Talk:Dysthymia

A-historic and pseudo-atheoretic

Like the DSM itself, this article is a-historic and a-theoretic, which no serious article about mental illness should be. Depriving mental illness of its meaning doubles the problems you are dealing with. All this might be dismissed as POV, but who are you fooling by suggesting there is something as NPOV, especially when it comes to the mind and mental illness?

One concrete thing that bothers me: nowhere is mentioned that the term dysthymic disorder is originally Freud's concept of the neurosis or neurotic depression, as it was still called in DSM-I and DSM-II. The "biologication" of the DSM was going to deprive the psychoanalytically oriented psychiatrists of a label to give the patients they were treating analytically, so the dysthymic disorder was coined, basically as a barter between the new biologists and the back then still powerful psychoanalysts. You don't have to agree with the psychoanalytic viewpoint, but a subsection History that mentions its appearance in the DSM, together with some well-sourced info about it (I'm just gossiping here, I know; but I'm sure there is enough source-material out there to validate my claim) would be welcome. This article seems a good place to start: http://www.ncbi.nlm.nih.gov/pubmed/14579202 — Preceding unsigned comment added by 134.58.253.56 (talk) 09:47, 22 November 2012 (UTC)

Pharmacological Interventions & Neurophysiology

While a list of medications that are used for the treatment of this disorder is useful on some level, it would be helpful to also provide some empirical evidence of the effectiveness of such interventions. Similarly, the details of why such medications are thought to be helpful to those that suffer from dysthymia could be a nice way to explore some of the neurobiological contributions of the disorder. This might also be helpful under a new section explaining some of the brain chemistry and structures that are involved. — Preceding unsigned comment added by MDKLUC (talk • contribs) 15:24, 17 November 2011 (UTC)

Major loss in childhood; death of parent

Does anyone else believe this sentence to be out of place and irrelevant (in it's current style)?

"Some people with dysthymia experienced a major loss in childhood, such as death of a parent."

Some people with dyslexia also experienced a major loss in childhood, such as death of a parent. :) —Preceding unsigned comment added by 69.250.164.100 (talk) 12:19, 16 August 2008 (UTC)

Yes I believe that the above is irrelevant. It might as well state that "Some people with dysthymia experienced a cold."Tomandzeke (talk) 04:11, 2 July 2012 (UTC)

St. John's Wort

Please note that while one survey did indeed show a small improvement using Saint John's Wort, several other surveys have shown no benefit at all for the consumption of Saint John's Wort. In fact, some studies show that Saint John's Wort is hazardous to the health of some individuals. --Desertphile 19:51, 4 March 2006 (UTC)

I have heard the same thing in regards side effects of St. Johns Wort (including excessive bleeding) - however, since it was word of mouth I am unable to reference it. Is there any place that does have this information? - Darkstar949 16:38, 6 March 2006 (UTC)

Request for information

More information on dysthymia would be very helpful. What are the current treatment regimens for this disorder? My understanding is that it is usually treated effectively with anti-depressant medication.

The description offered in "Classical Use of the Term" strikes me as sounding more like paranoia. I'd say that I am dysthymic in some sense relating to the "Classical" definition. Untreated, I often felt hopelessness from perceptions of an uncharitable society. On medication, my view has changed somewhat. I instead view society as a vastly incompetent and disorganized structure, full of selfish people struggling just to get by and provide for their children, me stuck in the middle of it. Treatment with pharmacology (paroxetine) doesn't seem to be entirely effective in my case.

Readable references (review papers maybe?) would be a great help.

Wikipedia really has the power to help transform health care. —Preceding unsigned comment added by 69.118.80.7 (talk • contribs)

See a useful Q&A about dysthymia (also known as dysthymic disorder) at: http://www.depressionny.com/q&a.htm —Preceding unsigned comment added by 156.111.105.71 (talk • contribs)

When I was diagnosed with Dysthymia, the psychiatrist said that anti-depressants could help to dull the symptoms, to a degree, but I actually have to have psychotherapy in order to treat it.

In the case of Dysthymia, anti-depressants are like taking pain killers for a stab wound. They might (in theory) ease the pain, but it's not going to cure the wound.--Jcvamp 01:36, 17 July 2006 (UTC)

"More information on dysthymia would be very helpful. What are the current treatment regimens for this disorder? My understanding is that it is usually treated effectively with anti-depressant medication."

It can be. However, due to the long-term nature of this condition, some doctors recommend cognative therapy in conjunction. --Mal 14:57, 14 August 2006 (UTC)

Any research on cultural causes? If everything around you has gone to hell then not being dysthymic would seem to be abnormal also. Smiling at funerals and bread lines looks really creepy.

