Emotional and Mental Health


Written by Dr. K Sneha and medically reviewed by Vandana Patidar

Image: Dysthymia


What is Dysthymia?

Dysthymia, otherwise called persistent depressive disorder (PDD), is a chronic form of depression. People suffering from this illness lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem. These feelings can also affect appetite and sleep. These symptoms can last for years and can interfere with the person’s relationships, work, school, and other daily routines.

In this type of depression, the symptoms are less severe and last for a longer time. As it is a chronic condition, it is more difficult to cope with the symptoms. Treatment with talk therapy and medication has been found to be helpful for patients with dysthymia.

What are the Symptoms of Dysthymia?

In dysthymia, the symptoms are similar to depression, but here the symptoms occur on most days for at least two years. Some of the symptoms are:

  • Insomnia or hypersomnia.

As the symptoms appear during childhood and adolescence, the symptoms to be aware in kids are:

  • Irritability.

  • Moody.

  • Bad performance in school.

  • Behave badly.

  • Problems interacting with other students.

What are the Types of Dysthymia?

Depending on when the symptoms start, dysthymia can be either-

  1. Early onset - before 21 years of age.

  2. Late onset - after 21 years of age.

What are the Causes and Risk Factors of Dysthymia?

The exact cause of this chronic condition is still not clear, but like all other major depressive illness, dysthymia is also caused by more than one factors like:

  • Physical and chemical changes in the brain.

  • Family history.

  • Previous history of any mental illness.

  • Traumatic life event.

  • Trauma to the brain.

  • People who have low self-esteem or who are too dependent or pessimistic.

  • Chronic illness like diabetes or heart problems.

What are the Complications seen with Dysthymia?

The complications seen are:

  • Drug and alcohol abuse.

  • Bad quality of life.

  • Can develop major depression, anxiety disorder, and mood swings.

  • Relationship problems.

  • Decreased productivity in school and work.

  • Suicidal thoughts.

  • Other mental health disorder.

  • Chronic physical illness.

How is Dysthymia Diagnosed?

The tests and examinations that your doctor will subject you to if he or she suspects dysthymia are:

  • History - The doctor will talk to you about your symptoms in depth and will ask you questions to determine the cause of your depression. If it is related to some underlying health condition, then the doctor might do physical examinations.

  • Psychological evaluation - Here, the doctor discusses your thoughts, feelings, and behavior in detail to come to a diagnosis. With the help of a questionnaire, the doctor might be able to come to the exact cause and psychological condition.

Dysthymia is diagnosed by some doctors depending on the presence of symptoms listed in the Diagnostic and Statistical Manual of Mental disorder (DSM-5). The symptoms listed are:

  1. Disturbed mood for almost every day or most of the day.

  2. Poor appetite or overeating.

  3. Sleep problems.

  4. Fatigue.

  5. Low self-esteem.

  6. Poor concentration.

  7. Difficulty making decisions.

  8. Feeling hopeless.

If an adult has most of these symptoms for almost every day for two or more years, then they are suffering from dysthymia. For children, this diagnosis is made if the child is irritable and moody for at least a year.

What are the Treatment Options for Dysthymia?

The treatment options are:


Many types of antidepressants are used in the treatment. The medicines used are-

  1. Selective serotonin reuptake inhibitors (SSRIs) like Fluoxetine and Sertraline.

  2. Tricyclic antidepressants (TCAs) like Amitriptyline and Amoxapine.

  3. Serotonin and norepinephrine reuptake inhibitors (SNRIs) like Desvenlafaxine and Duloxetine.


Psychotherapy or talk therapy is a way to deal with mental health problems by talking to a mental health professional. Cognitive behavioral therapy, which is a type of psychotherapy is found to be useful in treating dysthymia.

Lifestyle Changes:

Along with medicines and therapy, employing some lifestyle changes can have a positive effect on the treatment outcome. Some of the things that you can try are-

  • Regular exercise for at least 30 minutes.

  • Consume a diet rich in fruits and vegetables.

  • Avoid drug and alcohol.

  • St.John’s wort and fish oil are said to treat depression.

  • Practice relaxation techniques like yoga and meditation.

  • Maintain a journal about your daily activities.

When to See a Doctor?

If you notice these symptoms almost every day, then it is best you consult a psychiatrist, as it can be a sign of dysthymia. As the symptoms occur for many years, you might feel that it is a part of normal life, but it can cause serious complications. Never ignore the signs and symptoms and get help immediately before it gets worse.

How can Dysthymia be Prevented?

The following steps can help prevent almost all kinds of mental illness-

  • Manage stress and anxiety to boost your self-confidence.

  • In times of crisis, reach out to your family and friends.

  • If you notice signs of depression, get help immediately before it worsens.

  • Spend time outdoors and take out time to do things you like.

  • Exercise regularly and eat healthily.

How is Psychotherapy useful in Treating Dysthymia?

  • It helps you adjust to your current situation.

  • It helps to identify behaviors that contribute and aggravate your depression.

  • It helps replace negative behaviors with healthy and positive thoughts.

  • It helps build strong relationships with others.

  • It helps control your symptoms thus improving the quality of life.

Dysthymia is a chronic disorder and takes time to recover, so do not stop the medications and treatment half-way as there are high chances of relapse. If you notice signs and symptoms of depression and feel shy to consult a psychiatrist in-person, you can try online consultation with the help of online healthcare platforms.

Last reviewed at: 19.Mar.2019



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