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Understanding dysthymia: The chronic depression you should know about
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What is Dysthymia?
Dysthymia, also known as Persistent Depressive Disorder (PDD), is a chronic form of depression that lasts for at least two years in adults (or one year in children/adolescents).
Unlike major depressive disorder, symptoms are less severe but long-lasting, often leading to functional impairment and poor quality of life.
Key characteristics
- Persistent low mood
- Low self-esteem
- Fatigue
- Poor concentration
- Changes in appetite/sleep
- Feelings of hopelessness
Causes
1. Biological factors
- Imbalances in brain chemicals (neurotransmitters like serotonin, dopamine)
- Genetic predisposition (family history of depression)
2. Psychosocial factors
- Chronic stress
- Childhood trauma or neglect
- Loneliness or social isolation
3. Environmental triggers
- Long-term illness
- Financial or relationship stress
Diagnosis
- Based on clinical evaluation and DSM-5 criteria
- Symptoms must persist for ≥ 2 years (adults), with no remission >2 months
- Often underdiagnosed due to its “milder” but chronic nature
Treatment/cure
1. Pharmacological
- SSRIs/SNRIs (e.g., fluoxetine, sertraline)
- Atypical antidepressants (e.g., bupropion)
2. Psychotherapy
- Cognitive Behavioural Therapy (CBT)
- Interpersonal Therapy (IPT)
3. Lifestyle interventions
- Regular physical activity
- Structured routines
- Sleep hygiene
- Social engagement
Note: Early diagnosis and adherence to treatment are key to effective management.’
Why in news? (Contextual relevance for UPSC)
- Rising mental health burden in India post-COVID-19, especially among youth and professionals, has brought dysthymia and related disorders into public discourse.
- National Mental Health Survey (India) and Lancet studies highlight increasing cases of undiagnosed persistent depression.
- Recently, government has launched initiatives under Mental Health and Wellness Centres (MHWCs), part of Ayushman Bharat, addressing low-intensity chronic mental illnesses like dysthymia.
UPSC relevance
1. GS Paper II – Governance, Social Justice & Health:
- Government schemes related to mental health
- Mental healthcare rights under the Mental Healthcare Act, 2017
- Role of ASHA workers, telemedicine and school counselling
2. GS Paper IV – Ethics:
- Psychological well-being in public service
- Role of empathy in tackling mental health stigma
3. Essay/GS Paper I (Society):
- Mental health as a social issue
- Impact of lifestyle and urbanisation on emotional well-being
Practice questions
Short answer type
- What is dysthymia? How does it differ from major depressive disorder?
- Mention two government initiatives addressing mental health in India.
Long answer type
- Discuss the growing mental health crisis in India. What role can public policy play in addressing persistent depressive disorders like dysthymia?
Analytical essay type
- “Mental health is as important as physical health in achieving inclusive development.” Critically examine with reference to persistent depressive disorders.
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