Dysthymia in Youth

Prevalence of Dysthymia among Youth

The prevalence of dysthymia among youth varies globally. According to the World Health Organization (WHO, 2018), depression is one of the leading causes of disability among adolescents worldwide, affecting approximately 10-20% of youth. In Singapore, studies (Lim, et al., 2018) have shown that the prevalence of depression and related mood disorders among youth is on the rise, with increased academic pressure, social media usage, and other stressors contributing to mental health challenges.

What is Dysthymia?

Dysthymia, also known as persistent depressive disorder (PDD), is a chronic mood disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities (APA, 2013). In youth populations, dysthymia can significantly impair daily functioning and overall well-being. 

Causes of Dysthymia 

The causes of dysthymia in youth are multifactorial, with a combination of genetic, biological, environmental, and psychosocial factors playing a role. Genetic predisposition, imbalances in brain chemistry (such as serotonin and dopamine), childhood trauma or adverse experiences, chronic stress, and family history of mood disorders can contribute to the development of dysthymia in young individuals.

Signs and Symptoms of Dysthymia in Youth 

  • Persistent low mood
  • Irritability or agitation
  • Feelings of worthlessness or guilt
  • Fatigue or low energy
  • Changes in appetite or weight
  • Sleep disturbances (insomnia or hypersomnia)
  • Difficulty concentrating or making decisions
  • Social withdrawal or isolation
  • Decreased interest in activities once enjoyed
  • Suicidal thoughts or behaviors (in severe cases)

Diagnosis of Dysthymia in Youth

Diagnosing dysthymia in youth requires careful consideration of developmental factors, age-appropriate symptoms, and the duration of symptoms. According to DSM-5 criteria, the diagnosis of dysthymia in youth featured with:

1. The depressed or irritable mood has been for at least one year (in children and adolescents) and has caused clinically significant disturbances in daily functioning.

2. Presence, while depressed, of two (or more) of the following symptoms:

  • Poor appetite or overeating.
  • Insomnia or hypersomnia.
  • Low energy or fatigue.
  • Low self-esteem.
  • Poor concentration or difficulty making decisions.
  • Feelings of hopelessness.

Treatment for Dysthymia in Youth 

Treatment for dysthymia in youth typically involves a multimodal approach, including psychotherapy, medication, and lifestyle interventions. Cognitive-behavioral therapy (CBT) is commonly used to help young individuals identify and modify negative thought patterns, develop coping skills, and improve problem-solving abilities. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), may also be prescribed under the supervision of a psychiatrist or pediatrician.

In Singapore, mental health services for youth are also available through various channels, including school-based counseling programs, community mental health clinics, and private practitioners. Efforts to raise awareness about mental health issues and reduce stigma surrounding seeking help for mental health concerns are ongoing in both Singapore and globally.

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

World Health Organization (2018). Adolescent mental health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health

Lim, S., et al. (2018). Prevalence and correlates of depression in adolescents in Singapore. Asia-Pacific Psychiatry, 10(3), e12321. https://doi.org/10.1111/appy.12321

Written by:
Jenny Zeng
Psychologist
SACAC Counselling

Reflections on grief

Manu Keirse is a Clinic Psychologist from Belgium who specialises in grief. He has done a lot of research and has written multiple books. He is an inspiration in the psychology field. 

He has written a book in Dutch, a guide for professionals and families named: “Helpen bij verlies en verdriet”, which means “How to help with loss and sadness”. 

Grief is the emotional, physical and cognitive reaction of people who are confronted with a severe loss. Everything that has to do with “loss” creates a grieving process. Every form of loss, such as health issues, illness, losing a job, loss of faith, the ending of a relationship, death, divorce, failing at school, disabilities related to yourself or a loved one, being diagnosed. 

It usually is a confrontation with feelings of injustice, unfairness and/or a feeling of helplessness. 

Grief is not about saying goodbye or letting go but about learning to hold differently. Sadness about a loss is something that won’t change, but you learn to live with it. With death, a life ends, but the relationship never ends. Grief is like a fingerprint: recognisable to everyone, yet always different and unique. Death transforms relationships but does not end them. 

Important to know is that everyone grieves differently, and it is not something that has an end date. Everyone has their own process, their own pace and their own feelings. 

Manu Keirse mentions that to survive loss, you need to do “grieving work/mourning work”. He mentions grieving is not passive, but it is a heavy emotional active activity. Grieving is working to find meaning and rebuild your personal world that has been shaken by the loss. 

He has defined 4 tasks part of the “grieving work/mourning work”: 

1. Facing the reality of the loss. 
2. Experiencing the pain of the loss. 
3. Adjusting to the world after this loss. 
4. Learning to enjoy again and keep the memories. 

He mentions these tasks overlap. Unfinished tasks can get in the way of happiness in life.

My next blog will be on how to support someone with the “grieving work/mourning work”. “ How to support someone who’s going through grief? “ 

Reference
Keirse, M. (2017). Helpen bij verlies en verdriet. 

Written By:
Flo Westendorp
Clinical Psychologist
SACAC Counselling