A special type of depression: dysthymia

A special type of depression: dysthymia

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  • 1 Depression, an increasing evil
  • 2 The problem of multi-causality
  • 3 Depression and clinical diseases:
  • 4 Body-mind, a dichotomy allowed
  • 5 Depression and sadness
  • 6 Classification of depression
  • 7 The peculiarity of dysthymic disorder
  • 8 Prevalence by sex and age
  • 9 What symptoms to pay attention to?
  • 10 Dysthymia Forecast

Depression, an increasing evil

The depression, the most common of mental disorders, will affect 10% of the general population at some time in their life.

An estimated 340 million people in the world are victims of this disease.

The prevalence is 15% and in women it rises to 25%. And, according to a recent WHO report, this disorder, which currently ranks 5th among the top ten causes of disability and death, by 2020, will have jumped to 2nd place, after coronary ischemia. That is why it is considered a silent epidemic.

It is detected in 50% of cases; they receive the correct treatment 1/3 of those who consult and despite the good prognosis, most of those who suffer from it, do not consult in the first years, because of the social stigma that still weighs on mental illnesses, as if this "discontent with himself "(S. Freud) was the sin of acidia, as" the lows of the soul "were considered in the Middle Ages.

It predominantly affects people who lack important interpersonal links.

The problem of multiple causes

An interaction of factors: a certain genetic predisposition, a biological vulnerability and a personal history and of vital events that will be combined in a very particular way, will constitute the multi-causality of mood disorders.

to. The weight of genetic factors is inferred through the study of the incidence of these disorders that, in relatives of 1st. Grade is 2 to 3 times higher.

b. Biological factors such as serotonin, a neurotransmitter related to the pathophysiology of depressive disorders and alterations in some neuroendocrine responses, would constitute the necessary organic substrate, but not sufficient, to justify the onset of depression.

c. Psychosocial factors influence not only as triggers in adult life (loss of employment, death of loved ones, divorce, removal of children from home, etc.) but as constitutional factors from early childhood (losses). Painful situations in the early stages of life leave marks that will remain latent to hatch in the face of a subsequent imbalance.

Depression and clinical diseases:

Depression, as "negative emotion" (such as anger, despair, etc.) is a risk factor for many somatic diseases.

Emotional states not only fulfill the role of precipitating factor or cause of diseases, but are responsible for the development, aggravation and chronification of them.

And when diseases become chronic, emotional states affect health even more, by inducing unhealthy behavior habits such as: alcohol intake, consumption of tobacco, the varied diet, sedentary lifestyle, etc.

Therefore, by preventing depression, another series of disturbances such as:

to. The cerebrovascular accident (CVA).
b. The Parkinson's disease.
c. Myocardial infarction
d. Migraine.
and. Digestive disorders
F. Irritable bowel
g. Immune diseases.
h. Etc.

Body-mind, a dichotomy allowed

How can it be that depression, "a mood disorder"
(according to him DSM V) that is a disease of the so-called "mental" influences the "organic" diseases?

Psychosomatic Medicine, the Psychophysiology, Health Psychology and modern Psychoneuroendocrinoimmunology have been responsible for accounting for the complex mechanisms that are activated when, for example, a person enters a deep malaise as a result of a personal crisis.

And this happens because the famous body-mind dichotomy is a fiction created by science to try to facilitate the compression of a human being living that is neither psyche nor soma, but a psychosome.

Depression and sadness

Most people use the term depression as a synonym for sadness. From the psychological point of view, it is considered both as a symptom, as a syndrome or as a disease.

Sadness is a state of mind that normally happens to a situation of mourning for the loss of a loved one, for the frustration of a project or simply for a disappointment. Generally, after a certain period of time, the sufferer overcomes the bad trance and continues his life with total normality.

In the face of the same situation, some people, on the other hand, react with a persistent depression that can even lead to the desire for self-elimination. These people react with a depressive illness that in addition to sad mood, they will have from an inhibition to a psychomotor agitation, feelings of self-reproach, and sometimes they can be accompanied by somatic symptoms such as headaches, digestive problems, etc.

Obviously, the latter will require treatment.

