Dysthymia (also called dysthymic disorder) is a type of clinical depression that may have fewer or less severe symptoms than major depressive disorder but that lasts longer.
For a diagnosis of dysthmia, one experiences a chronically depressed mood most of the day, more days than not, for at least two years.
Additionally, the symptoms of dysthymia necessary for diagnosis include at least two of the following:
- poor appetite or overeating,
- insomnia or hypersomnia (sleeping too much),
- low energy or fatigue,
- low self-esteem,
- poor concentration or difficulty making decisions, and
- feelings of hopelessness.
A diagnosis of dysthmia is not indicated if the depressed mood is determined to be caused by drug or alcohol abuse, medications, or a general medical condition (American Psychiatric Association, 2000).
While symptoms of dysthmic disorder may be less severe than those of major depressive disorder, dysthymic disorder can be associated with significant impairment and distress.
About 6 percent of the American population suffers from dysthymia in their lifetime (Sadock & Sadock, 2003). Unlike depressive disorder, individuals with dysthymic disorder are less likely to experience vegetative symptoms (sleep, appetite, weight change, or slowing down of movement).
Double depression refers to symptoms of dysthymia and major depressive disorder occurring during the same time frame. People diagnosed with dysthymia have a greater likelihood of developing major depressive disorder.
Women are two or three times more likely to be affected by dysthymic disorder than men (American Psychiatric Association, 2000). The chronic symptoms of dysthymic disorder can interfere with individuals’ occupational and social functioning and with their quality of life.
Children diagnosed with dysthymia tend to be irritable rather than depressed. People usually experience symptoms of dysthymia for a long period of time before they decide to seek treatment.
Because of the long duration and chronic nature of this disorder, it is possible that the sufferers and those around them come to believe that the symptoms are normal for them. This viewpoint further decreases the likelihood that the sufferer will seek treatment or remain in treatment once he has sought it.
Research suggests that people may inherit a predisposition to dysthymia. Individuals with dysthymic disorder are more likely to have first-degree relatives with major depressive disorder or dysthymic disorder than the general population (American Psychiatric Association, 2000).
Common treatments for dysthymia include antidepressant medications and cognitive therapy, which involves changing the sufferer’s negative thinking patterns.
Antidepressant medications as treatment for dysthymia have been studied more than cognitive therapy and other forms of psychotherapy. A review of several studies that compared medication to short-term psychotherapy revealed that antidepressant medication was more effective in the short term than psychotherapy as a treatment for dysthymia. However, psychotherapy demonstrated more effectiveness on follow-up (Imel, Malterer, McKay, & Wampold, 2008).
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
- Imel, Z.E., Malterer, M.B., MacKay, K.M., & Wampold, B. E. (2008). A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia. Journal of Affective Disorders, 110, 197 – 206.
- Kessler, R.C., Berglund, P., Demler, O. Jin. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distribution of DSM-IV disorders in the National Comordity Survey Replication. Archives of General Psychiatry, 62, 593 – 602.
- Sadock, B.J., & Sadicjm V. A. (2003). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (9th ed.). Philadelphia: Lippincott, Williams, and Wilkins.