Dysthymia (Mild, Chronic Depression)

Dysthymia, sometimes referred to as mild, chronic depression, is less severe and has fewer symptoms than major depression. With dysthymia, the depression symptoms can linger for a long period of time, often two years or longer. Those who suffer from dysthymia can also experience periods of major depression-- sometimes called "double depression." In modern diagnostic classification systems, dysthymia and chronic depression are now both referred to as persistent depressive disorder.

What Causes Dysthymia?

Experts are not sure what causes dysthymia or depression. Genes may play a role, but many affected people will not have a family history of depression, and others with family history will not have depression problems. Abnormal functioning in brain circuits or nerve cell pathways that connect different brain regions regulating mood are also thought to be involved. Major life stressors, chronic illness, medications, and relationship or work problems may also increase the chances of dysthymia in people biologically predisposed to developing depression.

What Are the Signs and Symptoms of Dysthymia?

The symptoms of dysthymia are the same as those of major depression but fewer in number and not as intense. They include the following:

• Sadness or depressed mood most of the day or almost every day
• Loss of enjoyment in things that were once pleasurable
• Major change in weight (gain or loss of more than 5% of weight within a month) or appetite
• Insomnia or excessive sleep almost every day
• Being physically restless or rundown in a way that is noticeable by others
• Fatigue or loss of energy almost every day
• Feelings of hopelessness or worthlessness or excessive guilt almost every day
• Problems with concentration or making decisions almost every day
• Recurring thoughts of death or suicide, suicide plan, or suicide attempt

Is Dysthymia Common in the U.S.?

According to the National Institute of Mental Health, approximately 1.5% of adult Americans are affected by dysthymia. While not as disabling as major depression, dysthymia can keep you from feeling your best and functioning optimally. Dysthymia can begin in childhood or in adulthood and seems to be more common in women.

How Is Dysthymia Diagnosed?

A mental health specialist generally makes the diagnosis based on the person's symptoms. In the case of dysthymia, these symptoms will have lasted for a longer period of time and be less severe than in patients with major depression.

With dysthymia, your doctor will want to make sure that the symptoms are not a result of a physical condition, such as hypothyroidism.

If you are depressed and have had depressive symptoms for more than two weeks, see your doctor or a psychiatrist. Your provider will perform a thorough medical evaluation, paying particular attention to your personal and family psychiatric history.

There is no blood, X-ray or other laboratory test that can be used to diagnose dysthymia.

How Is Dysthymia Treated?

While dysthymia is a serious illness, it’s also very treatable. As with any chronic illness, early diagnosis and medical treatment may reduce the intensity and duration of symptoms and also reduce the likelihood of developing an episode of major depression.

To treat dysthymia, doctors may use psychotherapy (talk therapy), medications such as antidepressants, or a combination of these therapies. Often, dysthymia can be treated by a primary care physician.

What Is Psychotherapy?

Psychotherapy (or talk therapy) is used in dysthymia and other mood disorders to help the person develop appropriate coping skills for dealing with everyday life and challenging erroneous negative beliefs about oneself. Psychotherapy can also help increase adherence with medication and healthy lifestyle habits, as well as help the patient and family understand the mood disorder. You may benefit from one-on-one therapy, family therapy, group therapy, or a support group with others who live with chronic depression.

How Do Antidepressants Help Ease Dysthymia?

There are different classes of antidepressants available to treat dysthymia. Your doctor will assess your physical and mental health, including any other medical condition, and then find the antidepressant that is most effective with the least side effects.

Antidepressants may take several weeks to work fully. They should be taken for at least six to nine months after an episode of depression. In addition, it sometimes may take several weeks to safely discontinue an antidepressant, so let your doctor guide you if you choose to stop the drug.

Sometimes antidepressants have uncomfortable side effects. That’s why you have to work closely with your doctor to find the antidepressant that gives you the most benefit with the least side effects.

What Else Can I Do to Feel Better?

Getting an accurate diagnosis and effective treatment is a major step in feeling better with chronic depression. In addition, ask your doctor about the benefits of healthy lifestyle habits such as eating a well-balanced diet, getting regular exercise, avoiding alcohol and smoking, and being with close friends and family members for strong social support. These positive habits are also important in improving mood and well-being.

Can Dysthymia Worsen?

It’s not uncommon for a person with dysthymia to also experience an episode of major depression at the same time. This is called double depression. That’s why it’s so important to seek an early and accurate medical diagnosis. Your doctor can then recommend the most effective treatment to help you feel yourself again.

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