Persistent Depressive Disorder - Dysthymia

Last updated date : October 04, 2021

Dysthymia is a Greek word, meaning the bad state of mind or ill-humour. Although not directly meaning depression, these are two major symptoms of depression. Depression can carry many meanings, ranging from suicidal thoughts to inconsolable hopelessness, delusions, sadness or discouragement, among many others. Depression is not a celebrated visit, and it can make things much worse when it decides to stick around for a very long period of time.

Dysthymia or Persistent Depressive Disorder is a version of depression. Its symptoms are not as severe as those of major depression and are often referred to as a mild chronic depression. However, it tends to last longer than major depression and is commonly known as mild chronic depression. Those who suffer from persistent depressive disorder are also likely to experience major depressive symptoms from time to time, which is a time frame known as “double depression”. Dysthymia can last up to two years, a behaviour rich with depressive symptoms. As such, depression and persistent depressive disorder got a lot in common. Dysthymia includes almost all the symptoms of major depressive disorder except for anhedonia or psychomotor symptoms.

Both are in uniform depressed.


A general understanding of Dysthymia

Dysthymia of Persistent Depressive Disorder is as worse as depression gets. Though symptoms are generally believed to be milder than those of major depression, some dysthymias symptoms can take a toll on people more than major depression disorder ever did. At least one-third of patients who are receiving psychotherapy suffer from a persistent depressive disorder. It is more likely to be seen in women, but that does not mean men do not get dysthymia. It is also more likely to arise during the earlier stages of life. Those with this condition are eventually likely to develop at least a few episodes relating to major depressive disorder. However, it may be difficult to identify dysthymia from the mild depression that can last a while after one recovers from a major depressive disorder.


Noticeable symptoms of Persistent Depressive Disorder.

Symptoms of persistent depressive disorder can vary in intensity, while they often come and go through a period of time. However, the gap between these time frames is not for more than two months. As mentioned before the symptoms are mostly just the same as major depressive disorder, most of the time fewer in number and not as intense.

  • Having a particularly negative mood or be upset most of the time in the day
  • Losing interest in day to day activities, even those that one used to enjoy the most
  • Sadness, hopelessness feeling worthless and a general sense of pessimism
  • Tiredness and a lack of energy
  • Feeling incapable or like they count on nothing
  • Easily irritable
  • Anger issues intensified
  • Choosing to be alone and avoiding social activity or society as a whole
  • Thoughts associated with guilt about incidents from the past
  • Either eats less or binge eats
  • Does not fall asleep, insomniac or oversleeps
  • Physically restless
  • Fatigue and lethargy
  • Inability to focus or make decisions
  • Suicidal or likely to self-harm


What can cause Dysthymia?

This form of depression has no obvious reason, like for many other forms of depression. Chemical abnormalities in the brain, according to mental health specialists, can be one of the leading causes of Dysthymia. Depression is considered to be caused by a variety of reasons. Environmental, psychological, biological, and genetic variables are among them. This disease has also been related to chronic stress and trauma.


Genetics and dysthymia

Genetics can also play a role when it comes to disorders related to depression. If a close family member has been diagnosed with persistent depressive disorder, the rest of the family are more at risk of developing the same issue. There is a chance up to 50% that the family members of the same circle developing the disorder, and experiencing its early onset. However, this does not mean that everyone with the genes will develop the issue.


Other illnesses and dysthymia

Also, if the individual has a history of anxiety, depression, trauma, they are also more susceptible to developing a chronic depressive situation such as dysthymia. Stressful or traumatic events that can take a toll on a person life can also be a trigger towards dysthymia. Adding to those are chronic physical illnesses such as diabetes, arthritis, heart diseases, etc. as well as brain-related issues which can act as potential causes behind the persistent depressive disorder. At least a three-quarter of those diagnosed with dysthymia also are suffering from such a chronic illness.

