Persistent depressive disorder (dysthymia)

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Persistent depressive disorder, also called dysthymia (dis-THIE-me-uh), is a continuous long-term (chronic) form of depression. You may lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem and an overall feeling of inadequacy. These feelings last for years and may significantly interfere with your relationships, school, work and daily activities.
If you have persistent depressive disorder, you may find it hard to be upbeat even on happy occasions — you may be described as having a gloomy personality, constantly complaining or incapable of having fun. Though persistent depressive disorder is not as severe as major depression, your current depressed mood may be mild, moderate or severe.
Because of the chronic nature of persistent depressive disorder, coping with depression symptoms can be challenging, but a combination of talk therapy (psychotherapy) and medication can be effective in treating this condition.

Persistent depressive disorder symptoms usually come and go over a period of years, and their intensity can change over time. But typically symptoms don’t disappear for more than two months at a time. In addition, major depression episodes may occur before or during persistent depressive disorder — this is sometimes called double depression.
Symptoms of persistent depressive disorder can cause significant impairment and may include:
• Loss of interest in daily activities
• Sadness, emptiness or feeling down
• Hopelessness
• Tiredness and lack of energy
• Low self-esteem, self-criticism or feeling incapable
• Trouble concentrating and trouble making decisions
• Irritability or excessive anger
• Decreased activity, effectiveness and productivity
• Avoidance of social activities
• Feelings of guilt and worries over the past
• Poor appetite or overeating
• Sleep problems
In children, symptoms of persistent depressive disorder may include depressed mood and irritability.



Persistent depressive disorder often begins early — in childhood, the teen years or young adult life — and is chronic. Certain factors appear to increase the risk of developing or triggering persistent depressive disorder, including:
• Having a first-degree relative with major depressive disorder or other depressive disorders
• Traumatic or stressful life events, such as the loss of a loved one or financial problems
• Personality traits that include negativity, such as low self-esteem and being too dependent, self-critical or pessimistic
• History of other mental health disorders, such as a personality disorder
Conditions that may be linked with persistent depressive disorder include:
• Reduced quality of life
• Major depression, anxiety disorders and other mood disorders
• Substance abuse
• Relationship difficulties and family conflicts
• School and work problems and decreased productivity
• Chronic pain and general medical illnesses
• Suicidal thoughts or behavior
• Personality disorders or other mental health disorders


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