (Cymbalta, Effexor);
mood stabilizers (lithium).

Psychotherapy:

individual consultations of a psychotherapist (solving personal problems with the help of a specialist);
group therapy (increasing self-esteem, getting rid of negativity, finding the meaning of existence);
family assistance (rendering psychological support from relatives and relatives).

With somatized dysthymia, the following drugs are effective:

traditional antidepressants ("Anafranil", "Velaksin", "Fluoxetine");
dual action antidepressants to eliminate symptoms and improve mood (Coaxil, Lerivon, Moclobemide, Pyrazidol).

With characterological dysthymia, long-acting antipsychotics and antidepressants are used for behavioral adjustment. Of the antipsychotics, Haloperidol, Decanoate, Fluanxol Depot are effective.

How to find lost joy (video)

The video tells about chronic depression and methods of dealing with it. Causes and symptoms of mental illness. Refusal to self-medicate. Mandatory trip to a psychotherapist.

Dysthymia is a chronic mood disorder that differs from depression in that it has milder manifestations and lasts a very long time. It is possible to diagnose only when a person has a low mood for at least two years. With this problem, people almost never turn to specialists. The fact is that with depression, a person notices changes in himself, and with dysthymia, he most often does not remember himself as another. These are chronic pessimists who always and in everything look for only bad features, always do not believe in the possibility of a successful development of events. This persistence makes them think that it is not a disorder, but a personality trait.

Dysthymia becomes a medical problem due to the presence of other problems with which such people turn to doctors of various specializations. True, there is one difficulty here. If other problems are more serious, then the symptoms of dysthymia are absorbed by something more significant, and simply no one thinks about them.

Dysthymia is similar to depression, but its manifestation is milder.

However, this is a rather serious problem. The fact is that such people are constantly in the zone of special risk. We list the main problems that they face.

major depressive disorder

Dysthymia in a person can be from an unknown time, some features were noticeable even in childhood. At the age of 25-30 years, all the signs begin to increase, and a serious deterioration in the quality of life can be traced. Social alienation turns into autism, and the desire for solitude into unhealthy reclusion. Then all the signs of BAD appear, and hospitalization is already necessary.

generalized anxiety disorder

Most often, it does not occur against the background of depression, but against the background of dysthymia. This is just one example of how the disorder is hidden behind other symptoms. Not only the patient himself, but also the psychotherapist will reduce all attention to anxiety, and the low mood will simply be mentioned in the general context.

social phobia

Rarely does it come to some kind of antisocial behavior. This is more about autism. A person does not faint at the sight of another, but quite noticeably breaks social ties, seeks to limit the circle of familiar faces to one or two people.

conversion disorders

Strange somatic symptoms, which are explained mostly by mental rather than physical problems. Most likely, dysthymia simply enhances the potential for such fantastic symptoms to occur without disease, but is not their direct cause.

Somatic diseases

In this case, we are talking about secondary dysthymia. The fact is that some of the symptoms of conversion disorders sooner or later can be confirmed clinically. For a long time they thought that there was a disease, and not just one. And yet there is one...

Drug addiction and alcoholism

We won’t talk about the fact that alcohol is an antidepressant, and drugs, whatever one may say, psychoactive substances, as well as about their harm. We only note that if a person has at least some very small predisposition to alcoholism, and at the same time he is in constant mild depression, then the likelihood that he will become an alcoholic is simply huge.

As for depression, it combines with dysthymia as follows. There may be only one episode of major depression, a second episode, and none at all. In this case, they talk about "pure" dysthymia. But cyclothymia and dysthymia are incompatible concepts at the diagnostic level. If a hypomanic phase is observed, then this is simply cyclothymia. The state itself can be exactly the same. But the excitement phase slightly changes the nature of the problem. If it is, then the focus is usually on the mood swings rather than the presence of the phases themselves. In addition, hypomanic can be pleasurable. Dysthymia and cyclothymia are similar mainly in that both are associated with mild symptoms.

Dysthymia may be the result of drug use

What is dysthymia - the main types

It is customary to distinguish two types. The division is built on the basis of the most characteristic features of the expression.

Somatized dysthymia.
Characterological dysthymia.

