Test Your Knowledge

There is only about a 10 percent chance per year that the symptoms of dysthymia will go away without treatment. The symptoms of dysthymia can often be completely eliminated, though treatment may have to be maintained indefinitely to prevent them from returning. In many cases, dysthymia responds equally to psychotherapy and medication.

Psychotherapy teaches coping skills and more effective ways to deal with problems in life. It also targets symptoms and addresses any substance use. One form known as cognitive behavior therapy (CBT) is often used. During CBT, the therapist engages the patient with conversation to gain insight into and to change negative patterns of thought or behavior that are associated with dysthymia. Sometimes, the patient will be given “homework” assignments between sessions. CBT teaches patients to gain more satisfaction and rewards from their own actions and resolve problems.

Medications for dysthymia typically offer relatively quick relief of symptoms. The primary medications for this disorder are antidepressants. Patients should be aware that a physician may need to adjust the dosage or change medications to achieve the best results with minimal side effects. In addition, the U.S. Food and Drug Administration (FDA) has advised that antidepressants may increase the risk of suicidal thinking in some patients, particularly children and adolescents, and all people being treated with them should be monitored closely for unusual changes in behavior. However, the benefits of such medications typically outweigh the risks.

Over-the-counter herbal and dietary supplements may be used by some people for dysthymia. Among the most commonly used of these is the herb St. John’s wort. Although used in Europe for the treatment of many forms of mild to moderate depression, including dysthymia, scientific studies demonstrating their effectiveness are lacking. The National Institute of Mental Health (NIMH) is currently conducting studies on the effectiveness and safety of this herb in the treatment of dysthymia and other forms of depression. It is important for patients to speak with a physician before taking any herbal or dietary supplement because many supplements may cause serious drug interactions.