“Over the past decade there has been a revolution in the treatment of chronic depression. We really can treat this illness effectively in many people. This couldn’t be said fifteen or twenty years ago…” --David Hellerstein, MD

1) What is dysthymic disorder and how is it diagnosed?

Dysthymic disorder (abbreviated as DD) is chronic low-grade depression. To qualify for the diagnosis of dysthymic disorder, a person must have been feeling depressed for at least two years. In practice, people often after have suffered from dysthymic symptoms for twenty or thirty years or more before seeking treatment!

Dysthymic disorder can be thought of as a paradoxical disorder. Though its symptoms are fairly mild on a day-to-day basis, over a lifetime DD is actually a severe disorder—leading to high rates of suicide, work impairment, and social isolation. In fact, the risk of suicide is higher with dysthymia than major depression! Another aspect of the paradox is that because people think of dysthymia as mild they often do not seek treatment. Or if they do seek treatment, it is with types of medicine or therapy that are unlikely to help them feel better.

2) What are the main symptoms of dysthymic disorder?

The main symptoms of DD include: depressed mood (lasting 2 or more years); feelings of hopelessness; poor concentration or difficulty making decisions; low self-esteem; low energy or fatigue; poor sleep; and poor appetite or overeating.

Our research studies have shown that there are more subtle symptoms of DD as well, which may be even more common. People with DD are also often socially withdrawn, and perform below their abilities at work and school. They often find it difficult to take normal day-to-day risks such as asking someone out on a date, or calling to apply for a job. They are often easily discouraged, and often have difficulty completing tasks. They are often overly pessimistic.

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Q and A about Dysthymic Disorder (Chronic Depression)