The first relates predominantly to the conversion disorders mentioned above and their transformation into actual ones. Patients are constantly in an unpleasant physical condition. They also have palpitations, shortness of breath, constipation, or some other type of gastrointestinal disorder. They are tearful, may not sleep well, there is also a short-term nervous tic.

Characterological dysthymia is more related to personality traits. At the same time, patients of the first category also have them, but for those, all this is also accompanied by physical manifestations. As for the character, it is always bad. These are always dissatisfied people who are difficult to please. The main problem is that as soon as something joyful happens, they manage to spoil everything by seeing it as unreliable and superficial. If an ordinary person simply agrees that there is suffering in this world, then such a person will emphasize that everything is suffering. From a philosophical point of view, there is a certain rightness in this.

All people close to us will someday die, there is little reliability in society, wars and similar negative phenomena occur. However, this does not mean that you need to push your loved ones away from you and shed tears all the time. As long as there is no grief, then why grieve ahead of time? Dysthymia in psychology is a character that grieves in advance. At the same time, such people are often able to convey their mood to everyone around.

Dysthymia: treatment

As in all similar cases, it consists of a complex of psychopharmacotherapy and just psychotherapy. It just doesn't make sense to use pills alone. Firstly, their reception will only create conditions for looking at the world differently. Antidepressants will not change the look itself. Secondly, in some cases, it makes no sense to say something to people in a chronic depressive state just like that. They long ago forgot how to enjoy life, the words that this is possible are perceived only figuratively.

Antidepressants of all types can be used - typical (imipramine, amitriptyline, clomipramine) and SSRIs. Moclobemide is also used, which is a reversible MAO inhibitor type A.

Antidepressants are used to treat dysthymia

What is the main difficulty of therapy. Imagine a person with moderate or severe depression. He knows very well that he has changed. Previously, something pleased him, he was active, he had friends, but now nothing pleases him, he does not want to hear his friends, he closed himself, constantly in sadness. He realizes that this is a problem. Even if he gives up on himself, he sees the fact of the problem. Dysthymia is a state in psychology when people do not know how to rejoice for many years. Nor do the symptoms have the same strength as those of depression. The patient himself does not see the problem, and the psychotherapist's arguments are always perceived as a call to become different - explicit or hidden, but something pushing for it. It is unlikely that anyone wants to take and become a different person. And if he wants to, then we will also evaluate the complexity of such a task.

This is the situation when the task is not immediately solved. It must be divided into parts and solved sequentially.

Such people with self-esteem do not have any special problems. But they are not sure of themselves. This is not the result of a drop in self-esteem as such, but the same craving to see the negative in everything. If once something did not work out, then they are convinced that it will not work out again. Therefore, they refuse to participate in some projects. It is necessary to gradually find such failures, develop a plan for preparing for action and taking action. Just to make sure everything works out.

Classes in groups, where you can play some skits, are of good use. For example, a person recalls how he himself turned a certain team against himself. And repeats with other participants. Scene " How I had a fight with my friends and now I regret it" or " How I ruined the guys mood". They were going on a tourist trip, and he talked all day about the dangers, how they would break their arms and legs there, get poisoned by stale food, and the like. Participation in such classes helps to look at yourself from the outside.

Here is a typical example. The therapist asks the patient (client) to remember something pleasant from his life. How he achieved something or just got lucky, and it was very good. He shrugs. He doesn't remember this at all. By the way, the person also had an anxiety disorder.

In a state of dysthymia, a person may not experience feelings of joy for many years.

Let's say, but what would you now evaluate as a success or a very pleasant thing? You entered the institute, you probably rejoiced, - says the psychotherapist.
But not very. Well, he did, so what? The diploma brought more joy, yet it all ended, - the client answers.
Here, remember!
Yes, you know, I then got drunk and got into the police.
And yet ... Well, here's the first love.
Carrot. How much blood she then drank to me, this love.
And at work? Were there any successes?
10 years down the drain. Well, I was happy on the day of payday. Only after the distribution of debts there was little ground for joy ...

That's how it didn't work out. The therapist wanted to teach him how to project joy from the past into the present. How was he to know that in the past the client had nothing at all joyful? Never…

Strange as it may seem, there are situations when you need to learn to rejoice. Only if the patient, and this is the case when the term "sick" is appropriate, has somatized dysthymia, and he is offered to rejoice, then he is unlikely to be delighted with such a proposal. He lives in a state of a panic attack extended in time with mild forms of expression, and he is offered to rejoice. Even cruel...

