Dysthymic disorder, or dysthymia, is a chronic disorder characterized by at least two years of mild-moderate depression. Individuals suffering from dysthymic disorder often report that they don't remember ever not feeling depressed. Most individuals with this disorder function relatively well, but usually have some difficulty managing the tasks and responsibilities of daily life.

Dysthymia is a fairly common type of depression that is estimated to affect up to 3% of the population. Dysthymia can begin in childhood or in adulthood, and is more often diagnosed in women.

Like the other mood disorders, dysthymia is believed to be caused by an imbalance of the neurotransmitters in the brain. Most experts agree that low levels of serotonin are responsible in many cases of this disorder.

DSM-IV Diagnostic Criteria for Dysthymia:

A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.

B. Presence, while depressed, of two (or more) of the following:

(1) poor appetite or overeating
(2) Insomnia or Hypersomnia
(3) low energy or fatigue
(4) low self-esteem
(5) poor concentration or difficulty making decisions
(6) feelings of hopelessness

C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in Criteria A and B for more than 2 months at a time.

D. No Major Depressive Episode has been present during the first 2 years of the disturbance (1 year for children and adolescents); i.e., the disturbance is not better accounted for by chronic Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission. Note: There may have been a previous Major Depressive Episode provided there was a full remission (no significant signs or symptoms for 2 months) before development of the Dysthymic Disorder. In addition, after the initial 2 years (1 year in children or adolescents) of Dysthymic Disorder, there may be superimposed episodes of Major Depressive Disorder, in which case both diagnoses may be given when the criteria are met for a Major Depressive Episode.

E. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode, and criteria have never been met for Cyclothymic Disorder.

F. The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophrenia or Delusional Disorder.

G. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

** Specify if:

Early Onset: if onset is before age 21 years
Late Onset: if onset is age 21 years or older

** Specify (for most recent 2 years of Dysthymic Disorder):

With Atypical Features

Treatment of Dysthymia:

Treatment of dysthymia usually consists of a combination of psychotherapy and antidepressant medications. Without intervention, symptoms can continue for many years and reduce the individual's quality of life. Unfortunately, many individuals with this disorder are not aware that the symptoms they are experiencing are abnormal. This often leads to delays in seeking help from a mental health professional.

Personal Description of Dysthymia:

"I spent every day for three years feeling tired and discouraged and unhappy. I thought it was just my personality, that I was just a pessimistic and unhappy person. I had no interest in sex or in socializing, and to save my marriage I went to see a psychiatrist. I was diagnosed with dysthymia and generalized anxiety disorder and put on zoloft. My life completely changed over the next few months. I have my real personality back again and have found some meaning and purpose in life."
- Amanda P.

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