Girl holding medicine card- depressive

Diagnosing the persistent depressive disorder

As with any mental health-related issues, the diagnosis should come from a licenced mental health specialist. The diagnosis is going to be based on symptoms. It is mostly a case of identifying whether the symptoms mean a major depressive disorder or a persistent depressive disorder. if the symptoms are relatively milder than those of major depressive disorder but have lasted a long time, the patient is likely to be diagnosed with persistent depressive disorder. A part of this process is making sure that these symptoms you are experiencing are not caused by an outside factor or a different underlying illness. For example, hypothyroidism can show signs similar to those of dysthymia.

The doctor may also consider if the patient has been exposed to other factors and illnesses which can cause dysthymia, such as heart diseases. It is important that you provide your doctor with an accurate analysis of your symptoms to help them understand your illness and give you an accurate diagnosis. There are no lab tests that can help identify dysthymia. However, testing may be done in terms of blood work that will help your doctor understand the state of any physical illnesses you may and have also to rule out the possibility of drug effects that may be causing dysthymia, prior to diagnosing one with persistent depressive disorder.


The DSM-5 criteria for dysthymia

The patient’s situation must match the diagnostic criteria listed in DSM-5 for the doctor to diagnose them with the disorder. Some of those criteria include,

  1. Adults experiencing symptoms of depression for at least two years or more, and often.
  2. Children experiencing depressive symptoms for at least one year.
  3. Symptoms must be strong enough to result in messing with a person’s normal day-to-day function.

It is also difficult for people to understand such long-lasting symptoms to be something they need to get help for and are more likely to dismiss them as a normal part of their lives. However, the faster the diagnosis is the faster a treatment plan can come into action, which means recovery is on the way.


Risk factors relevant to persistent depressive disorder

Most of the risk factors become causes of dysthymia. Risk factors are what makes you more vulnerable compared to those that do not have the risk factors for developing a certain condition. Those with risk factors need to be extra careful than those who are without.

  • Having a close relative who has a diagnosis of persistent depressive disorder, major depressive disorder or any other form of a condition related to depression.
  • Those who use drugs/substances or alcohol frequently
  • Going through a traumatic life event, or having gone through one from which you haven’t quite recovered completely
  • Being a negative, worrisome, pessimistic, caring and over-sensitive person by nature
  • Having a dependant, low self-esteem, extremely hard on themselves and are hard satisfy attitude
  • Having a diagnosis of mental health disorders before

Feeling tired depression.


Complications that accompany dysthymia

Not only does dysthymia stand in the way of someone spending a quality life, but it also becomes responsible to come more complications as mentioned below.

Mood disorders

Persistent depressive disorder can make its victim vulnerable to changing moods that are rapid and for no real reason.

Substance abuse

Sometimes substance or drug abuse is generally associated with negative moods and wanting to be happier. With dysthymia the patient is almost always likely to be sad, depressed, criticizing themselves, feeling worthless and hopeless. As much as drugs and substances can cause this disorder, it can also be the other way around, there the effects of dysthymia pushes its victims to find a temporary escape in intoxication.

Interpersonal problems

It is difficult to maintain successful relationships when you are always looking at the negativities and find it difficult to be happy. Making happy memories and generally uplifting the spirit plays a major role in a successful relationship. Not being able to contribute to making such happy memories can be the downfall of relationships.

Productivity issues

Persistent depressive disorder can take a severe effect on someone’s ability to focus on a task. Due to the lack of concentration, performance, as well as productivity, can drop in schoolwork or in the corporate sector. Without the same level of focus, one can not perform the way one used to and can put one off of their game.

Pain and illnesses

The pain and illnesses caused by dysthymia or are the cause of dysthymia can generally make life uncomfortable for anyone. Especially because there is no exact way to treat the issue, there can be good days and bad days in the life of someone who has a diagnosis of persistent depressive disorder.

