Recurrent depressive disorder (Dysthymia)

Dysthymia, or Recurrent depressive disorder, is a continuous, long-lasting (chronic) form of depression. You could become disinterested in routine of everyday activities, experience hopelessness, be unproductive, have low self-esteem, and feel insufficient all around. Your studies, employment, relationship and daily activities may be greatly hampered by these symptoms, because it persists for years. Symptoms of persistent depressive disorder typically appear and disappear over years, and their strength can fluctuate. However, symptoms generally last for longer than two months at a time. Additionally, significant depressive episodes may start or continue to exist alongside persistent depressive disorder; this is known as double depression.

Symptoms

(A)Depressed mood for the most of the day, on the majority of days, as shown by either personal experience or third-party observation, for at least two years.  The duration must be at least one year and the mood can be irritable in children and teens.

(b)presence of two (or more) of the following while depressed

  • persistent feelings of sadness or emptiness
  • loss of interest in activities
  • difficulty concentrating or making decisions
  • irritability or anger
  • changes in appetite or weight
  • fatigue or lack of energy
  • feelings of worthlessness or excessive guilt
  • changes in sleep patterns
  • anxiety or restlessness
  • unexplained physical pains or gastrointestinal disturbances
  • suicidal thoughts or attempts

(C) The significant distress or impairmentin social, occupational, or other important areas of functioning.

Causes

Even though a cause for recurrent depressive disorder has not been identified, scientists think that genetics, hormones, and brain chemistry may all play a role. Furthermore, it has been demonstrated that people with depression have different physiological characteristics in their brains from people without the condition.

Depressive illnesses have a high probability of recurrence, which has prompted substantial research in this field. Only a few risk variables have been identified in studies to predict whether someone will have repeated depressive episodes despite the fact that many risk factors have been investigated in this regard (degree of the initial depressed episode)

Concurrent disorders that increase the risk of psychological distress include severe depression, dysthymia (permanent moderate depression), and anxiety (i.e., a tendency for anxiety, depression, self-doubt, and other negative feelings) tense living circumstances (sadness and other mental illnesses run in the family)

Recurrent depressive illness may be more likely to occur in people who use drugs, have experienced discrimination, or were abused as children, according to some studies.

Treatment

When a person is going through an active depressive episode, medication and psychotherapy are the most typical and efficient treatments, much like for most other types of depression. This course of treatment may continue for several months, or at least until the symptoms are easier to control. When the recurrent depressive episode is deemed to be in remission, psychotherapy may be discontinued, but the patient may continue taking medication to guard against future episodes.

Drug-Based Maintenance Therapy

In order to prevent a relapse following a depressive episode, it is typically advised that drug therapy be continued for at least a year after the person feels better. Those who have a history of concomitant depressive episodes following the withdrawal of medication, however, may require pharmacological intervention for years, if not for the rest of their lives.

Prolonged Psychotherapy

Even while psychotherapy is often stopped once a patient feels better, some research suggests that continuing treatment, particularly with cognitive behavioural therapy, can help prevent recurring depressive episodes.

Electroconvulsive Therapy

Shock therapy, also known as electroconvulsive therapy, may be used as a last resort for people who have failed many rounds of medicine and psychotherapy. Even though this treatment has a high chance of success, it can initially cause disruption in a person’s life. It is not advised to continue receiving electroconvulsive therapy to maintain gains. Instead, it has been demonstrated that using specific drugs after the initial shock therapy is useful in lowering relapse.

For many people, major depressive disorder (MDD) can be a chronic or even lifelong condition. Maintenance therapy is designed to prevent relapse after people with recurrent depression have reached remission. Patients who still experience symptoms, deal with persistent psychosocial stressors, or have coexisting conditions are good candidates for maintenance therapy. Experts in the treatment of depression debate issues related to maintenance treatment in the conversation that follows, including treatment duration, medication dose, psychotherapy, and electro-convulsive therapy (ECT). Additionally, recommendations are made for enhancing subthreshold depressed symptoms and treatment compliance

Facts

A lifetime of dysthymia is also extremely prevalent. estimated  to be between 2.5 and 6 percent Dysthymia typically lasts 4 to 5 years, however it can last for 20 years or longer. Over a 7.5-year follow-up period, chronic stress has been proven to make symptoms worse. Over 50% of patients who seek treatment had an onset before age 21, and dysthymia frequently starts in the teenage years. A 10-year prospective analysis of 97 people with early-onset dysthymia reported that 74% healed during that time but that 71% relapsed, with the majority of relapses happening within the first three years of follow-up.

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piyush sharma
Author: piyush sharma

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