Dysthymic Mood Disorder - Essay Example

? Mood Disorders: Dysthymic Mood Disorder First of school A Mood disorder such as dysthymia disorder which is also known as persistent depressive disorder is a mood disorder that is a long term chronic depression, which hinders an individual from functioning properly and enjoying life. However, there are diagnosis, treatments and other factors that are involved in recovery that will be discussed in this paper when examining dysthymia disorder. Keywords: mood, disorder, dysthymia, persistent, depressive, depression, chronic. Mood Disorders: Dysthymic Mood Disorder Introduction Mood disorderalso known as affective disorders is referred to as a group or category of diagnoses of mental health problems in a system of classification where any disturbance in the mood of an individual is theorized to be the sole feature (Sadock, 2002). There are two groups or categories of mood disorders including major depression or clinical depression and bipolar disorder, which is also known as manic depression (June, Black & Richardson, 2002). In the period of 1970s and 1980s, health professionals specializing with mental cases started to identify symptoms of mood disorders in adolescents, children and adults, where adolescents and children do not really exhibit similar symptoms as adults (Egeland & Hostetter, 1983). Thereason is because it is extremely difficult to diagnose children who have mood disorders as a result of their inability to express the way they feel. This makes mood disorder in adolescents and children a mental health problem because it remains underdiagnosed. Causes of Mood Disorders The causes of mood disorders are not well known. However, endorphins, which are chemicals in the brain are said to be responsible for positive moods (Steward, 2000). In light of this revelation of endorphins, mood disorders and depressions are caused by the imbalance of chemical in the brain (Castren, 2005). Simple events in life of an individual that has undesirable changes like unplanned pregnancies or poor performance at school may contribute to a mood that has features of depression. In families, affective disorders are considered to be inherited as a result of factors that produce the condition of genetics from the genes of both or one parent (Cadoret, 1978). Individuals Affected By Mood Disorders Individuals could feel depressed at times or sad. Nonetheless, mood disorders are more extreme and challenging to manage than the usual feelings of unhappiness. Since mood disorders are inherited genetically from parents as we have seen in causes of mood disorders above, adolescents, adults, or children who their parents have mood disorders, have a substantial chance of inheriting mood disorder (Cadoret, 1978). In some instances, problems in life can cause depression. For instance, getting divorced or fired from a job, losing a lover, financial problems, and death of a child in the family, can be trying and managing the pressure may be difficult. These problems in life can cause depression and make managing mood disorder very hard. World Health Organization has forecasted that by 2030, depression will contribute to highest level of disability in the world (WHO, 2004). Australia has significant levels of depression affecting approximately twenty percent of adults during their lifetime, with almost twice numerous women diagnosed compared to men (Manicavasagar, Parker & Perich, 2011). It is approximated that almost eighty percent of reported suicides are preceded by a mood disorder, and higher rates of death and disability from diabetes (Eaton, 2002), cardiovascular disease (Frassure-Smith & Lesperence, 1995) and cancer (Massie, 2004) are associated with depression in individuals. Types of Mood Disorders There are numerous types of mood disorders including major depression, dysthymic or dysthymia disorder, manic depression or bipolar disorder, substance induced mood disorder, and mood disorder as a result of a medical condition (Lack & Green, 2009). Let us examine these mood disorders. First, major depression is a two-week period of irritable mood or depression or decrease in pleasure in normal activities that goes beyond feeling sad (Lack & Green, 2009). Second, dysthymia disorder is a long term chronic depression that can last up to two years or more, and mainly hinders an individual from functioning properly and enjoying life (Lack & Green, 2009). Third, manic depression or bipolar disorder is a mood disorder or affective disorder that last beyond a day’s ups and downs, and a serious health concern and medical condition (Lack & Green, 2009). Fourth, mood disorder as a result of a medical condition is due to manic episodes or depressions that are caused by existing medical conditions and is characterized by elevated or irritable mood with diminishing interest in activities (Lack & Green, 2009). Lastly, substance induced mood disorder is due to the effects of drug abuse, medication, or any other treatment in any other forms (Lack & Green, 2009). In this paper we are going to examine dysthymic mood disorder. Dysthymic Mood Disorder In the discussing types of mood disorders, we have learnt that dysthymia disorder which is also known as persistent depressive disorder is a long term chronic depression that can last up to two years or more, and mainly hinders an individual from functioning properly and enjoying life (Lack & Green, 2009). DSM defines persistent depressive disorder as a serious chronic depression state that persists for at least or almost two years where in most cases the persistence for children and adolescents is one year (American Psychiatric Association, 2000). DSM also describes persistent depressive disorder as being severe and less acute than other major depressive disorders (American Psychiatric Association, 2000). Diagnosis of Dysthymic Disorder Individuals with low grade depression like dysthymia have been portrayed as introverted, habitually gloomy, incapable of having fun, preoccupied with personal failure and overly conscientious (Akiskal, 1983). Dysthymic is characterized by crafty onset, often in adolescence or childhood, and a persistent, or fluctuating course (Akiskal, 2009). As viewed in Table 1 (Cold Springs Harbor Laboratory, 2013), its diagnosis entails the presence of predominantly mood of depression for at least two years, where in criterion A, irritability and one year duration will fulfill the criteria in adolescents and children. In addition, the other requirement in Table 1 (Cold Springs Harbor Laboratory, 2013) are at least more than or two criterion B features, which are change is sleep and appetite, low self-esteem, decreased energy, hopelessness, and