Mar 10, 2025
Dysthymia, also called Persistent Depressive Disorder, is a type of depression that is mild but persistent. Dysthymia must last at least 2 years, making it a longer disorder than Major Depressive Disorder, which can be as short as 2 weeks. Dysthymia is also milder than Major Depressive Disorder. People with dysthymia may not seek treatment because of this, making it a difficult disorder to treat.
However, when treatment is sought, persistent depressive disorder (PPD) can be treated through a combination of talk therapy and medication. The first step is to understand the symptoms. This article will walk through what Dysthymia is, the symptoms of Dysthymia, and how to seek treatment for it.
What Is Dysthymia?
Dysthymia is also known as Persistent Depressive Disorder or PPD for short. It is a diagnosable, clinical type of depression found in the DSM-5—the handbook for diagnosing and treating mental health disorders for therapists.
Dysthymia, like Major Depressive Disorder, affects one’s emotions, thoughts, behavior, and social interactions. It is not as simple as feeling sad. Many people with Dysthymia struggle with anhedonia, which is the lack of pleasure in things one used to find pleasurable, or a hollowed-out, empty feeling.
Usually, Dysthymia is not as debilitating as other forms of depression can be, but that does not mean it is easy to deal with. Being as long-term and persistent as it is, Dysthymia can feel hopeless and suffocating to many people suffering from it. Treatment for Dysthymia is possible.
-(1).jpg)
Symptoms of Dysthymia
Dysthymia has similar symptoms to Major Depressive Disorder and other types of depression. Symptoms include:
- Persistent Sadness: Feeling consistently down or sad for most of the day, nearly every day.
- Low Self-Esteem: Experiencing feelings of worthlessness or inadequacy, often accompanied by self-criticism.
- Loss of Interest: Losing interest in activities that were once enjoyable, leading to a sense of apathy or disconnection.
- Fatigue: Persistent feelings of fatigue or low energy, even after restful sleep.
- Difficulty Concentrating: Struggling to focus, make decisions, or remember things due to mental fog or lack of clarity.
- Changes in Appetite: Significant changes in appetite, either increased or decreased, leading to weight fluctuations.
- Sleep Disturbances: Insomnia or oversleeping, including difficulty falling or staying asleep.
- Hopelessness: A pervasive sense of hopelessness about the future or feeling stuck in a cycle of negativity.
- Social Withdrawal: Withdrawing from social activities or relationships, preferring isolation over engaging with others.
- Irritability: Feeling easily irritable, agitated, or quick to anger, even in situations that wouldn't normally trigger such emotions.
At least 2 of the above symptoms must last at least 2 years. Over time, the persistence of these symptoms can wear down the joy in one’s life, making treatment necessary for a healthy, fulfilling life.
Treatments for Dysthymia
It’s important to remember that Dysthymia is a treatable condition. Because of the persistence of the symptoms, long-term care may be necessary. The most common treatment for Dysthymia is a combination of medication and therapy.
Many people with Dysthymia also have a comorbid disorder, meaning they have more than one diagnosable mental health condition. People with Dysthymia may also struggle with Major Depression at times, Bipolar Disorder, PTSD, or c-PTSD.
Medication for Dysthymia
Many experts believe Dysthymia is caused by chemical imbalances in the brain, although there is no definite proof of this. Depression is usually rooted in a combination of environmental and genetic. Chronic stress and trauma are two powerful risk factors for Dysthymia.
Because Dysthymia is commonly caused by genetics and brain chemicals, medication can be very effective at minimizing symptoms. Medication for Dysthymia includes many antidepressants such as:
- Selective Serotonin Reuptake Inhibitors (SSRIs):
- Examples: Fluoxetine (Prozac), Sertraline (Zoloft), Escitalopram (Lexapro)
- How they work: SSRIs help increase serotonin levels in the brain, which can improve mood and reduce depressive symptoms.
- Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):
- Examples: Venlafaxine (Effexor), Duloxetine (Cymbalta)
- How they work: SNRIs increase levels of serotonin and norepinephrine, neurotransmitters that play a role in regulating mood.
- Tricyclic Antidepressants (TCAs):
- Examples: Amitriptyline, Imipramine, Nortriptyline
- How they work: TCAs affect multiple neurotransmitters in the brain, helping to alleviate depressive symptoms in some individuals.
- Atypical Antidepressants:
- Examples: Bupropion (Wellbutrin), Mirtazapine (Remeron)
- How they work: Atypical antidepressants work differently from other classes of antidepressants and can be effective for some individuals with dysthymia.
- Monoamine Oxidase Inhibitors (MAOIs):
- Examples: Phenelzine (Nardil), Tranylcypromine (Parnate)
- How they work: MAOIs increase the levels of neurotransmitters in the brain, which can help regulate mood and improve symptoms of dysthymia.
Learn more about antidepressants and how to choose one that’s right for you using our Guide to Antidepressants.
Therapy for Dysthymia
Talk therapy, or psychotherapy, is a very common and effective approach to treating depression. During talk therapy, you will meet one-on-one with a licensed therapist. There are many different modalities a therapist may choose to work from, including:
- Cognitive Behavioral Therapy (CBT): CBT focuses on changing negative thought patterns and behaviors, helping individuals develop healthier coping strategies for managing dysthymia.
- Interpersonal Therapy (IPT): IPT focuses on improving communication and relationship skills, addressing social isolation, and interpersonal difficulties that may contribute to dysthymia.
- Mindfulness-Based Cognitive Therapy (MBCT): MBCT combines mindfulness practices with CBT techniques, empowering individuals to be present in the moment and cultivate self-awareness to manage depressive symptoms.
- Psychodynamic Therapy: Psychodynamic therapy explores how past experiences and unconscious processes influence current thoughts and behaviors, providing insight into underlying issues related to dysthymia.
- Acceptance and Commitment Therapy (ACT): ACT helps individuals accept their thoughts and feelings while committing to actions aligned with their values, fostering a sense of purpose and fulfillment despite dysthymic symptoms.
- Dialectical Behavior Therapy (DBT): DBT focuses on developing skills for emotion regulation, distress tolerance, and interpersonal effectiveness, offering practical tools to navigate the challenges of living with Dysthymia.
Some people also find group therapy effective, as it helps them feel less alone and encourages them to form social relationships, an important part of recovery.
Lifebulb has online therapists who are effective at treating Dysthymia and psychiatrists who can prescribe antidepressants. If you think you’re struggling with Dysthymia, don’t wait to receive help. Unlike some mental disorders, Dysthymia is unlikely to go away on its own. Seeking treatment is the first step to health and a brighter future.
