Dysthymia - Diagnosis

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How do health-care professionals diagnose dysthymia?

Many providers of health care may help make the diagnosis of dysthymia, including licensed mental-health therapists, pediatricians, or other primary-care providers, specialists whom one sees for a medical condition, emergency physicians, psychiatrists, psychologists, psychiatric nurses, and social workers. One of these professionals will likely conduct or refer for an extensive medical interview and physical examination as part of establishing the diagnosis. Dysthymia may be associated with a number of other medical conditions, the result of exposure to alcohol or other drugs of abuse or as part of a general medical condition, so routine laboratory tests are often performed during the initial evaluation to rule out other causes of symptoms. Occasionally, an X-ray, scan, or other imaging study may be needed.

As part of this examination, the sufferer may be asked a series of questions from a standardized questionnaire or self-test to help assess the presence of depression. Thorough exploration for any history or presence of mental-health symptoms will be conducted such that dysthymia can be distinguished from other types of depression like major depression, depressive symptoms in reaction to stress (adjustment disorder), or depression as part of the mood swings of bipolar disorder or cyclothymia. The mental-health professional will also explore whether other forms of mental illness are present.

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Comment from: David, 45-54 Male (Patient) Published: December 01

After years of counseling and mild use of prescribed antidepressants, several different events took place at once. After losing a job in the spring the anxiety and depression I normally had seemed to ramp up several steps and at one point while waiting for a train to pass at the crossing I wondered how fast it would take me to die from the impact. It was just a fleeting thought but I had several of these episodes over 40 years of dealing with dysthymia and I could almost picture myself doing it. I told my wife about my thoughts and she talked with a psychiatrist she was working with. I couldn't see her right away but she said I needed to see my general physician as soon as possible, which I did. He added a small dose of Lexapro along with the bupropion I was already taking. It got me through the rough spot until I could see the psychiatrist. Within the first visit she was able to diagnose dysthymia as the cause. She increased doses of both the bupropion and the Lexapro. The voices of negativity were greatly quieted and my optimism is now much stronger, the anxiety of job searching is now just another chore and not some great mountain I must conquer. I am planning to take some courses in the next few months and my social anxiety feels like 'why was I afraid of this' kind of attitude. I am now looking at my job loss as a great opportunity now as I probably would have kept plodding along, always depressed and angry and going nowhere.

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