Diagnosing Dysthymia
Diagnosing dysthymia can be difficult, since its symptoms overlap with those of major depression and other mental health conditions. The first step your healthcare provider will likely take is perform a physical exam and conduct some lab tests to determine if your symptoms are the result of another physical condition. However, no single lab test can provide a dysthymia diagnosis.
Your doctor will likely ask you questions about your health, symptoms and life circumstances. You might want to mention the following symptoms, if you have them:
- Changes in appetite
- Fatigue or lack of energy
- Feeling guilty, hopeless, irritable or angry
- Feeling less productive
- Feeling sad or down
- Lack of interest in daily or social activities
- Low self-esteem or a lot of self-criticism
- Poor concentration or trouble making decisions
- Problems sleeping.
You may need to fill out a psychological questionnaire to help your doctor determine your state of mind.
Clinical Criteria for Diagnosing Dysthymia
When diagnosing depression, U.S. healthcare providers must follow the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. According to the DSM, for a dysthymia diagnosis, in addition to feeling depressed most of the time for at least two years (one year for children and adolescents), you also must display at least two of the following symptoms:
- Feelings of hopelessness
- Insomnia or excessive sleep
- Low energy or fatigue
- Low self-esteem
- Poor appetite or overeating
- Poor concentration or indecisiveness.
Although the criteria include two years of feeling depressed, you can have had a normal mood for up to two months during that time and still receive a dysthymia diagnosis.
Other DSM criteria for a dysthymia depression diagnosis are:
- You must not have had an episode of major depression in the first two years of having dysthymia (the first one year for children)
- You must not have a history of mania (unusually elevated, hyperactive moods).
Dysthymia often starts early in life; it’s considered “early onset” if symptoms begin before the age of 21, and “late onset” if symptoms begin at age 21 or later. When mental health professionals evaluate children for a dysthymia diagnosis, it may be helpful to evaluate a child’s family, if possible.
If you do receive a dysthymia diagnosis, the next step is work with your doctor to determine the best treatment for you. Medication and psychotherapy are common next steps after receiving a depression diagnosis.
Resources
Children’s Hospital Boston Staff. (n.d.). Dysthymia. Retrieved May 24, 2010, from the Children’s Hospital Boston website: www.childrenshospital.org/az/Site816/mainpageS816P0.html.
Langenfeld, S. (2009). Dysthymic disorder. Retrieved May 24, 2010, from the eMedicine website: emedicine.medscape.com/article/290686-overview.
Mayo Clinic Staff (2008). Dysthymia (dysthymic disorder): Tests and diagnosis. Retrieved May 26, 2010, from the Mayo Clinic website: www.mayoclinic.com/health/dysthymia/DS01111/DSECTION=tests-and-diagnosis.