Dysthymia is not a form of depression

Regardless of ciculated belief, doctors unofficially consider it part of personality disorders, and not a form of actual depression. —Preceding unsigned comment added by 209.226.121.143 (talk • contribs)

First, you should sign your comments, and second, I have not heard anywhere, that dysthymia is not a form of depression. Also, considering the fact that the DSM-IV-TR uses the term 'depressed' in the diagnosis criteria for dysthymia, I find your comment to be suspect at best. - Darkstar949 21:15, 15 March 2006 (UTC)

I agree with the previous writer that I have also NEVER see dysthymia considered as a personality disorder as opposed to depression. My education level is Registered Nurse with Degree.

Notes for whoever revises this next: the link at the bottom which claims to go tot he DSM description goes to a UK-based page, and doesn't seem to say it's using the DSM description. A US-based page such as the following: http://www.psych.org/psych_pract/treatg/pg/Depression2e.book-11.cfm#table8 might be more helpful, either as an addition or instead of the other link, which while helpful might need relabeling. Feyandstrange 03:46, 29 April 2006 (UTC)

Huh? What? dysthymia is not a form of depression? That unsigned assertion of the first writer is dead wrong. Having been a chronic dysthymic for decades I know with first hand knowledge what it is and how it is treated. While it is indeed in part a form of a personality disorder, it is primarily a form of depression; witch could be considered to be a personality disorder in itself . Bdelisle 05:12, 5 June 2006 (UTC)

Although some individual professionals do speculate that the nature of dysthymia better fit an Axis II (personality disorder) diagnosis, it is imortant to remember that the APA officially considers the condition an Axis I, clinical disorder. The role of Wikipedia is to report facts rather than propose new theories.

Dysthymia is DEFINITELY related to depression, but I think what the first person is referencing is the fact that the low-level chronicity of the disease is more related to personality than a major depressive episode and is therefore much more difficult to treat. —Preceding unsigned comment added by 173.8.218.204 (talk) 19:14, 15 October 2009 (UTC)

The US Department of Health's National Institute of Health has stated that dysthymia is a form of depression see: http://www.nimh.nih.gov/health/publications/depression/what-are-the-different-forms-of-depression.shtmlTomandzeke (talk) 04:17, 2 July 2012 (UTC)

Dysthymia lasts for at least 2 years?

I've been looking at the "cyclothymia" entry which links here. Do you know if there is dysthymia that lasts for only days or hours? Frumpter 05:02, 22 May 2006 (UTC)

• One of the requirements for a diagnosis of Dysthymia is that you have had a depressed mood for more than two years, as such there is no form of Dysthymia that lasts for a short period of time. --Darkstar949 14:08, 22 May 2006 (UTC)

You can have dysthymia for only a few days or hours because it is a symptom. In order to meet criteria for DYSTHYMIC DISORDER you must experience dysthymia more often than not for 2 years. This article is flawed by inappropriate use of semantics and is obviously leading to much confusion. —Preceding unsigned comment added by 173.8.218.204 (talk) 19:18, 15 October 2009 (UTC)

While two years is the requirement for adults, the DSM-IV allows for a diagnosis of dysthemia using the criteron one year in the case of a child Tomandzeke (talk) 04:21, 2 July 2012 (UTC)

Too much repetition!

It would make sense to shorten this article by quite a bit. It can't be necessary to mention every possible symptom a half dozen times? --Hordaland (talk) 13:35, 17 May 2008 (UTC)

I've cleaned it up. --Formerly the IP-Address 24.22.227.53 (talk) 03:47, 7 June 2008 (UTC)

Language of the article does not sound scientific in this quote

"Remember the risk of leaving depression untreated is far greater than the risk of treatment with an anti-depressant." sounds like an advertisement. I think you could tell the same idea in a more neutral way. (Or support it with statistics generated by independant of medical industrials sources.) Thank you. RuFr (talk) 09:38, 21 June 2008 (UTC)RuFr

The National Institute of Health uses the statement "Depression is a common but serious illness. Most who experience depression need treatment to get better." See: http://www.nimh.nih.gov/health/publications/depression/what-are-the-different-forms-of-depression.shtmlTomandzeke (talk) 04:25, 2 July 2012 (UTC)

The very same...

