Dysthymia (Persistent Depressive Disorder)

Medically Reviewed by Jabeen Begum, MD on January 02, 2024
6 min read

Persistent depressive disorder is a psychological condition in which you have mild or moderate symptoms, such as sadness and hopelessness, that last for a long time. It's also called dysthymia.

Dysthymia vs. depression

What most people probably picture when they think of depression is the most serious kind, called clinical depression or major depressive disorder. It's also the most common form. Dysthymia has similar symptoms, but they are less severe. They're also long-term (lingering for 2 years or longer).

People who have dysthymia can also experience periods of major depression -- sometimes called “double depression.”

Dysthymia vs. cyclothymia

Cyclothymia is a form of bipolar disorder, a condition in which your mood swings between extreme highs and lows. Like dysthymia, cyclothymia has milder symptoms than the more common form of bipolar disorder. But with dysthymia, you only have the lows, not the highs.

Experts aren't sure what causes persistent depressive disorder or clinical depression. Genes may play a role, but many affected people don't have a family history of depression, and others with a family history of depression don't have depression problems. Abnormal functioning in brain circuits or nerve cell pathways that control mood are also thought to be involved. Stressful life events, chronic illness, medications, and relationship or work problems may also trigger depression.

The symptoms of persistent depressive disorder are the same as those of clinical depression, but fewer in number and not as intense. They include the following:

  • Sadness or depressed mood most of the day or almost every day
  • Loss of enjoyment in things that were once pleasurable
  • Major change in weight (gain or loss of more than 5% of weight within a month) or appetite
  • Insomnia or excessive sleep almost every day
  • Being physically restless or rundown in a way that is noticeable by others
  • Fatigue or loss of energy almost every day
  • Feelings of hopelessness or worthlessness or excessive guilt almost every day
  • Problems with concentration or making decisions almost every day
  • Recurring thoughts of death or suicide, suicide plan, or suicide attempt

According to the National Institute of Mental Health, approximately 1.5% of adult Americans are affected by dysthymia. While not as disabling as major depression, persistent depressive disorder can keep you from feeling your best and interfere with your daily life. Dysthymia can begin in childhood or adulthood and seems to be more common in women.

Persistent depressive disorder can be very difficult to recognize and diagnose. Because it goes on for so long (by definition, depression symptoms must persist for at least 2 years), you and the people around you may just assume gloominess and negativity are part of your personality.

If you think you may have chronic depression, see your doctor. They'll examine you and may do blood or other lab tests to make sure your symptoms aren't being caused by a physical condition, such as hypothyroidism.

They'll also want to know about your personal and family psychiatric history.

Persistent depressive disorder test

There's no specific test that tells a doctor you have persistent depressive disorder. A mental health specialist generally makes the diagnosis based on symptoms including a depressed mood, hopelessness, low self-esteem, and low energy. They may give you a questionnaire, or ask about your thoughts, feelings, and behaviors. With dysthymia, these symptoms will have lasted for a longer period and be less severe than in patients with clinical depression.






While persistent depressive disorder is a serious illness, it’s also very treatable. Early diagnosis and medical treatment can improve your symptoms and make you less likely to have an episode of major depression.

To treat dysthymia, doctors may use psychotherapy (talk therapy), medications such as antidepressants, or a combination of these therapies. Often, it can be treated by a primary care physician.


Psychotherapy (or talk therapy) is used in persistent depressive disorder and other mood disorders . It helps you learn coping skills for dealing with everyday life and challenge negative beliefs about yourself. Psychotherapy can also help you stick with your medication routine and healthy lifestyle habits, in addition to helping you and your family understand what you're dealing with. You may benefit from one-on-one therapy, family therapy, group therapy, or a support group with others who live with chronic depression.


There are different classes of antidepressants available to treat dysthymia. To find the antidepressant that's most effective for you with the least side effects, your doctor will consider your physical and mental health, including any other medical conditions.

It may take some time. Antidepressants take several weeks to work fully, and they can have uncomfortable side effects that often go away as your body adjusts. You may need to try more than one drug to find the right fit. It can also take several weeks to safely discontinue an antidepressant, so let your doctor guide you if you choose to stop the drug.

With persistent depressive disorder, you may need to take antidepressant medication long term.

Other ways to feel better

Getting an accurate diagnosis and effective treatment is a major step in feeling better with chronic depression. Ask your doctor about the benefits of healthy lifestyle habits such as eating a well-balanced diet, getting regular exercise, and avoiding alcohol and smoking

It’s not uncommon for a person with persistent depressive disorder to also experience an episode of clinical depression at the same time. This is called double depression.

Stick with your medication and therapy schedule and talk to your doctor if you feel like your symptoms are getting worse. You may need to temporarily adjust your treatment. It's a good idea to let your loved ones know to watch for any warning signs that may mean that you need help.

With some adjustments, you can manage life with persistent depressive disorder to ensure that you feel your best. Stick with your treatment plan, even if you start feeling better. Healthy lifestyle choices can also help, like eating well and exercising. Here are some other tips:

Be patient. Dysthymia isn't going to go away overnight. You may need several weeks of treatment before you start feeling improvement.

Educate yourself. Learn about your condition so you know what to expect from treatment and what symptoms to watch out for. It can help to understand how your lifestyle choices can affect your mood. Ask your doctor where to get reliable information.

Respect your limitations. While you're recovering, be kind to yourself, and don't expect too much, too soon. You may need to take on fewer obligations and prioritize your daily tasks. If you have trouble focusing, make lists or write yourself notes to help you remember things you need to do. Avoid making any important decisions while you're struggling.

Get support. Make sure you have someone you can talk to, whether it's a friend or someone from a support group. Get together often with family and friends. Isolation can make depression worse, and hanging out with positive people can improve your mood.

Get plenty of sleep. Treatment for depression can help with sleep problems, or your doctor may have other suggestions.

Practice self-care. When you're feeling down, do something you enjoy, like taking a yoga class, watching a movie, or getting your nails done. Learn stress relief techniques such as meditation and breathing exercises. Doing something nice for someone else can also boost your mood.

Don't self-medicate. Alcohol and recreational drugs may temporarily relieve some depression symptoms, but doctors say it makes it harder to treat in the long run.

Dysthymia is a type of depression with mild to moderate symptoms that go on for at least 2 years. It can be hard to recognize and diagnose it, but it can be treated with psychotherapy and medication.

What are the two types of dysthymia?

Researchers who've studied dysthymia have suggested there are two subtypes, anxious and anergic. People with the anxious subtype have feelings of insecurity and low self-esteem and tend to be anxious and agitated. People with the anergic subtype more often have low energy and tend to show little enthusiasm or enjoyment in life.

Is dysthymia curable?

Dysthymia can be successfully treated with therapy, medications, or a combination of the two. You may need long-term treatment to control your symptoms.

Is dysthymia a personality disorder?

No. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, dysthymia, or persistent depressive disorder, is a kind of depression. That reflects the belief of psychiatrists that it's something that can be treated, rather than an ingrained part of who you are.