What is Dysthymia? (Chronic Depression)
Dysthymia disorder is a depressive mood disorder. Dysthymia is characterized by longstanding depression symptoms where the patient is depressed more days than not for a period of two years or longer. People who suffer from chronic depression often experience life-long depression. About 6% of people will experience dysthymia disorder at some point in their lifetime.1
Dysthymia is defined as having depression most of the day, for most days, for two years or longer. Dysthymia is often called chronic depression due to its duration. For a diagnosis of dysthymia, a person must suffer from at least two of the following dysthymia symptoms:
- Lesser or greater appetite than normal
- Sleep too much (hypersomnia) or too little (insomnia)
- Low energy or fatigue
- Low self-esteem
- Trouble concentrating
- Decision-making difficulties
- Feelings of hopelessness
Dysthymia disorder is only diagnosed when no major depressive episodes have happened during the first two years of the illness and no manic periods are present. Periods of normal mood for up to two months may be present in dysthymia depression.
Signs and Symptoms of Dysthymia
Dysthymia was once considered less severe than major depression, and due to its elongated nature, its diagnosis was often missed. More and more though, clinicians are realizing dysthymia can have major consequences on a person's life and functioning.
Similar to major depression, dysthymia impairs everyday functioning, increases the risk of death from physical disease and increases the risks of suicide. As dysthymia is a depressive disorder, depressed and negative moods are common as well as restlessness, anxiety and irritability. Other dysthymia, or chronic depression, symptoms are:
- Unexplained periods of unhappiness in childhood
- Being overweight / underweight
- Loss of pleasure from activities previously found enjoyable
- Little time spent on hobbies and activities
- A family history of dysthymia
- Effort spent primarily on work and little left for social and personal relationships
- Substance abuse issues
- Increased negative reaction to criticism
- Slowed speech and minimal visible emotion
Risk Factors and Causes of Dysthymia
The causes of dysthymia have not been clearly established but dysthymia appears to share the some biological markers of major depression. In electroencephalogram (EEG) and polysomnogram testing, 25% of people with dysthymia disorder have sleep changes similar to those seen in major depression. Chronic stress and illness are associated with chronic depression (dysthymia) and it seems to run in families, occurring more often in women than in men. Many people with dysthymia have a long-term medical problem or another mental health disorder, such as anxiety, alcohol abuse, or drug addiction.
The treatment of dysthymia is similar to the treatment of major depression: both antidepressant medication and psychotherapy are recommended (read more about: Depression Therapy). Therapy combined with medication has been found superior to either medication or therapy alone in dysthymia treatment. Types of dysthymia treatment recommended include:
- Short and long-term psychodynamic (talk) therapy
- Cognitive behavioral therapy (CBT) – individual or group settings
- Interpersonal therapy (IPT) – individual or group settings
Each of these therapies focus on the handling of current problems. Long-term psychodynamic therapy can also help someone with dysthymia get to any issues underlying their chronic depression or other problems, such as substance abuse.
Last Updated: 14 June 2016
Reviewed by Harry Croft, MD