Page medically reviewed by Dr Patrick Mbaya (MB ChB, MSc, MD, FRCPsych, Cert. Psychopharmacology), Lead Consultant for Addictions at Priory Hospital Altrincham
Definition | Symptoms | Causes | Treatment
Dysthymia, also known as persistent depressive disorder (PDD), is a type of long-term (chronic) depression. As with other forms of depression, dysthymia can be an extremely debilitating to your quality of life. Sadness and hopelessness are common symptoms for people suffering with depression, however with dysthymia, you may experience these feelings over the course of many years.
Without treatment, PDD can affect you emotionally, mentally and socially – having a negative impact on your health, relationships and working life.
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.
However, dysthymia is different from depression in two key ways:
- Dysthymia symptoms don’t tend to be as debilitating as those experienced with other types of depression, especially severe depression. Instead, dysthymia symptoms are generally classed as ‘mild’ or ‘moderate’. However, they can still impair your ability to function socially and at work
- Dysthymia is a chronic and enduring condition. People with dysthymia often experience their symptoms for years at a time, as opposed to having depressive episodes that come and go
The timeframe for your symptoms is central to getting a diagnosis of depression. To be diagnosed with depression, your symptoms need to have persisted for over two weeks, whereas to be diagnosed with dysthymia, your symptoms need to have been ongoing for at least two 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. This, coupled with the fact that symptoms don’t tend to be severe, means that dysthymia is often normalised and simply put down to a person’s personality, as opposed to a serious mental health condition that needs treatment. Over time, that individual may be viewed by others as somebody who is generally miserable or has an inability or an unwillingness to have fun or find enjoyment in anything. This making spotting sufferers of dysthymia quite difficult.
If you recognise the above symptoms and perceived personality traits in yourself or a loved one, it could be that you or they are suffering from dysthymia. Consider how you can help someone with depression by attending a GP appointment with your loved one to seek a diagnosis, or contact Priory for information on how our highly trained mental health professionals treat sufferers of depression and help them on the road to recovery.
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 is 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 persistent depressive disorder. Common risk factors include:
- Your family’s, or your own, history with depression or other mental health conditions
- Personality traits like being very self-critical or a perfectionist can make it more likely you will 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
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It’s important to recognise that PDD, like other forms of depression, has many effective treatments. Those who suffer with the condition don’t have to struggle in silence. By seeking treatment for depression, you can set yourself on a path to return to the positive and healthy life that you deserve.
As persistent depressive disorder 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.
For many, 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.
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