... holds for this sentence: "Cognitive behavioral therapy is designed to examine and help correct faulty, self-critical thought patterns and correct the cognitive distortions that persons with mood disorders commonly experience." The wording is extremely tendentious. The first part of it could be easily reformulated as "examine and help reshape self-critical thought patterns", but I don't know how to circumvent speaking of "cognitive distortions" without sounding overly biased in another direction. -- 62.178.119.181 (talk) 18:12, 20 December 2008 (UTC)

Misinterpretation possible

Under the section "Treatments" under the sub-section "Side affects of medications" it says "Some antidepressants are ineffective in patients[citation needed]." I was just worried that this could be interpreted as ALL patients. I suggest it say something like "Some antidepressants are ineffective in some patients." or something like "Sometimes antidepressants are ineffective in patients." That may make the statement more accurate. However, I don't know how often this really occurs, and if it should actually be "Most" or "Many" patients and/or antidepressants. Its all relatives (talk) 11:07, 25 April 2010 (UTC)

References

As the poster above noted, the references for this section need a lot of work. Many of them are in the incorrect format (and I'm not sure if the original reference is even there). More scientific data would be useful. Also, there seems to be an excessive use of quotations for things which could easily be summarized: "is twice as common in women as it is in men, although this may be because women are more likely to report their symptoms". I also worry that certain sections sound like anti-depressant advertisements. --Elizard16 (talk) 02:09, 3 December 2008 (UTC) 21:08, 2 December 2008

I couldn't stand those bright red messages about faulty refs and removed them all. Some statements now have [citation needed], some were deleted. There's still an excessive use of quotations; the article needs work. - Hordaland (talk) 01:06, 6 December 2008 (UTC)

False References Found

The correspondence of the statements made and the references cited is in question. In at least one instance the reference does not support the claim, i.e., "SSRIs are usually the first line of treatment via pharmacotherapy due to its more tolerable nature and reduced side effects versus the irreversible monoamine oxidase inhibitors or Tricyclic antidepressants.[21]"

The reference goes to: John M. Grohol (2008), Dysthymia Treatment . psychcentral.com which does state SSRIs are the most common class of antidepressants prescribed but does not state that this is "due to its more tolerable nature and reduced side effects versus the irreversible monoamine oxidase inhibitors or Tricyclic antidepressants." That part of the sentence should be deleted since it is unsupported and use of the word irreversible is totally inappropriate. While it is easy to correct this one instance by deleting the unsupported statement, it makes the remaining references suspect. The question of whether or not the remaining references in the article support the statements made, can only be answered by an effort to check each claim and reference.Tomandzeke (talk) 04:04, 2 July 2012 (UTC)

There is a possibility that this article has random references to make look like the statements are something other than opinion. Here is another false reference:

"Additionally, exercise and good sleep hygiene (e.g. improving sleep patterns) are thought to have somewhat of an additive effect on treating dysthymic symptoms and preventing them from worsening.[8]" This reference goes to a WebMD entry "Double Depression: Definition, Symptoms, Treatment, and More . Webmd.com (2012-01-07). Retrieved on 2012-07-01." However, the entry does not state anything about exercise, sleep and good hygiene are (note the weasel words) "...somewhat of an additive effect on treating dysthymic symptoms..." In addition to this being unsubstantiated it is a poor practice to use vague possibilities in an encyclopedia entry which should contain matters of fact. It either has an effect or not, somewhat of an additive effect is not a definite statement.Tomandzeke (talk) 05:05, 2 July 2012 (UTC)

Association with bipolar false

Previous versions of the symptoms section strongly associated dysthymia with bipolar disorder manic episodes. Dysthymia is not to be confused with Cyclothymia. Persons suffering from dysthymia, though there symptoms fluctuate in intensity, they do not go over to the other side of the spectrum and experience mania. I have made changes to reflected this, please see references and keep this in mind when editing. —Preceding unsigned comment added by Tnedutsaus (talk • contribs) 03:25, 28 May 2009 (UTC)

Depression spectrum link

Should 'depression spectrum' at the top of the article link to Types of psychological depression, rather than another kind of depression? edit: In fact, the three-sentence-long first paragraph links indirectly to major depression three times. LieAfterLie (talk) 06:59, 3 October 2009 (UTC)

Dysthymia - is a symptom; dysthymic - is a disorder

Disthymia is not itself a disorder, it is a symptom of Dysthymic Disorder. Someone should appropriately edit this page. —Preceding unsigned comment added by 173.8.218.204 (talk) 19:06, 15 October 2009 (UTC)

Copyright problems with diagnostic criteria

The American Psychiatric Association has not released its Diagnostic and Statistical Manual of Mental Disorders into public domain, but claims copyright. The Wikimedia Foundation has received a letter of complaint (Ticket:2010030910040817, for those with access) about the use of their diagnostic criteria in this and a number of other articles. Currently, this content is blanked pending investigation, which will last approximately one week. Please feel free to provide input at the copyright problems board listing during that time. Individuals with access to the books would be particularly welcome in helping to conduct the investigation. Assistance developing a plan to prevent misuse of the APA's material on Wikipedia projects would also be welcome. Thank you. Moonriddengirl ^(talk) 13:59, 11 March 2010 (UTC)

"Some antidepressants are ineffective in patients"?

