treatment plan for dysthymia

Treatment Plan for Dysthymia When SSRIs Fail

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One of the most elusive and frustrating mental health disorders is dysthymia, also referred to as persistent depressive disorder. Basically, individuals who suffer from dysthymia are held hostage by key depression symptoms for more than two years. Many of these people experience impairment across various aspects of daily life, even potentially becoming debilitated by the most severe cases of dysthymia. Because of the relentless depression symptoms, finding an effective treatment plan for dysthymia is essential.

What is Dysthymia (Persistent Depressive Disorder)?

Individuals who struggle with ongoing, unrelenting feelings of despondency and malaise for two years or longer may have a condition called dysthymia, also known as persistent depressive disorder. It generally a less intense version of major depression disorder, but lingers as a chronic condition, rendering the individual a gloomy demeanor similar to poor Eeyore of Winnie the Pooh fame. This low energy, low mood persistent state may have lingered so long that the individual just assumes that is just how they are.  But dysthymia is treatable, so there is no reason not to seek help.

Someone with chronic low grade persistent depression will experience a minimum of two of the following symptoms:

  • Low energy, fatigue
  • Insomnia or hypersomnia
  • Poor appetite or eating excessive amounts
  • Low self-esteem
  • Feelings of hopelessness, sadness
  • Difficulty making decisions
  • Poor concentration
  • General low mood

For a diagnosis of dysthymia there must be a level of impairment or distress related to work, school, or social functioning. Also, the disorder cannot be the result of a medical condition that might cause low mood, or a substance addiction.

What is the Treatment Plan for Dysthymia?

Treatment for dysthymia is basically the same as for major depressive disorder. This involves a two-pronged approach including psychotherapy and SSRIs, or antidepressants. The psychotherapy that has netted the best results for patients with major depression is cognitive behavioral therapy (CBT). CBT is a short-term therapy that helps depressed patients pinpoint negative thought patterns that result in persistent sadness or despair. By helping patients shift their thoughts toward more positive, constructive thoughts it helps change brain chemistry as well as overall attitude for the better.

Antidepressants are available in a variety of forms, including SSRIs, SNRIs, MAOIs, and tricyclic antidepressants. These drugs work to modify brain chemistry, especially targeting neurotransmitters, such as serotonin, dopamine, and norepinephrine.

What is Medication-Resistant Dysthymia?

While antidepressants can work effectively for most patients with depression or dysthymia, a significant percentage of them are found to be medication resistant. These patients may have trialed three or four different drugs, or had the drug dosage adjusted, or a period of several months but just could not find a successful result with any of them. Some patients discontinue drug therapy when adverse effects, such as weight gain, blurred vision, fatigue, nausea, or sexual dysfunction, become intolerable. Patients who are medication resistant become frustrated and hopeless as a result of the inability to find relief from symptoms. Some will give up trying, while others forge on to seek alternative remedies for their dysthymia.

TMS Therapy for Dysthymia

Transcranial magnetic stimulation (TMS) is a safe, noninvasive treatment intervention for medication resistant patients with persistent depressive disorder. TMS was FDA approved in 2008 for this purpose, and in the last decade has brought relief to thousands. TMS therapy offers an alternative treatment option for people who have to date been unsuccessful in finding an effective treatment for their dysthymia.

TMS therapy works by using powerful magnetic pulses generated by technology similar to an MRI. These magnetic fields are harnessed and delivered through the patient’s scalp, using a coil that is place over the left prefrontal cortex. The repetitive magnetic pulses create electrical currents in the brain tissue, reaching about 2 centimeters into the brain. As a result, the electrical currents then stimulate the dormant neurotransmitters to recalibrate brain chemistry that has been out of balance.

A course of TMS therapy typically lasts about 4-6 weeks, with each therapy session lasting 37 minutes. Over the course of treatment, patients will begin to notice improvements in symptoms after the tenth treatment session. In the ensuing weeks, the patient may notice they are getting better quality sleep. They may begin to feel more energized. Many patients notice they are more focused and can concentrate better. By the end of the treatment period, overall mood is improved as well.

TMS therapy can be successfully used in tandem with antidepressants and/or psychotherapy, or as a standalone treatment. TMS is well tolerated, with few side effects reported. Some patients have reported mild headaches or scalp tenderness, but these effects tend to resolve on their own as treatments continue. TMS therapy isn’t for everyone. There are certain situations, such as patients with a pacemaker or other electrical implants, patients with stents in the neck or brain, shrapnel or bullet fragments in or near the head, and other conditions may not allow someone to be a candidate for TMS.

How Does TMS Therapy Fit In To a Treatment Plan for Dysthymia?

When someone is medication resistant but is a candidate for TMS therapy, they can utilize TMS therapy on its own, or combine TMS with cognitive behavioral therapy. These two interventions work well together; the TMS targets brain chemistry, while the CBT focuses on thought/behavior patterns. Because dysthymia is a long-term disorder, CBT can be very helpful in changing entrenched negative thought patterns and focusing patients toward constructive behaviors or responses.

Another benefit of TMS therapy for treating major depression or dysthymia is its effectiveness in also treating co-occurring anxiety disorder. Since these two disorders frequently present together, patients who had sought TMS treatment for depression soon discovered that their anxiety symptoms were also better as a result.

Anew Era TMS & Psychiatry Provides Treatment for Medication-Resistant Dysthymia

Anew Era TMS & Psychiatry can provide a comprehensive treatment plan for dysthymia, including psychiatric, psychotherapy, and TMS therapy interventions. Anew Era TMS & Psychiatry is a leading provider of TMS therapy in Southern California, helping to improve the quality of life for hundreds of patients. To learn if you are a candidate for this promising alternative treatment for dysthymia, please contact Anew Era TMS & Psychiatry today at (888) 503-1549.