Dysthymia

What Is It?

Dysthymia, also called dysthymic disorder, is a form of depression. It is less severe than major depression, but usually lasts longer. Many people with this type of depression describe having been depressed as long as they can remember, or they feel they are going in and out of depression all the time.

The symptoms of dysthymia are similar to major depression, though they tend to be less intense. In both conditions, a person can have low or irritable mood, a lack of interest in things and a loss of energy. Appetite and weight can be increased or decreased, and the person may sleep too much or have trouble sleeping. He or she may have low energy and concentration. It also is common for the person to be indecisive and pessimistic, and have a poor self-image.

The symptoms can escalate into a full-blown episode of major depression, a situation sometimes called "double depression" because the acute, intense episode is superimposed on a background of chronic low mood. In fact, people with dysthymia have a greater-than-average chance of developing major depression.

While major depression often occurs in episodes, dysthymia is more constant, persisting for long periods of time, sometimes starting in childhood. As a result, a person with dysthymia will tend to believe that depression is a part of his or her character. He or she may not even think to report the depression to people in a position to help, such as health-care providers, family members or friends.

Dysthymia, like major depression, tends to run in families. It is very common, and is two to three times more common in women than men. Some people with dysthymia have experienced major losses in childhood, such as the death of a parent. Some describe being under chronic stress. It is often difficult to tell whether people with dysthymia are under more stress than is typical or if the dysthymia causes them to perceive more stress than others do.

Symptoms

The main symptom of dysthymia is a long-lasting low or sad mood. People with dysthymia also can be irritable. Other symptoms include:

• Increased or decreased appetite or weight
• Poor sleep or sleeping too much
• Fatigue or low energy
• Low self-esteem
• Difficulty concentrating
• Indecisiveness
• Hopelessness or pessimism

Diagnosis

Primary-care physicians usually are prepared to recognize when a person has some form of depression. A specific diagnosis of dysthymia is usually made by a mental-health professional, after a full evaluation. Dysthymia is diagnosed when a person has had low mood, along with some of the symptoms described above, for two years or more. Someone who has symptoms for less than two years may not officially qualify for the label, but treatment should be considered for any persistent or distressing symptoms.