Dysthymia

• Alternative Names

  Neurotic depression (dysthymia); Dysthymic disorder; Chronic depression; Depression - chronic

• Causes, incidence, and risk factors

  The exact cause of dysthymia is unknown.

  As with major depressive disorder, dysthymia occurs more women in women than in men and affects up to 5% of the general population. Dysthymia can occur alone, or together with more severe depression or another mood or psychiatric disorder.

• Symptoms

  The main symptom of dysthymia is low, dark, or sad mood nearly every day for at least 2 years. The symptoms are less severe than in patients with major depression, but people with this condition can still struggle with:

  • Feelings of hopelessness
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem
  • Poor appetite or overeating
  • Poor concentration
• Signs and tests

  Your health care provider will take a history of your mood and other mental health symptoms over the past several months.

• Treatment

  As with other forms of depression, there are a number of treatment options for people with dysthymia:

  • Selective serotonin reuptake inhibitors such as fluoxetine (Prozac)
  • Tricyclic antidepressants
  • Talk therapies, such as cognitive/behavioral therapy and interpersonal therapy

  Medications do not work as well for dysthymia as they do for depression. It also may take longer after starting medication for you to feel better.

  Some evidence suggests that combining medication and psychotherapy may lead to the most improvement.

• Expectations (prognosis)

  Dysthymia is a chronic condition that lasts many years. Though some people completely recover, others continue to have some symptoms, even with treatment. Some people need to continue taking medication and undergoing therapy.

• Complications

  Antidepressant drugs have side effects that can complicate treatment. For example, selective serotonin reuptake inhibitors may cause stomach upset, mild insomnia, and reduced sex drive.

  If not treated, dysthymia can turn into a major depressive episode. This is known as "double depression."

• Calling your health care provider

  Call for an appointment with your health care provider if you regularly feel depressed or low.

• References

  Institute for Clinical Systems Improvement. Health Care Guidelines: Major Depression in Adults in Primary Care. 11th ed. May 2008.

  Stewart JW. Treating depression with atypical features. J Clin Psychiatry. 2007;68:25-29.

Review Date: 8/22/2008

Reviewed By: Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.