The recommendation to use some kind of meditation techniques or methods of body-oriented psychotherapy is perceived as if it were an offer to live on Mars for a week. Any technique? Something to practice... In real life, it is patients with somatized dysthymia who end up in psychotherapists. Because they often have tachycardia, shortness of breath, irritable stomach syndrome and the like. They go to treat... What are they going to treat? That's right, vegetovascular dystonia, and with such a diagnosis, some neurologists delegate their patients to psychotherapists. This is the main supplier of such people to psychotherapy.

A psychotherapist can help you deal with dysthymia

Now imagine a picture. At the reception, a full teary woman. She complains that she has something with her heart, or rather, about other doctors who cannot diagnose this something. At the same time, tachycardia is real - a rapid pulse is observed and phantom pains in the atrial region. There is also heartburn, which is anxiety. And all together this is such a depression. If you tell her about some exercise related to eye movement and breathing, for example, then she will look at the psychotherapist as a pretty dreamer. Dysthymia, what is it? This disbelief in yourself, in methods, in everything. That's why antidepressants are needed.

Dysthymia is a kind of erased depression, which is much easier compared to the classic, endogenous depression. Dysthymia in its distribution significantly exceeds many pathologies, which in turn leads to disability problems, taking away potentially working individuals.

It is characteristic that this disorder is spreading more and more, which is associated with the mode of life of individuals. It is believed that the motor-mental load and work mode can lead to a latent course of this disorder, complicating the diagnosis. For such pathologies, their early detection is very important, which contributes to the exclusion of complications.

What is dysthymia?

Chronic dysthymia is the typical course of this disorder. It tends to be mild, but it drags on for a long time. It is characteristic that the disease lasts at least two years, because its course is shallow and hidden, leading to a crumpled symptomatology.

The very name "dysthymia" was first used by Spitzer, he tried to replace this term with a completely different group of disorders: neurasthenia, as well as a similar kind of psychasthenia. According to CIS data, about 20% of individuals after adulthood at least once suffered from this kind of disorder. This is very depressing, given the working age of people who are affected by the disease. But compared to this pathology, it is much less disabling, but dysthymia is more dangerous for the somatic side, and also paralyzes the mental and psychic side. All this limits the life of the individual, and very significantly.

The occurrence of this pathology is more common in adolescence and even in childhood. In children, it occurs more due to family influence, and in adolescents due to the trials of school age. Women are prone to dysthymia, which is associated with hormonal changes. Dysthymia is rarely diagnosed immediately, this is due to the blurring of symptoms. Adults most often do not pay attention to the symptoms, dumping it on the characterological features of the individual. The diagnosis of this pathology is very hidden in the presence of another pathology, because. it is often covered by other symptoms, so it is very difficult to detect additional symptoms.

Chronic dysthymia is diagnosed more often when other symptoms overlap. Hysterical dysthymia also occurs in this type of individuals, which is associated with both personality type and upbringing. This disease is not able to stay in one place for a long time, gradually progressing. If the pathology progresses to 21 years, then the course is considered unfavorable. Then relapses become more frequent, increasing the number of symptoms.

An individual prone to dysthymia is characterized by a multiple clinic, the symptoms multiply, combining many complex syndromes. Examination also demonstrates the presence of organic ailments, and in most people with dysthymia. Often this pathology is combined with anxiety and phobic disorders. There may also be conversion, that is, hysterical disorders. Somatic and narcotic diseases are also combined with dysthymia.

Dysthymia has several classification categories. Somatized dysthymia includes characteristic complaints: a general negative state of health with somatic complaints, while vegetatives with gastrointestinal disorders are connected. Complaints are not characteristic of a somatic nature directly, but are somewhat pretentious with interesting formations, i.e. it will drill in the head, cut the stomach and the like. Characterological dysthymia is observed in individuals with certain constitutional features, it is especially characteristic of depressive and suspicious persons.

Chronic dysthymia has a wide variety of causes, although they are often quite minor. Individuals with a huge array of fears and stressors are most susceptible to dysthymia. Chronic somatopathology also has a negative effect. Neurotic personality and pathological upbringing also play a role, especially in the constitutional form. Even the mode of life contributes to the development of pathology.

