Dysthymia vs. Depression

By Paula Holmes LCSW

Dealing with depression is challenging in many ways, as it’s a disorder that can impact all aspects of a person’s life. There are many different types of depressive disorders, but people struggling with depressive symptoms can’t always tell what type of depression they are experiencing. Dysthymia and depression are mistaken for one another due to their similarities, but there are some differences between these conditions. 

What Is Dysthymia?

Dysthymia, also known as persistent depressive disorder, is a long-term depressive condition with ongoing symptoms that continue for a minimum of two consecutive years. People with dysthymia experience depressive symptoms for most of the day, and they typically feel depressed more often than not throughout the week. 

Sometimes, people with dysthymia experience depressive symptoms for so long that it begins to feel like part of who they are, rather than a mental health condition. Because it is so pervasive and impacts all areas of life, dysthymia may go undetected for long periods of time. 

What Is Major Depression?

Major depression is a disorder that causes someone to experience feelings of sadness, numbness or disconnection that impacts all areas of life. To meet diagnostic criteria for major depression, a person needs to have symptoms nearly every day for a minimum of two consecutive weeks. 

Major depression impacts the way a person thinks, feels and behaves. Often, people with depression have a negative view of themselves as a result of their condition. Suicidal thoughts pose a major risk for people struggling with depression, particularly if they do not get help when it is needed.

Major Depressive Disorder vs. Persistent Depressive Disorder

When comparing major depression and persistent depressive disorder (dysthymia), it can be challenging to distinguish one from the other. Both disorders have similar symptoms. A major difference between the two conditions is the length of time symptoms must be present in order to form a diagnosis.

Signs and Symptoms

Depression and dysthymia have similar symptoms. These disorders can present in many different ways, but often they show up as: 

  • Negative self-worth 
  • Low energy levels
  • Mental fog
  • Cognitive challenges
  • Feelings of sadness
  • Feelings of disconnection and numbness

Depression and dysthymia impact the way a person lives their life; they affect emotions and influence the way one thinks and behaves.

Causes and Risk Factors

People who have first-degree relatives with depressive or other mood disorders are more likely to experience depression or dysthymia, as there is evidence that both conditions have a genetic component. Situations, life events and exposure to trauma can also increase the potential for depressive disorders. 

Co-occurring conditions can also pose a risk for people with depression and dysthymia. Anxiety commonly co-occurs with depression, and it can lead to anxiety attacks and social avoidance, which can reinforce negative self-talk. Substance use disorders can also develop when someone tries to cope with their emotions by using drugs or alcohol. 

Diagnosis

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people with dysthymia must have at least two of the following symptoms during a two-year span:

  • Poor appetite of overeating
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness

During the two-year span in which these symptoms are present, they must be experienced more often than not. In addition, the symptoms must not go away for longer than a two-month span. 

The DSM-5 criteria for major depression includes nine symptom types. For a diagnosis of major depression, a person must meet five criteria for a minimum of two weeks. At least one of the symptoms must be a depressed mood or a lack of interest or pleasure in things one normally enjoys. The nine symptoms that are commonly associated with major depression include:

  • Depressed mood for the majority of the day on more days than not
  • Decreased interest or pleasure in life
  • Unintended weight loss or weight gain, changes in appetite
  • Insomnia or hypersomnia (wanting to sleep too much)
  • Being extra fidgety or moving excessively slow (to the extent that others would notice)
  • Exhaustion or loss of energy nearly every day
  • Feeling worthless or overly guilty nearly every day
  • Problems with concentration and thinking, or difficulty with making decisions
  • Ongoing thoughts of death, suicidal thoughts (with or without a plan) or a suicide attempt

Prevalence

Major depression is more common than dysthymia. During an average one-year span, depression is present in 6.7% of the adult population and dysthymia is present for 0.5%

Depression and dysthymia are an issue for all races, ethnicities and genders. Women are more likely to be diagnosed with these disorders than men. However, the gap has become narrower over time, as more men are seeking mental health treatment now than in past years. 

Treatment

Depression and dysthymia can be treated in a number of ways. Medication management and psychotherapy are the two most common treatment methods, but additional options can be explored if these initial treatment modes are ineffective. 

Transmagnetic stimulation (TMS) has shown positive results and is far less intensive than treatments like electroconvulsive therapy (ECT). Newer treatment modalities include the monitored use of low-dose hallucinogens in a controlled environment by a trained professional. However, talk therapy remains the least risky treatment approach for depression. People with depressive disorders should consult with their physicians prior to engaging in any medication or behavioral regime. 

Double Depression

People who have a diagnosis of major depression and have experienced these symptoms for two or more years consecutively may have both dysthymia and major depression. This combination is known as double depression. As one would expect, double depression can be even more complicated to manage due to the intensity of symptoms and long-lasting duration. 

Getting Help for Depression

If you are struggling with depression or dysthymia, it is important to reach out for support from others. It can be difficult to talk about feelings of depression, but in doing so, you can improve your quality of life and feel like yourself again. Whether you start by talking to a loved one, your medical provider or a therapist, there is no wrong way to reach out for help. A great way to access support is through a user-friendly app called Nobu. Nobu allows you to learn techniques like cognitive behavioral therapy, coping skills, mindfulness and even yoga, which can all help you in your journey of healing. For an additional fee, you can also connect with a licensed mental health expert and receive professional treatment for depression and other disorders. Download the Nobu app today and see how it can help you begin a healthier, happier lifestyle.

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Edited by – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor’s in Communication in 2017 and has been writing professionally ever since. He has written, edited and published content for health care professionals, educators, real estate agents, lawyers and high-level university faculty… Read more.

Written by – Paula Holmes, LCSW

Paula Holmes is a licensed clinical social worker, psychotherapist and freelance writer who lives and works in midcoast Maine. She received her master’s degree in Social Work in 2008 from the University of Maine. With over a decade of experience in the field of mental health, she is always amazed at the strength, beauty, and resilience of the human spirit… Read more.

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Medically Reviewed by – Dr. Angela Phillips

Angela is a licensed therapist and clinical researcher, and has worked in public, private, government, and not-for-profit organizations, across clinical and research-oriented roles. Angela’s clinical and research experience has included suicide prevention, cognitive behavioral… Read more.