difficulties in making decisions or concentrating. Dysthymic disorder diagnosis cannot be confirmed when an individual has a history of mixed affective episodes, hypomania, cyclothymic, or mania as seen in criterion E. However, psychotic symptoms history does not exclude out dysthymic disorder symptoms provided the mood symptoms are not fully existing during episodes of psychotic as seen in criterion F. In the classification that currently exists, numerous specifies can be used describe the disorder, especially atypical features and its presence and early versus late onset (American Psychiatric Association, 1994). The difference occurring in late and early onset dysthymia is believed to have certain significance prognosis implications (American Psychiatric Association, 1994). Differential Diagnosis of Dysthymic Disorder Similarities and coexistence with the several forms of MDD can lead or result to diagnostic difficulties. In light of this, adults who fulfill the criteria for major depressive disorder can be diagnosed with dysthymic disorder as long as the disorder has been manifest for at least two years before onset of major depressive episode. It is a fact that in most people’s lifetime that have dysthymic disorder will surely experience major depressive episodes, and at least twenty percent of people with major depressive disorder will have antecedent dysthymic disorder in their history (Keller et al., 1995). As discussed previously, one should consider chronic symptoms in addition to the intensity of the symptoms when diagnosing dysthymic disorder. Dysthymic disorder, by convention is that the burden of the symptom in a two week intervals is really below the benchmark for diagnosis of major depressivedisorder. This convention is the reason why chronic specifier is used to explain major depressive episodes that are known to last for two years or more in people with major depressive disorder (American Psychiatric Association, 1994). However, patients or individuals with major depressive disorder can have chronic illness as a result of failure have their symptoms in full remission. Hence, they will not fulfill the criteria for dysthymia, rather they would be diagnosed with recurring major depression without full recovery (American Psychiatric Association, 1994). The existence of continuing medical conditions should be explored when a patient is evaluated with chronic depression. Such medical conditions include hypernatremia, anemia, infections, tumors, multiple sclerosis, epilepsy, and Parkinson’s disease. In some instances, it is obvious that mood symptoms that are chronic are caused by the abuse of alcohol or drugs and can be induced by steroids, retinoic acid, antimicrobials, oral contraceptives, analgesics, among other medications (William &Shepherd, 2000). Treatment of Dysthymic Disorder The treatment for individuals with dysthymic disorder is a combination approach of psychotherapy with antidepressant medication (Grohol, 2013). Let us look at psychotherapy then medication Psychotherapy A health professional should conduct an evaluation to assess the type of mood the patient is in and then proceed to establish a suitable psychotherapeutic approach (Grohol, 2013). Cognitive behavioral therapy should be considered because it is centered on the patient and offers suitable environment that is best tailored for that patient (Grohol, 2013). The first psychotherapy approach to treating dysthymic disorder is the use of group therapy. A group can be extremely supportive to a patient than a single therapist can and can help identify the inconsistences of the behavior and thinking of a patient. Self-esteem issues usually accompany dysthymic disorder patients, so utmost care must be used when placing a person in a group as failure may be inevitable. Group therapy involving couples or families can be beneficial as they allow patients to be open in a therapeutic triad and the therapist can easily help the patient in dealing with dysthymic disorder. Medication Antidepressant medication that elevate energy levels are taken with individuals suffering from dysthymia disorder and keeps them from being depressed (Grohol, 2013). Antidepressants known as selective serotonin reuptake inhibitors or SSRIs such as Prozac, Zoloft, Paxil and Luvox are the prescribed medications for treating chronic depression (Grohol, 2013). A study called STAR*D indicate that people suffering from depression and who are always on medication should try several brands of medicine and be patient in awaiting their results (Rush, 2007). The results from the study conducted by STAR*D shows that in the event first treatment with one SSRI does not work, about one individual in four individual who switches to another medication will get better. This supports the notion that individuals should try different brands of medication to cure dysthymia disorder. Evaluation of Factors Involved In Recovery Effective and ineffective therapies will be examined in looking at the factors involved in recovery of an individual with dysthymia disorder. Dietary supplements, vitamins and acupuncture are seen as being ineffective form of therapy for the recovery of mood disorders including dysthymia disorder. In order to have individuals who have dysthymia disorder get effective therapies that may aid in recovery, continuation of psychotherapy and medication should be encouraged. The number of psychotherapy sessions should be increased and higher doses of antidepressant medicines should also be increased to ensure smooth and speedy recovery from dysthymia disorder. Effective treatment of dysthymia disorder in adults may not be useful in older individuals who have this disorder. Conclusion In the discussion, we have learnt that dysthymia disorder also known as persistent depressive disorder is a mood disorder that hinders an individual from functioning properly and enjoying life. We have also learnt that it is severe and less acute and can persist for almost two years, in which case if left untreated can result to functional impairment. To conclude, it is would be wise for therapists to be competent enough to identify and use psychotherapy and medication approaches to treat individuals suffering from dysthymia disorder. References Akiskal H. (1983). Dysthymic disorder: psychopathology of proposed chronic depressive subtypes.  Am J Psychiatry, 140, 11–20. Akiskal, H. (2009). Mood disorders: clinical features, in Kaplan and Sadock's Comprehensive Textbook of Psychiatry American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders. (4th ed). American Psychiatric Pub. American Psychiatric Association. (2000). 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