I'm not sure what this means. Are they trying to say that for some patients, some antidepressants are ineffective? Surely they don't mean some antidepressants are ineffective for all patients, which begs the question of why such a thing would be called an antidepressant. —Preceding unsigned comment added by 204.50.199.4 (talk) 23:48, 23 August 2010 (UTC)

While it is true that some patients do not respond to some antidepressants and some patients do not respond to any antidepressants, this article is not the place to make that statement.Tomandzeke (talk) 04:31, 2 July 2012 (UTC)

Yes it is; many people require deep psychological treatment irrespective of pharmacological intervention, in order to manage their thought patterns. I would know. 31.220.207.71 (talk) 22:14, 9 November 2013 (UTC)

External link to a video

There is a discussion at Talk:Depression_(mood)#Youtube_external_link about adding this video as an external link to some depression-related articles. Your input is welcome. Anthony (talk) 06:19, 19 October 2010 (UTC) I have now inserted the link. Anthony (talk) 12:35, 27 October 2010 (UTC)

Possible causes +

nationalencyklopedin lists the following as possible causes for dysthymia: "excessive dependence or early loss of parents, learned helplessness, lack of tenderness or overprotection". [1] (swedish). i think this should be mentioned in the article, preferably with better/english-language sources.

other comments: the introduction of the current revision is a bit repetitive - it seems as if different editors added a new "dysthymia is...", while leaving the previous information untouched. also, the references section has an odd-looking entry at the bottom. k kisses 16:32, 13 December 2010 (UTC)

Deleted material

I have removed and temporarily replaced references to Ginseng (uncited, unverified) and a number of other questionable allusions. This whole section needs a rewrite by a clinical specialist, as the vagueness and unsupportable claims which had grown here can be regarded by sufferers as "gospel" if they see such claims written down. Trevor H. (UK) — Preceding unsigned comment added by Trevor H. (talk • contribs) 13:18, 25 September 2011 (UTC)

"This whole section needs a rewrite by a clinical specialist"

Good luck with that. Academic experts have no more influence at WP than the common dolt, and their contributions and corrections are frequently deleted by loud groups of ignorant or agenda'd people.

If one of these people is a friend of an admin, the expert is either reprimanded or banned. Admins will always support another admin in serious matters (as opposed to things like removing a temporary block), so that they will themselves be supported when they wish to advance an agenda.

Though I am NOT an expert in depression (I do different clinical medicine), I just removed a propaganda section almost certainly written by scientology because of the word "debunk". It was supported by exactly one paper that was published in an online "open" site, not a real medical journal. It contradicts decades of universal medical understanding, FDA-approved package inserts, and everything else but scientology propaganda.

But I have to do it not logged in so my real, high-edit, respected at WP username isn't banned, since the cult almost certainly has infiltrated the admin hierarchy. — Preceding unsigned comment added by 77.234.42.150 (talk) 03:47, 30 December 2013 (UTC)

GA Review

This review is transcluded from Talk:Dysthymia/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Jmh649 (talk · contribs) 01:54, 25 December 2011 (UTC)

Significant work is yet needed

• The main issues that need to be addressed is that of references. Per WP:MEDRS review articles or major textbooks from the last 3-5 years should be used.
• Also there are a number of style issues. WP:MEDMOS and WP:MOS can help with this.
• What is the epidemiology is other countries and what does the ICD 10 say about this condition?

Once these are addressed I will provide a more thorough review. Cheers Doc James (talk · contribs · email) 01:54, 25 December 2011 (UTC)

Classed as nominator not active.Doc James (talk · contribs · email) 21:01, 1 January 2012 (UTC)

