Dysthymia in Women
Dysthymia is a psychiatric condition that belongs to a larger group of conditions known as depressive disorders. People with the disorder have somewhat less severe forms of some of the symptoms found in people with major depressive disorder (major depression). However, by its very nature, dysthymia lasts for extended periods of time, and its overall effects can actually be worse than the effects of major depression. Women develop dysthymia much more frequently than men. In addition, when the disorder appears in pregnant women, it can have a significant negative impact on fetal health.
Dysthymia is also known as dysthymic disorder. According to guidelines established by the American Psychiatric Association, people with the disorder feel generally depressed most of the time for a minimum of two consecutive years. They also have at least two of six additional symptoms, which include a diminished ability to concentrate or make decisions, abnormal fatigue or lack of energy, abnormal sleepiness (hypersomnia) or inability to sleep (insomnia), abnormally low appetite or high food intake, lack of normal self-esteem and a recurrent or chronic sense of hopelessness. Some people experience a form of the disorder called anxious dysthymia, which produces restlessness and higher risks for low self-esteem. Others experience a form of the disorder called anergic dysthymia, which produces fatigue, sleepiness, and an inability to experience pleasure (anhedonia).
As stated previously, dysthymia typically produces symptoms that are less intense than the symptoms found in people with major depression. In addition, people with major depression commonly experience certain symptoms-including repetitive suicidal thoughts and significant weight loss or weight gain-not typically found in people with dysthymia. However, in part because of its prolonged nature, dysthymic disorder can produce life disruptions equal to or worse than the disruptions associated with major depression. When compared to people without a depressive disorder, people with dysthymia have higher risks for premature death from generally poor health, as well as higher risks for suicide attempts and actual completed suicides.
Prominence in Women
Dysthymia affects anywhere from 1.5 percent to 6 percent of the adult population in the United States. The disorder also appears in a slightly different form in unknown numbers of teenagers and younger children. Prepubescent males and females appear to develop dysthymia at roughly equal rates, Medscape Reference reports. However, during their childbearing years, women develop the disorder roughly twice as frequently as men. Postmenopausal women also experience the condition more frequently than older men, but typically develop less damaging symptoms than their male counterparts.
Impact During Pregnancy
When you experience stress, your body produces abnormally high amounts of an adrenal gland hormone called cortisol (hydrocortisone). Normally, this hormone serves important functions such as regulating your immune system and blood pressure, regulating the release of glucose-controlling insulin into your bloodstream, and controlling the amount of inflammation in your tissues. However, when it accumulates in your bloodstream and doesn’t dissipate, excess cortisol can produce damaging effects that include abnormal blood pressure increases, blood glucose imbalances, significant losses in muscle tissue and bone density, a diminished ability to think clearly, reduced immune system function and a potentially dangerous accumulation of abdominal fat. In pregnant women, chronic high cortisol levels are associated with both slower fetal growth rates and abnormally low birthweight.
Depression is heavily associated with both chronic stress and high cortisol levels. In 2008, researchers at the University of Miami published findings from a study that examined the links between cortisol levels, depression, pregnancy and fetal health. These researchers found that slightly higher than 20 percent of the women in their study met current guidelines for a dysthymia diagnosis early in their pregnancies. Another roughly 23 percent of study participants met current guidelines for a major depression diagnosis at the same point in their pregnancies.
As often happens when comparisons between major depression and dysthymia are made, pregnant women with major depression experience more severe and extensive symptoms than pregnant women with dysthymia. However, while expectant mothers with major depression experienced a greater negative impact on their overall sense of well-being, expectant mothers with dysthymia experienced greater accumulations of excess cortisol. In turn, these higher cortisol levels triggered more serious negative effects on developing fetuses; when compared to fetuses carried by expectant mothers with major depression, fetuses carried by dysthymic expectant mothers had significantly lower body weights and also experienced slower bone growth.