Dysthymia: Symptoms and Risk Factors

MAOIs and Serotonin Syndrome

• Patients taking MAOIs are placed on a low-tyramine diet to avoid serotonergic hyperstimulation.
• Serotonin syndrome occurs when there is a combination of MAOI with serotonergic agents, leading to ↑ blood levels of serotonin.
• Symptoms of serotonin syndrome include:
  • Tachycardia
  • Hypertension
  • Fever
  • Sweating
  • Shivering
  • Confusion
  • Anxiety
  • Restlessness
  • Disorientation
  • Muscular spasm and rigidity
• Risk factors for serotonin syndrome include:
  • Concomitant use of antidepressant from different classes (e.g., TCAs and SSRIs)
  • Inadequate time between discontinuing one antidepressant and initiating another
  • Combined use of serotonergic agonists with SSRIs
  • Combined use of SSRIs with St. John's wort

Major Depressive Disorder (MDD)

• Etiology:
  • Biological theories:
    • Genetic factors (twin and adoption studies)
    • Neurobiological hypotheses (deficiency in neurotransmitters norepinephrine, dopamine, and serotonin)
    • Neuroendocrine hypotheses (endocrine alterations, specifically hypothalamic-pituitary-adrenal axis and hormone production)
  • Psychological theories:
    • Psychodynamic factors (built on Freud's theory of early lack of love, protection, and care)
    • Behavioural factors (reduction in rewarding activities or increase in unpleasant events)
    • Developmental factors (loss of a parent or inadequate parenting)
  • Cognitive factors (irrational beliefs and negative thoughts about self and future)
• Social theories:
  • Family factors (maladaptive patterns in family interactions)
  • Social factors (adverse traumatic life events)

Dysthymia

• Definition: Milder, but long-lasting form of depression, also known as persistent depressive disorder (PDD)
• Caused by chemical imbalances in the brain
• Risk factors:
  • Environmental, psychological, biological, and genetic factors
  • Chronic stress and trauma
• Symptoms:
  • Lasting sad, anxious, or "empty" mood
  • Less ability to concentrate, think, or make decisions
  • Less energy, fatigue
  • Feeling hopeless
  • Weight and/or appetite changes
  • Changes in sleep patterns
  • Low self-esteem

Premenstrual Dysphoric Disorder (PMDD)

• Definition: A health problem similar to premenstrual syndrome (PMS) but more serious
• Symptoms:
  • Depressed mood
  • Irritability
  • Anxiety
  • Symptoms usually go away 2-3 days after period starts
• Treatment: Selective serotonin reuptake inhibitor (SSRI)

Substance/Medication-Induced Depressive Disorder

• Definition: Depression caused by substance abuse
• Assessment:
  • Physical behavior:
    • Psychomotor retardation or agitation
    • Grooming, dress, and personal hygiene
    • Appetite and sleep changes
  • Communication:
    • Slow speech
    • Comprehension is slow
    • Lack of immediate response
  • Medications:
    • Frequency and dosage of over-the-counter medications
    • Use of herbal or cultural related treatments
    • Lethality of medication
    • Use of alcohol, marijuana, and other mood-altering medications for drug-drug interactions

Interdisciplinary Treatment of the Disorder

• Goals of treatment:
  • Reduce or control symptoms and, if possible, achieve remission

Explore the symptoms and risk factors associated with Dysthymia, a milder yet long-lasting form of depression also known as persistent depressive disorder (PDD). Learn about the causes, symptoms like lasting sad mood and fatigue, and potential risk factors including environmental, psychological, biological, and genetic influences.