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What is dysthymia? Symptoms, causes and treatment

Dysthymia can leave you feeling trapped in a persistent low mood, but recognising the signs can be the first step towards finding the support and care you need.

Written by: Will Hinch
Mental health & addictions writer
Clinically reviewed by: Dr Patrick Mbaya
Lead Consultant for Addictions at Priory Hospital Altrincham in Manchester

Dysthymia at a glance:

  • Also known as persistent depressive disorder (PDD)
  • Involves long-term low mood lasting 2 years or more
  • Symptoms are often milder but more persistent than depression
  • Can affect sleep, energy, confidence and concentration
  • Is treatable with therapy, medication or a combination of both

Dysthymia, also known as persistent depressive disorder (PDD), is a long-term form of depression that causes ongoing low mood, low energy and reduced interest in daily life.

It can be less severe than major depression, but because it lasts for a long time, it can have a significant impact on how you feel, think and function day to day.

Dysthymia vs depression

Many of the experiences people with dysthymia go through are similar to other types of depression. Dysthymia causes people to experience low moods, feelings of hopelessness, low self-esteem and a lack of enjoyment in daily life.

Dysthymia is different from depression in the following ways:

FeatureDysthmiaDepression
Severity of symptomsTypically mild to moderate, but still impactful on daily life, work and relationshipsOften more severe and can be highly debilitating
DurationLong-term and chronic, with symptoms lasting at least 2 yearsOccurs in episodes, which may come and go
Pattern of symptomsOngoing, persistent low mood over timeMore intense periods of low mood followed by possible recovery
Impact on daily lifeCan gradually affect functioning over timeCan significantly disrupt daily functioning during episodes
Common symptomsLow mood, low self-esteem, hopelessness, lack of enjoymentSimilar symptoms, but often more intense and overwhelming
Diagnosis timeframeSymptoms present most of the time for at least 2 yearsSymptoms present for at least 2 weeks for a diagnosis
How it feelsOften described as a constant “low-level” depressionOften described as more acute or intense depressive episodes

The timeframe for your symptoms is central to getting a diagnosis of depression.

To be diagnosed with persistent depressive disorder, your symptoms need to have persisted for over 2 weeks, whereas to be diagnosed with dysthymia, your symptoms need to have been ongoing for at least 2 years.

Signs of dysthymia

Dysthymia symptoms can vary from person to person, and many are similar to the core symptoms of depression. Typically, they may consist of persistent feelings of sadness, that can last for years at a time. As well as experiencing an enduring low mood, PDD can also cause:

  • A lack of interest in hobbies or activities that you may once have found enjoyment in
  • Feelings of hopelessness and emptiness
  • Anger, irritability and frustration
  • Low self-esteem
  • Feelings of guilt
  • Sleep problems such as insomnia
  • Feeling tired all the time
  • Changes in appetite, causing you to gain or lose weight
  • Difficulty concentrating or making decisions

For those experiencing the condition, it can feel like their low mood and sadness are always present. Coupled with symptoms that don’t tend to be severe, means that persistent depressive disorder is often normalised and simply put down to a person’s personality, as opposed to a serious mental health condition that needs treatment.

Causes of dysthymia

If you’ve been suffering with depression, know that you are far from alone. Research conducted on depression suggests that as many as 4.5% of the UK’s population are struggling with the condition.

As with other kinds of depression, there's no one direct cause of dysthymia. It’s more likely that many causes of depression contribute to the development of the condition. These include:

  • Severe physical health problems, especially ones that are debilitating to your quality of life
  • Abuse or neglect during childhood
  • Stressful or traumatic life experiences, such as a divorce, bereavement or losing your job

Risk factors for dysthymia

We also know that, depending on your biological and environmental circumstances, you can be more or less likely to develop a condition like PDD. Common risk factors include:

  • Your family’s, or your own, history with depression or other mental health conditions
  • Personality traits, such as being very self-critical or a perfectionist, can make it more likely you'll develop depression
  • Age and gender – older people are more likely to develop depression than younger people. Women also have a higher prevalence of depression than men

How is dysthymia treated in the UK?

By seeking treatment for depression, you can return to the positive and healthy life you deserve.

In the UK, dysthymia is typically treated using a combination of psychological therapies and, in some cases, medication.

Common treatment options include:

  • Talking therapies such as cognitive behavioural therapy (CBT)
  • Antidepressant medication, particularly for more persistent symptoms
  • Lifestyle changes, including sleep, activity and routine support

Many people begin by speaking to their GP, who can assess symptoms and discuss treatment options. Depending on your needs, you may be referred for NHS support or choose to access private therapy services.

Dysthymia treatment options

Therapy

As PDD is a type of depression, it responds well to a number of therapeutic methods that are used to treat depression. The most common type of therapy used to treat depression is cognitive behavioural therapy (CBT), but dialectical behaviour therapy (DBT) can also be used.

Whichever type of therapy is appropriate for you, they will all involve attending a number of sessions with a highly qualified therapist to:

  • Process your emotions in a healthy way
  • Talk through your life challenges and learn to adjust
  • Learn coping strategies to deal with your emotions
  • Identify and minimise harmful behaviours and thought patterns
  • Develop a more positive mindset

Therapy sessions can be delivered on a one-to-one basis (in person or as part of an online therapy service), or as part of group or family therapy.

Medication

For some people, medication will be the first line of treatment – especially if your depression is severe or there is a history of depression in your family.

Selective serotonin reuptake inhibitors (SSRIs) are the most common antidepressant used to treat depression. Fluoxetine (Prozac) and sertraline (Zoloft) are examples of effective types of this medication.

A wide range of safe and effective medications to treat depression are available, but it’s vital you consult a professional who can prescribe you the right medication to treat your condition. At Priory, our consultant psychiatrists can help you decide if medication is right for you, outlining the best course of treatment for your needs.

It's important to know that with treatment, it’s possible for you to make a full recovery and take back control of your life. If your depression is having a severe effect on how you live your life, consider contacting Priory for world class mental health treatment.

Is dysthymia the same as depression?

Dysthymia is a form of depression, but it tends to be longer-lasting and may be less severe than major depressive episodes.

How long does dysthymia last?

To be diagnosed with dysthymia, symptoms typically need to be present for at least 2 years in adults.

Can dysthymia be treated?

Yes, dysthymia can be treated with therapy, medication or a combination of both, and many people see improvements with the right support.

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