Persistent Depressive Disorder (Dysthymia)

What is persistent depressive disorder?

Persistent depressive disorder, also known as dysthymic disorder, is classified as a type of affective disorder (also called mood disorder) that often resembles a less severe, yet more chronic form of major (clinical) depression. However, people with persistent depressive disorder may also have major depressive episodes at times.

Depression is a mood disorder that involves a person's body, mood, and thoughts. It can affect and disrupt eating, sleeping, or thinking patterns, and is not the same as being unhappy or in a "blue" mood, nor is it a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Treatment is often necessary and many times crucial to recovery.

There are three primary types of depression, including:

  • Major depression (clinical depression)

  • Bipolar disorder (manic depression)

  • Persistent depressive disorder (dysthymia)

Who is affected by persistent depressive disorder?

Persistent depressive disorder affects women twice as often as men. Persistent depressive disorder affects approximately 1.5% of American adults age 18 years of age or older during their lifetime. According to the National Institute of Mental Health Disorders, some adults with persistent depressive disorder may also meet criteria for major depressive disorder or bipolar disorder in a given year.

What are the symptoms of persistent depressive disorder?

Although less severe, yet more chronic than major depression, the following are the most common symptoms of persistent depressive disorder. However, each person may experience symptoms differently. Symptoms may include:

  • Persistent sad, anxious, or empty mood

  • Decreased ability to concentrate and make decisions

  • Decreased energy

  • Increased feelings of hopelessness

  • Weight and/or appetite changes due to over- or under-eating

  • Changes in sleep patterns

  • Low self-esteem

For a diagnosis of persistent depressive disorder to be made, an adult must have a depressed mood for at least two years (one year in children and adolescents), accompanied by at least two other depressive symptoms (noted above). The symptoms of persistent depressive disorder may resemble other psychiatric conditions. Always consult your health care provider for a diagnosis.

How is persistent depressive disorder diagnosed?

Because depression has shown to often coexist with other medical conditions, such as heart disease, cancer, or diabetes, and other psychiatric disorders, such as substance abuse, or anxiety disorders, seeking early diagnosis and treatment is crucial to recovery. A diagnosis is often made after a careful psychiatric examination and medical history performed by a psychiatrist or other mental health professional.

Treatment for persistent depressive disorder

Specific treatment for persistent depressive disorder will be determined by your health care provider based on:

  • Your age, overall health, and medical history

  • Extent of the condition

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Treatment may include either, or a combination, of the following:

  • Antidepressant medications

  • Psychotherapy (most often cognitive-behavioral and/or interpersonal therapy that is focused on changing the individual's distorted views of themselves and the environment around them, working through difficult relationships, and identifying stressors in the environment and how to avoid them)

Because episodes of persistent depressive disorder usually last for longer than five years, long-term treatment of the disorder may be necessary.