Persistent depressive disorder

DSM-5 replaced dysthymic disorder and chronic major depressive disorder by persistent depressive disorder. A new editor made a good-faith edit in which s/he replaced every single mention of dysthymia in this article with Persistent Depressive Disorder - including titles of sources and url's. First I agreed with the change (at least in the text, not in the sources) and I even moved this page to Persistent depressive disorder, but on second thought I reverted everything, including the changes in the text.
Yes, we should start writing about persistent depressive disorder, but we cannot just "blindly" replace the word dysthymia with persistent depressive disorder. I don't have access to DSM-5, but my guess is that the diagnosis criteria are not exactly the same. Our text is based on sources, and these sources have written about dysthymia, not about persistent depressive disorder. We cannot just assume that everything that is written about dysthymia is also valid for persistent depressive disorder. So I think that the change from dysthymia into persistent depressive disorder should be done in a careful way. We'll use the term persistent depressive disorder when our sources use that term, but we should keep the term dysthymia when our sources used that term. Please, tell me what you think! Lova Falk talk 09:12, 2 December 2013 (UTC)

The strange thing is that, when DSM-IV came out, maybe the definition of dysthymia was changed a little bit, but -because it had the same name- no one really cared to distinguish the "new" dysthymia from the "old" dysthymia in this article.

From Highlights of Changes from DSM-IV-TR to DSM-5:

[...] DSM-5 conceptualizes chronic forms of depression in a somewhat modified way. What was referred to as dysthymia in DSM-IV now falls under the category of persistent depressive disorder, which includes both chronic major depressive disorder and the previous dysthymic disorder. An inability to find scientifically meaningful differences between these two conditions led to their combination with specifiers included to identify different pathways to the diagnosis and to provide continuity with DSM-IV.

I have no medical background, but I have the following opinion: The title of the article should be "persistent depressive disorder", and the term dysthymia should be mentioned in the first sentence of the article (maybe together with the above reference as a footnote). For now, the article should assume the equivalence of the two terms, but -as you suggest- I think we should stick to the term that the cited sources used (at least for now and unless a professional in the field has a different opinion). ylloh (talk) 08:45, 27 February 2014 (UTC)

The article reads:

"When and if such people seek out treatment, the treatment may not be very effective if only the symptoms of the major depression are addressed, but not the dysthymic symptoms."

I guess I am not understanding. Treatment of a symptom is in general not effective whether one is dealing with a physical or with a psychological trauma. Depression is a symptom whether it is brief or chronic. I would re-right the above as follows:

"When and if such people seek out treatment, the treatment may not be very effective if only the symptoms of depression are treated, but not the underlying problems that created the dysthymia." Zedshort (talk) 03:25, 19 May 2014 (UTC)

Comorbid and diagnostic section contradict each other

This page has a pretty big contradiction. In the comorbidity section cyclothemia is listed as sometimes occurring alongside dysthymia but in the diagnostic section it specifically lists the absense of any cyclothemia as a criteria for diagnosis.

(Also, you may notice I stupidly erased the entire talk page for about 1 minute. Accidentally hit a key on my ipad and poof! Undid it immediately. Apologies. — Preceding unsigned comment added by 70.71.0.16 (talk) 01:11, 1 July 2014 (UTC)

Consider removal of the Moclobemide notes if no citation is known

Note to those monitoring the article who know more about primary research on Moclobemide: Please, consider adding the citation in the next paragraph or remove the full sentence. This article are widely used by patients to know more about its illness and not sourced information must be avoided or we may disrupt their treatment.

..This is not the case for newer MAOIs, such as Moclobemide, which is more tolerable than SSRIs, doesn't cause sexual dysfunction and is very well tolerated, without the dietary restrictions needed for older MAOIs and thus can be considered the first line of defense in treatment of dysthymia.

--95.16.36.172 (talk) 01:23, 22 November 2015 (UTC)

Intro paragraph: sentence that doesn't make sense

This sentence probably made sense when it was written, but now seems out of place:

"Serious state of chronic depression will last at least three years, with this length of recovery, it can stay balanced enough to control it from major depressive disorder."

Does anyone know what this is getting at, and if so could they fix this? Thanks! Myoglobin (talk) 14:23, 17 April 2016 (UTC)

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Suggested addition

Hello, I was thinking of adding in a 2000 Cochrane review. It was updated in 2015, but this was withdrawn. My suggested changes would be to include it as follows (the 2005 meta analysis is already cited), my changes are bolded.

According to a 2000 Cochrane Review and a 2005 meta-analysis, SSRIs and TCAs may be equally effective in treating dysthymia. MAOIs may have a slight advantage over the use of other medication in treating this disorder. However, MAOIs should not necessarily be the first line of defense in the treatment of dysthymia, as they are often less tolerable than their counterparts, such as SSRIs. The use of TCAs may lead to more people stopping their medication and more side effects when compared to the other medications available.

Thanks, JenOttawa (talk) 03:16, 14 November 2017 (UTC)

This would be a good addition. Patriciamoorehead (talk) 23:15, 25 November 2020 (UTC)

References