Dysthymia and the Elderly
Dysthymia is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), as “semichronic, smoldering mood disorder with ongoing waxing and waning symptoms. Symptoms must be present for at least two years in adults and for at least one year in children and adolescents.” (Sansone & Sansone, 2009, p. 14) The disorder is further characterized as requiring symptoms lasting two years in adults and one year in children or adolescents and requires at least two of the following symptoms. 1) A change in appetite, either an increase or decrease. 2) A change in sleep patterns, again, either an increase or decrease. 3) Feelings of fatigue or low energy. 4) Lowered self esteem. 5) A decrease in concentration or being indecisive. Finally, (6) feelings of hopelessness. (Ibid, p. 15.) Further, while symptoms may alleviate and normal mood return, dysthymia patients will never be absent symptoms for more than two consecutive months. Initial patients don’t have a history of major depression, but after onset many experience contiguous episodes of acute depression. (Ibid, p. 15.)
In the article “Recognition and Treatment of Dysthymia in Elderly Patients,” authors Bellino, S., Bogetto, F., Vaschetto, P., Ziero, S., & Ravizza, L. observe that both major depression and dysthymia are less prevalent in elderly populations than in young adults. However, the mild to moderate syndromes are more common in the elderly than is major depression. (Bellino, S., Bogetto, F., Vaschetto, P., Ziero, S., & Ravizza, L. (2000). p. 108). Social and environmental factors can contribute to finding of dysthymia, as the article notes, “The occurrence of dysthymic disorder in both men and women was related to retirement because of sickness rather than age, a small number of rooms in their homes, lack of intimate friendships and in the occurrence of many long-standing and current social factors” (Ibid.