From the Guidelines
Dysthymia is a chronic form of depression characterized by a depressed mood that lasts for at least two years in adults, with symptoms that are less severe than major depression but persist for much longer periods. According to the American College of Physicians guideline 1, dysthymia is distinct from major depressive disorder (MDD) and subsyndromal depression in terms of its duration and severity. The symptoms of dysthymia include a consistently low mood, poor self-esteem, low energy, sleep or appetite disturbances, difficulty concentrating, and feelings of hopelessness.
Key Characteristics of Dysthymia
- Lasts for 2 or more years in adults
- Symptoms are less severe than major depression
- Persistent depressive mood
- Impacts quality of life, relationships, and work performance
Treatment of dysthymia typically involves a combination of psychotherapy, such as cognitive-behavioral therapy, and antidepressant medications like SSRIs or SNRIs 1. These medications usually need to be taken for extended periods to maintain symptom relief. The goal of treatment is to improve quality of life and reduce the risk of morbidity and mortality associated with chronic depression. It is essential to recognize dysthymia as a treatable condition, as many people may not seek help due to the chronic nature of their symptoms.
From the Research
Definition and Characteristics of Dysthymia
- Dysthymia is a chronic mood disorder that is common and often more disabling than episodic major depression 2
- It is characterized by a low-grade, intermittent course, and is complicated by superimposed highly recurrent major depressions 3
- Dysthymia can be difficult to detect in psychiatric and primary care settings until it intensifies in the form of a superimposed major depressive episode 2
Treatment of Dysthymia
- Selective serotonin reuptake inhibitors (SSRIs) have been shown to be efficacious and well tolerated for the treatment of dysthymia without concurrent major depression 4, 5, 6
- Tricyclic antidepressants (TCAs) are also efficacious in the treatment of dysthymia, but may have a higher dropout rate compared to SSRIs 5
- Other treatments, such as L-Acetylcarnitine, may be effective for dysthymia in elderly patients, but require further investigation 6
- Psychotherapeutic approaches, such as supportive psychotherapy and psychoeducation, may be useful for patients with dysthymia 3
Diagnosis and Comorbidity
- Dysthymia is often comorbid with other mental disorders, and its diagnosis can be complicated by its similarity to other depressive disorders 2, 6
- The DSM-5 includes dysthymia as a subtype of persistent depressive disorder, which also includes chronic major depression and recurrent major depression without recovery between episodes 2
- Dysthymia can have a significant impact on social, psychological, and emotional functioning, and may require longer treatment times and more intensive interventions 6