Dysthymia is long term, mild-to-moderate depression. It lasts for at least two years in adults. In children and teens, it lasts for one or more years.

Causes

The cause of dysthymia is not known. A brain chemical called serotonin may play a role.

Brainstem—Location of Serotonin Production

Risk Factors

Dysthymia is more common in women than in men. Other things that raise the risk are:

Loss and grief
Child abuse
Partner abuse
Stress, trauma, and life changes
Family history of depression or dysthymia
History of substance abuse
Long term illness
Brain injury

Symptoms

Symptoms of dysthymia and depression overlap. They may be:

Feeling sad or hopeless
Lack of hunger or overeating
Problems focusing
Sleeping too little or too much
Feeling tired
Low self-esteem
Problems at work or school

Bouts of major depression may also occur.

Diagnosis

The doctor will ask about your symptoms and health history. A physical and mental health exam will be given.

The doctor may refer you to a specialist. Tests may be done to look for causes like thyroid problems or anemia. Dysthymia is diagnosed after ruling out other causes.

Treatment

The goal is to ease symptoms and improve function. Severe symptoms may need hospital care. Care is urgent if someone might hurt themselves or others.

A number of treatments may be used. Options may be:

Antidepressants
Counseling, such as cognitive-behavioral therapy —to help with coping
Family therapy
Lifestyle changes, such as:
- A healthful diet
- Daily physical activity —to ease symptoms and stress
- Not using drugs and alcohol
- Good sleep
- Fun things to do

Prevention

There are no current guidelines to prevent dysthymia. However, early care may help those at risk.

RESOURCES:

National Institute of Mental Health
https://www.nimh.nih.gov

National Mental Health Association
http://www.mentalhealthamerica.net

CANADIAN RESOURCES:

Canadian Mental Health Association
https://cmha.ca

Canadian Psychiatric Association
http://www.cpa-apc.org

References:

Depression. Mental Health America website. Available at:
...(Click grey area to select URL)
Accessed March 12, 2021.

Depressive disorders. Merck Manual Professional Version website. Available at:
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Accessed March 12, 2021.

Major depressive disorder (MDD). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/major-depressive-disorder-mdd. Accessed March 12, 2021.

Persistent depressive disorder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/persistent-depressive-disorder. Accessed March 12, 2021.

Persistent depressive disorder. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/dysthymic-disorder. Accessed March 12, 2021.

Schramm E, Klein DN, et al, Domschke K. Review of dysthymia and persistent depressive disorder: history, correlates, and clinical implications. Lancet Psychiatry. 2020;7(9):801-812.

Last reviewed January 2021 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 03/12/2021

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