Symptoms of dysthymia

The expressiveness of the symptoms of dysthymia never exceeds depressive, but still there is some similarity in them. It is characteristic that such individuals are very pessimistic and irritable, often hypocrisy and excessive anxiety are manifested in their character. Spleen visits them not only on rainy days, but constantly, even on vacation. Such persons are almost always decadent and exhausted, and this, of course, affects all aspects of life. Sadness and depression are also always next to such personalities.

They are often given useless thoughts about the meaninglessness of their existence. Often there is a connection to dysthymia. Individuals become lazy and lethargic, unwilling to make even the slightest effort in life. In addition, their self-esteem is extremely low and entails a sense of failure in life. At the same time, they see the future and the past as extremely pessimistic and the present is not much different for them, everything looks like a merged gray mass of everyday life, which does not create a positive charge at all.

Dysthymia is also characterized by a decrease in needs and the absence of any, even primitive desires, the individual "dries up" in terms of life and potential. Anhedonia - lack of satisfaction from everything, a constant companion of dysthymia.

Somatic complaints can manifest themselves in a very diverse way, it can be either a minor ailment or a whole detailed picture of complaints. The sleep problems that haunt the patient with dysthymia are very characteristic, he gets rest only when he is very tired. Since there is still a lack of serotonin in the pathogenesis of dysthymia, it is difficult for a person to feel happiness and satisfaction, he is in a state of "despondency". There is even a dysthymic personality type that is prone to anxiety. It is to their strange artsy complaints that it is important to listen in order not to miss dysthymia.

Depending on the course, the forms of dysthymia differ in both symptoms and causes. Dysthymia with depression is a combination that, starting with dysthymia, eventually turns into expressive depressive symptoms, getting worse. Moreover, it can be either deep or frequent exacerbations. With pure dysthymia, the classic depressive triad is not observed, most often there is no motor inhibition. And already pure dysthymia has a somatized subtype, manifested by pretentious complaints of somatogenic origin.

The internal anxiety characteristic of dysthymia is usually projected into the future, so the individual does not predict life and expects only the most negative outcomes. It is characteristic that the past for them remains in the worst colors, which leads them to despair, forcing them to relive the phantom mistakes of the past again and again. Naturally, dysthymics are not able to build relationships and are perceived by people as closed. At the same time, they need support and if they trust someone, they will pour out their souls to infinity, very quickly plunging the trusted person into flight, because it is very difficult to listen to only eternal complaints. Their lack of initiative overrides all intellectual acquisitions.

Treatment of dysthymia

Treatment is applied with the correct confirmation of the diagnosis. In the case of dysthymia, this process can take up to two years due to subclinicality. In addition, diagnosis is hampered by the deprivation of symptoms and the imposition of other pathologies. Moreover, if in two years the disease struck the individual less than half the days of the year, dysthymia is excluded.

Most often in therapy, stimulation of the immune system is used. Even for classical dysthymia, immunomodulators will be an excellent remedy, and in the absence of an immunological consultation, safer adaptogens can be used: Ginseng, Eleutherococcus, Schisandra-Schisandra, Echinacea, Linden, Sage. An excellent drug for stimulation, one might say, of everything, is Tribestan and a similar group of drugs from tribulus, a plant that has excellent tonic properties. In case of excessive anxiety, you can use herbal sedatives: Valerian, Melissa, Mint, Persen.

Of the pharmacological selection, antidepressants are naturally relevant in the first place. In this case, depending on the severity, the effect will be given by different groups. In advanced cases, tricyclics are suitable: Amitriptyline, Sinequan, Clomipramine, Imipramine. For more sophisticated and long-term treatment, it is advisable to use SSRIs: Paxil, Prozac, Luvox, Melipramine, Cellex, Zoloft. Sometimes, in addition to serotonin, the drug captures norepinephrine: Simbalta, Effexor. Mood stabilizing drugs can be used: Litosan, Lithium under the control of blood lithium, or Valprok, Valpronat, Depakine.

Psychotherapeutic techniques have an excellent effect, especially on characterological dysthymia. It is better to start individually, cognitive psychotherapy and psychoanalysis are also suitable, depending on internal problems. Then you can connect group classes, which will form a positively oriented communication. In addition, family therapy will eliminate family pathogenesis, helping to maintain healthy family relationships.