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Mood Disorders

Treatment for Dysthymic Disorder continued...

Psychotherapy ("talk therapy") is generally considered the treatment of choice for dysthymic disorder, and no medicine is formally FDA-approved for its treatment.   However, if psychotherapy alone is not fully helpful, a two-pronged, long-term treatment approach may then include antidepressant medication in addition to psychotherapy.   Some studies show that antidepressant medications or psychotherapy can be effective for dysthymic disorder, and sometimes a combination of both may work best.

Antidepressants, such as selective-serotonin reuptake inhibitors or tricyclic antidepressants, are often used to treat dysthymic disorder. Because you may need to continue treatment for a lengthy period, it's important to consider which medications not only work well but also ideally have few side effects. You may need to try more than one medication to find the one that works best. But know that it may take several weeks or longer to take effect. Successful treatment for chronic depression often takes longer than for acute (non-chronic) depression.

Take your medications as your doctor instructs. If they're causing side effects or still not working after several weeks, discuss this with your doctor. Don't suddenly stop taking your medications.

Specific kinds of talk therapy, such as cognitive behavioral therapy (CBT), psychodynamic psychotherapy, or interpersonal therapy (IPT), are known to be effective forms of psychotherapy that treat dysthymic disorder.  A structured treatment lasting for a certain period of time, CBT involves recognizing and restructuring thoughts. It can help you change your distorted thinking. IPT is also a time-limited, structured treatment. Its focus is on addressing current problems and solving interpersonal conflicts.  Psychodynamic psychotherapy involves exploring unhealthy or unsatisfying patterns of behavior and motivations that you may not be consciously aware of which could lead to feelings of depression and negative expectations and life experiences.

Some studies also suggest that aerobic exercise can help with mood disorders. This is most effective when done four to six times a week. But some exercise is better than none at all. Other changes may also help, including seeking social support and finding an interesting occupation. Used for patients with seasonal affective disorder, bright-light therapy may also help some people with dysthymic disorder.

Mood Disorders: What Is Cyclothymic Disorder?

Bipolar disorder causes severe, unusual shifts in mood and energy that affect your ability to do normal tasks at home, school, or work. Cyclothymic disorder is often thought of as a mild form of bipolar disorder.

With cyclothymic disorder, you have low-grade high periods (hypomanias) as well as brief, fleeting periods of depression that don't last as long (less than 2 weeks at a time) as in a major depressive episode.  The hypomanias in cyclothymic disorder are similar to those seen in bipolar II disorder, and do not progress to full-blown manias. For example, you may feel an exaggerated sense of productivity or power, but you don't lose connection with reality. In fact, some people feel the "highs" of cyclothymic disorder are even enjoyable. They tend to not be as disabling as they are with bipolar disorder.

Up to 1% of the U.S. population -- equal numbers of men and women -- has cyclothymia. Its cause is unknown, but genetics may play a role; cyclothymia is more common in people with relatives who have bipolar disorder. Symptoms usually appear in adolescence or young adulthood. But because symptoms are mild, it is often difficult to tell when cyclothymia begins.

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