Depression Classification

There are two large groups of depressions: primary depressions and secondary depressions. In primary schools, it is difficult to find a previous trigger that justifies the onset of the disorder; while in secondary or reactive depressions the trigger is evident: traumatic events, certain diseases, substance abuse, etc.

In both types of pictures and depending on the severity of the symptoms, depression can be of degree:

to. Mild: It has few symptoms that generate a minor disability.
b. Moderate: greater number of symptoms and functional disability.
c. Serious: It is expressed through several disabling symptoms.

Another type of classification of mood disorders is provided by the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) which proposes for disorders whose main characteristic is a mood disorder, a division into 4 large groups: depressive disorders, bipolar disorders, those due to medical illness and substance-induced mood disorders.

Among the depressive disorders it is possible to stop in the dysthymic disorder, because it begins early, becomes chronic, usually goes unnoticed, but its consequences can be devastating on the person's life.

The peculiarity of dysthymic disorder

This concept was introduced by the American Psychiatric Association in 1980, to account for a low-grade affective symptomatology that occurs very frequently in the population and yet many of those who suffer from it are not treated.

The degree of symptoms is moderate, which does not imply that it is a mild disorder.

Dysthymia is characterized by a chronically depressed mood (sadness and discouragement) most of the day, for a minimum period of 2 years, in which 2 or more of the following symptoms occur:

to. Little appetite or voracity.
b. Insomnia or hypersomnia.
c. Little energy or fatigue.
d. Low self-esteem.
and. Difficulties concentrating or making decisions.
F. Feelings of hopelessness

Because 70-80% of cases begin in childhood or adolescence and insidiously, the patient feels that "it was always like this", that this is his "way of being", something that the family environment confirms and then no query And therefore it is not.

Other descriptive characteristics and associated mental disorders:

1. Feelings of incompetence.
2. Generalized loss of interest or pleasure, anhedonia.
3. Social isolation.
4. Feelings of guilt or sadness referred to the past.
5. Feelings of irritability or excessive anger.
6. Decrease in activity, efficiency or productivity.

Less frequently, vegetative symptoms may appear:

to. Sleep disorder
b. Appetite disorder
c. Psychomotor symptoms (slowness).

Although it may be associated with other disorders (brief recurrent depression and major depressive episode) pure dysthymia occurs in 12% of cases.

There are days or weeks in which the patient may be well, as an exception up to 2 months, but he is almost always tired, depressed, meditabundo, plañidero, sleeps badly and feels unable to undertake new activities.

In spite of everything, he can face the basic things of everyday life but, he finds no pleasure in what he does.

Since it can be complicated by a major depressive episode, he is at risk of suicide, especially because when not treated, the patient incurs repeated failures that gradually cut off his self-esteem, gradually.

Prevalence by sex and age

In adults, women are 2 to 3 times more likely than men. In contrast, in children, the disorder occurs equally in both sexes, but in addition to sadness, pessimism and low self-esteem, they present irritability, instability and poor development of social skills. This will lead to a deterioration in school performance.

What symptoms to pay attention to?

When a person loses interest in the things he has been doing, he feels tired, does not feel like participating, sharing and enjoying life, while changing weight and manifesting insomnia problems or an unpleasant awakening, or He has diffuse pain, negative thoughts, is frequently dull and slow, and evidences a deterioration in his work and / or academic life, although he does not know, he may suffer from a dysthymic disorder.

The important thing is not to resign yourself to lead a bleak life, avoid chronification and make an early diagnosis. In the case of children or adolescents, the responsibility of the consultation will fall on the parents or teachers advised on the form of presentation and on adults it will be the family environment that suggests the early consultation.

Dysthymia prognosis

When there is a dysthymic disorder there is a risk of complicating with a major depressive disorder (which is at risk of suicide) of 10%, if there is no adequate treatment; situation that is completely reversed with the latter.

8 Suggestions to prevent dysthymic disorder:
to. Try to share the problems with your loved ones.
b. Avoid social isolation.
c. Try to solve the problem of insomnia.
d. Increase physical activity.
and. If you have questions about your state of health, consult your GP.
F. Try to give yourself time to do the activities that are pleasurable.
g. If you find it very difficult to make all these changes alone, consult a psychologist; It is not true that needing help from a professional is a sign of weakness.

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