Depression: What is Dysthymia?

One variation of depression which is considered a disorder on its own is a chronic state of blues called dysthymia. Symptoms of dysthymia are more subtle than those of major depression but they can undermine a person’s ability to enjoy life and reach their full potential. Together with a chronically low mood, symptoms of dysthymia include chronic fatigue, poor self-esteem, difficulties concentrating and chronic upsets in appetite and sleep. Often, the disorder has existed for so long that there’s no clear point at which people can say they became “dysthymic”.

This explains why the diagnosis of dysthymia is often missed and why people can go through their entire adult life not realizing they have a mood disorder. Having been depressed for as long as they remember, they think it’s “just me”. Less common than major depressive illness, dysthymia still affects up to 4% of women, and 2% of men over a lifetime. (That said, because dysthymia is so often unrecognized, the incidence may well be higher). Dysthymia can progress to a major depressive illness – or conversely, a major depressive illness can precede dysthymia.

However, once symptoms have been present for at least two years in adults, and one year in children and adolescents, the diagnosis can be made. (A tip: Irritability and not a depressed mood is often indicative of dysthymia in younger people).

“One resolution I have made, and try always to keep, is this: to rise above little things.”
– John Burroughs

Once dysthymia has been diagnosed, medications used to treat the disorder are the same as those used for major depressive illness. However, response to the medications may be faster in people with dysthymia than they normally are, and mood may brighten considerably after only a few weeks on therapy. How long treatment will be continued may vary depending on the person.

Often, though, people feel so much better on medication that they are reluctant to discontinue it. With a good response, dysthymic people can look forward to a more fulfilling emotional life – often for the first time in their adult lives.

Currently recommended treatments for dysthymia in Canada include the same medications used for major depression. The newer cyclic antidepressants may be better tolerated over the long-term.