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Tests and diagnosis
By Mayo Clinic staffIf your doctor suspects you have dysthymia, exams and tests may include:
- Physical exam. The doctor may do a physical exam and ask in-depth questions about your health to determine what may be causing your dysthymia. In some cases, dysthymia may be linked to an underlying physical health problem.
- Lab tests. For example, your doctor may order a blood test called a complete blood count, do blood tests to check your folate and Vitamin D levels, or test your thyroid to make sure it's functioning properly.
- Psychological evaluation. This evaluation includes a discussion about your thoughts, feelings and behavior and may include a questionnaire to help pinpoint a diagnosis.
Checking for other conditions
Several other conditions have symptoms that may resemble dysthymia. Your doctor or mental health provider's evaluation will help determine if you have dysthymia or another condition that can affect your mood, such as major depression, bipolar disorder or seasonal affective disorder.
Diagnostic criteria for dysthymia
To be diagnosed with dysthymia, you must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
For a diagnosis of dysthymia, the main indication for an adult differs somewhat from that of a child:
- For an adult, depressed mood most of the day for two or more years
- For a child, depressed mood or irritability most of the day for at least one year
In addition to that, you must have at least two of these symptoms, and they must cause distress or interfere with your ability to function in your daily life:
- Poor appetite or overeating
- Sleep problems
- Tiredness or lack of energy
- Low self-esteem
- Hopelessness
- Poor concentration
- Trouble making decisions
- Dysthymic disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Oct. 23, 2012.
- Ebert MH, et al. Current Diagnosis & Treatment: Psychiatry. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=10. Accessed Oct. 24, 2012.
- Cuijpers P, et al. Psychotherapy for chronic major depression and dysthymia: A meta-analysis. Clinical Psychology Review. 2010;30:51.
- Understanding major depression. National Alliance on Mental Health. http://www.nami.org/Template.cfm?section=Search&Template=Search/SearchDisplay.cfm. Accessed Oct. 24, 2012.
- Depression and complementary health practices: What the science says. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/providers/digest/depression-science.htm. Accessed May 10, 2012.
- Depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml. Accessed Oct. 23, 2012.
- Marchand WR. Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression. Journal of Psychiatric Practice. 2012;18:233.
- Tanyi RA, et al. The effects of psychoneuroimmunology (PNI)-based lifestyle intervention in modifying the progression of depression in clinically depressed adults. International Journal of Psychiatry in Medicine. 2011;42:151.
- Cuijpers P, et al. Personalized treatment of adult depression: Medication, psychotherapy, or both? A systematic review. Depression and Anxiety. 2012;29:855.
- VonWolff A, et al. Selective serotonin reuptake inhibitors and tricyclic antidepressants in the acute treatment of chronic depression and dysthymia: A systemic review and meta-analysis. Journal of Affective Disorders. In press. Accessed Oct. 24. 2012.
- Hourani LL, et al. Influence of spirituality on depression, posttraumatic stress disorder, and suicidality in active duty military personnel. Depression Research and Treatment. 2012;2012:1.
- Wu J, et al. Acupuncture for depression: A review of clinical applications. Canadian Journal of Psychiatry. 2012;57:397.
- Chi J, et al. Tai chi and reduction of depressive symptoms for older adults: A meta-analysis of randomized trials. Geriatrics & Gerontology International. In press. Accessed Aug. 28, 2012.
- Chan MF, et al. The effectiveness of music listening in reducing depressive symptoms in adults: A systemic review. Complementary Therapies in Medicine. 2011;19:332.
- McCaffrey R, et al. Garden walking and art therapy for depression in older adults: A pilot study. Research in Gerontological Nursing. 2011;4:237.
- Carpenter DJ. St. John's wort and s-adenosyl methionine as "natural" alternatives to conventional antidepressants in the era of the suicidality boxed warning: What is the evidence for clinically relevant benefit? Alternative Medicine Review. 2011;16:17.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 26, 2012 & Nov. 18, 2012.
- Kung S (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 26, 2012.
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