What is Dysthymia?

With all that goes on in the world today, many people are having a difficult time with the day to day. Forms of mood disorders and depression are occurring more and more. Depression, to some, can have an air of being somewhat unspecific and not serious. However, they are very real and important disorders to pay attention to. Dysthymia is a type of depression, and affects many people around the US and world. 

What is Depression

To understand Depression, we must first quickly look at depression. We have all heard of it, and it has many names such as the blues, feeling down, biological depression, and more. All these names are really referring to a feeling of sadness and hopelessness. Usually it is accompanied by a lack of energy, not finding pleasure in things, and a lack of joy. No two people experience it the same. And there are many types of depression. So let’s take a close look at dysthymia.

What is Dysthymia or Persistent Depressive Disorder

Dysthymia, also known as persistent depressive disorder, is mood disorder with physical and cognitive symptoms similar to depression. The major difference are that dysthymia has less severe but longer lasting effects. While major depressive disorder can be shorter, dysthymia lasts from two years and can go longer. However, it is possible that they had been suffering for years before they were diagnosed. Because of this, some people think it is part of their personality rather than a mood disorder. This can make it difficult to diagnose when the person is unclear about it themselves.  

Persistent depressive disorder is a chronic form of depression that can cause people to lose interest in everyday activities. But the signs of major depression including anhedonia (inability to feel pleasure), lethargy or agitation, and suicidal thoughts are usually absent. 

Dysthymia can present alone as well as with other disorders. In fact, over half the people who deal with persistent depressive disorder will suffer from at least one episode of major depression. This is known as double depression. Switching between different states of depression causes a mild variation of bipolar disorder. 

Because of its long term effects, those suffering from this depressive disorder are at a higher risk for substance abuse and anxiety. And like major depression, dysthymia sufferers are twice as likely to be women. 

Dysthymia or Depression Symptoms 

The defining feature of dysthymia is a depressed mood that happens for most of the day, more often than not, for at least two years in adults and one year in children. It is possible for it to fluctuate over time. However, symptoms don’t usually go away for more than a month at a time. 

If you are dealing with dysthymia, people might describe you as often being down in the dumps or sad. However, people who suffer from this depression are more than just feeling sad. It is a chronic depression that causes lack of interest in everyday life and low self-esteem. Similarly, productivity goes down as well as feelings of inadequacy and negativity. One side affect is the toll this can take on your relationships, employment, education, or any other interactions you have with people. Even in good situations, people with dysthymia have trouble being upbeat and cheery. They might be seen as pessimistic or a complainer

While symptoms do vary, there are many factors that can indicate someone is in a depressive state including: 

  • Poor appetite or overeating
  • Loss of interest in daily activities
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem, self-criticism, or feeling incapable
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness
  • Decreased activity and/or productivity
  • Social isolation
  • Irritability or anger
  • Sadness or feeling down
  • Feelings of guilt
  • In children, depressed mood and irritability are often primary symptoms. 

The key to understanding the depressive symptoms is to look at the length of time and severity. Depressed mood over a long period of time is a strong indicator for dysthymia. People with bipolar disorder, anxiety disorders, or other personality disorders are more likely to also suffer from dysthymia. 

Dysthymia Test | Diagnosis

Depression happens on a variety of levels and it is difficult to know for sure. Online tests are available to answer some basic questions regarding this depressive disorder, but they won’t do be able to truly diagnose you. However, they might give you an idea if you feel you should speak to a mental healthcare professional. 

Some of the criteria to be diagnosed include the following:

  • During the majority of days for at least two years, you have been in a depressed mood or appeared depressed to others. 
  • When feeling depressed, you feel at least two of: low self-esteem, decreased or increased sleep, problem concentrating and decision-making, feeling of hopelessness, overall pessimism
  • During the latest two year period, you have had these symptoms without more than a two month break
  • You may or may not have suffered one or many major depressive episodes
  • During the two years, you don’t have any manic or hypomanic episodes 
  • Your depression is not connected to any disorders such as schizophrenia or delusional disorder
  • Depressive symptoms don’t come from any drugs or other medicines
  • There might be some effect in personal life, worklife, social circles, or other relationships

While adults are measured in 2 year intervals, children are diagnosed if they experience these for one year. Young adults and adolescents can also have other mental disorders associated with dysthymia. 

The key defining factor for being diagnosed with dysthymia is a long lasting depression. It is much longer than major depressive disorder, which can be as short as only two weeks. It also has been present at younger ages than other forms of depression.

Dysthymia Treatment

If you think you have dysthymia, it is important to seek help. There are ways you can treat it. Many people are able to find ways to overcome their depression and return to a normal way of life. Sometimes, live improves even more so than before because dysthymia had been undiagnosed for years before. So don’t worry, there is hope.


Visiting a mental health professional is the first thing to do on the road to recovery. While some people have trouble with it, therapy is an important step in recovery. Making an effort to go to therapy is a great step in taking care of your mental health and well-being. This is not something that can go away on its own.

Cognitive-behavioral therapy will help you learn to deal with you depression. In teaching skill-building and ways to manage stress, it introduces the concepts of empathy, reassurance, and care. Therapy can show you how to deal with negative thoughts and feelings. Similarly, that new way of thinking helps you identify and change a depressed mood. Other types of therapy proven to help include psychodynamic therapy and interpersonal therapy. Both help with interpersonal disputes, loss and separation, and other personal factors that may be contributing to the persistent depressive disorder.


A combination of therapy and medication is the most proven way to overcome persistent depressive disorder. The most common types of antidepressants to treat dysthymia are SSRIs (selective serotonin reuptake inhibitors), TCAs (tricyclic antidepressants), and SNRIs (serotonin and norepinephrine reuptake inhibitors).  These affect the serotonin levels which help reduce stress and elevate your mood. These are serious medications and you should check with you your doctor to ask about any potential side effects, especially if you have a history of suicidal thoughts or attempts. 

According to a follow-up study with people who had dysthymia for nine years and worked through it, confidence in your health care provider plays a huge role. Taking the time to find a therapist and psychiatrist who you feel comfortable with and fit your needs is key. Those in the study felt they gained “tools to handle life”. This included understanding themselves better, their disorder, and being able to accept both themselves and the situation, allowing them to focus their energy on finding ways to make themselves happy.
Therapy will help you learn ways to cope and deal with your mental health in positive way. It is important to remember that persistent depressive disorder is just that, persistent. Make sure you get the help of a medical professional. 

Dysthymia: Final Thoughts

Depression is not something to be taken lightly. It clearly has effects on life all around you and can make life harder. But depression is something that can be overcome. It can be worked on, and grown day by day to move past the feelings of hopelessness. The chronic effects of persistent depressive disorder can affect someone for years and often be hard to spot. With support, you can overcome this mood disorder.

Dysthymic behaviors only last if you don’t take the first step to get help. While it is no easy step, there is a way to find ways past the depression.  









author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
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