Self-harming tendencies

Due to the contact negative outlook on life and the mental strain put forth by other symptoms of persistent depressive disorder, those that are suffering may try to harm or kill themselves. This is especially possible due to the fact that they have succumbed to the idea of themselves being pessimistic people, not understanding that the long-lasting symptoms are a treatable disorder. Thus, they may not see a way out. This is also another reason why it is important to reach out for help when the symptoms first start showing.


Treating the persistent depressive disorder

As serious as persistent depressive disorder is, it is also a treatable problem. Not easy, but possible. The extent that treatment can really go is not usually experienced by the patients because they usually visit one family doctor who does not have a clear idea of what is happening. With time, they will stop any and all complaints and get used to their pessimistic life controlled by dysthymia. However, to those who decide to take the necessary steps to determine and real with what is wrong with them, life can be very much improved.

Like any other mental health problem, persistent depressive disorder also uses medication and psychotherapy as treatment methods.



When it comes to psychotherapy (talk therapy), there are several techniques in the process such as CBT, which focuses on identifying and altering underlying pessimistic thought patterns into the positive side, which are usually the main cause of contribution towards depressive thoughts. IPT is also a part of psychotherapy and drives to identify issues in interpersonal relationships and in communication, helping the patient with improving such shortcomings.

Therapy can help someone with many aspects that work towards an overall development in their personality. Some benefits of therapy are,

  • Finding and introducing better and healthy ways of expressing coping with emotions
  • Helping individuals cope with their overwhelming emotions
  • Better equipping people in ways that they can easily adjust to challenges and hardships in life
  • Helping clients identifying what triggers them, aggravates them and pushes them to their limit and thus helping them take care of their mental health by teaching them what to avoid
  • Working towards building positivity in people who only have a negative outlook on life
  • Working on increasing a sense of empowerment and control by helping clients be self-confident
  • Helping clients to establish goals and aims which are achievable

You can participate in therapy individually or join a group. For more information about this or to place an appointment with one of our clinicians, get in touch with our friendly team at Epsychiatry who are looking forward to guiding you through the process.


Prescribed medication

There are many different types of medications that help deal with depressive symptoms. Sometimes they may take a few weeks to work up to their full effect, so it is important to continue taking them at advice doses by your healthcare provider. Sometimes, with the progress medicines may have to switch or stopped. Make sure to not do any such changes without consulting your doctor first. In addition, it is not wise to have many different pills for your symptoms without visiting a doctor for treatment. This can happen with dysthymia since many do not realize that their condition needs help. Thus, if you are someone who has had the above symptoms and have been taking many different medicines to deal with them, it may be time for you to get a professional opinion.


Lifestyle changes

In addition to these clinical methods, lifestyle changes can also help one make life easier dealing with persistent depressive disorder. The condition is long term. With the medication and therapy, one must also focus on staying active and fit enough to complement medical treatment as well as face the symptoms better. If the body is weak and can not handle the pressure, there can be no improvement.

  • Getting at least 7h of sleep. Making sure you get enough rest.
  • Sticking to a healthy diet.
  • Working out or engaging in activities at least three times a week.
  • Reducing or completely stopping the usage of alcohol and drugs.
  • Practising mindfulness-based activities such as yoga
  • Meditating to ensure your mind is peaceful and calm
  • Having a journal to open up about, vent, and track your progress

You are in for a recovery journey that may take a while. It is your responsibility to stick to the medication, therapy and a quality lifestyle to make sure the recovery process is in no way slow or has disturbances. Also, make sure to ask your doctor about any doubts you may have before you take the administered medication, especially regarding the side effects.


What does the future look like?

Persistent depressive disorder is popular as a chronic disease. This means some people may never recover completely. However, it is possible to recover and needs resilience, commitment and dedication towards the cause. Even without being able to completely recover, treatment can still be a very effective way to manage symptoms in order to brush up the quality of one’s life. There can be times symptoms pop up when you least expect them to.

However, practising mindfulness which is a technique useful to strengthen the mind can help one face these unexpected challenges with understanding and patience.

If you need more help or feel like it is high time you seek professional help, team Epsychiatry is always at your service.