Dysthymia in Children: Causes, Symptoms, and Treatment

When a child experiences trauma or is genetically predisposed to depression, they can develop dysthymia. Dysthymia in children, while not as common as major depression, is a persisting problem that can negatively impact their daily lives.

Fortunately, by learning more about the condition and getting professional help, parents can provide the support their children need. Discover what causes dysthymia in children and what you can do to get help.

What is Dysthymia?

Dysthymia, also called persistent depressive disorder, is a type of chronic depression with longer-lasting episodes [*]. For a child to become diagnosed with dysthymia, they must present low, sad, or irritable moods for at least a year.

Dysthymia vs. Depression in Children

Dysthymia and depression in children may look the same, but they manifest differently. While milder than major depression, dysthymia episodes last longer. Children may experience mild depression but more frequent bursts of intense feelings. Dysthymia is also more challenging to diagnose than depression and is often left untreated.

How Common is Dysthymia in Children?

Dysthymia in children is not as common as major depression. The condition occurs in 0.6 to 4.6% of younger children and 1.6 to 8% of adolescents. [*]

However, general depression is one of the most common mental health conditions in children across America, with 11% of children between 13 and 18 becoming diagnosed with major depressive disorder.

What Causes Dysthymia in Children?

There is no exact cause of dysthymia, but several risk factors include the following:

• Chemical imbalances in the brain
• Family history of dysthymia or persistent depression
• Various environmental stressors, such as the death of a family member, abuse or neglect, coexisting mental health conditions, divorce, or social/academic struggles
• Temperamental factors, such as extreme shyness or social withdrawals

What are the Symptoms of Dysthymia in Children?

While symptoms may vary, a child suffering from dysthymia might experience the following:

• Constant depressed or irritable mood
• Appetite changes
• Sleep disturbances
• Fatigue and energy fluctuations
• Poor concentration
• Low self-esteem
• Difficulty making decisions
• Feelings of worthlessness and hopelessness
• Trouble maintaining relationships
• Loss of interest in regular activities
• Sensitivity to failure and rejection
• Suicide ideation and attempts

How is Dysthymia in Children Diagnosed?

Parents and caregivers can get a dysthymia diagnosis for their child through a mental health professional or child psychologist.

The child’s healthcare provider will conduct a thorough psychiatric evaluation, which may include a series of questionnaires and interviews. The healthcare provider may also interview teachers from your child’s school and other family members.

Your child may also undergo a physical exam in case their healthcare provider can link dysthymia symptoms to an underlying physical illness. This exam may entail blood extractions and lab tests to determine what may be causing depression symptoms.

How is Dysthymia in Children Treated?

The most effective treatment for dysthymia in children should be specific to their needs. Generally, children with dysthymia receive treatment in the following ways.

Medication

Most medical professionals will prescribe anti-depressants to treat dysthymia, which can take about four to six weeks to become effective. These medications might include the following:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants (TCAs)

Ensure your child takes their medication at the same time daily. While they may experience side effects, it’s important not to stop taking medication unless specifically instructed to do so.

Therapy

Psychotherapy, or talk therapy, is an effective method for treating dysthymia. In particular, your child’s healthcare provider may recommend cognitive behavioral therapy (CBT) [*]. Through CBT, your child’s therapist can help them identify long-term goals and methods for eliminating negative thought patterns associated with their condition. CBT can also help a child develop better social skills and encourage positive interactions with others.

Your child’s healthcare provider might also apply dialectical behavior therapy (DBT) to help them better manage negative thoughts and destructive behaviors. DBT highlights mindfulness, which children can apply when processing negative experiences. It also enhances a child’s interpersonal effectiveness and distress tolerance by equipping them with mental tools to be more flexible and self-reliant in the face of stress.

Generally, talk therapy aims to achieve the following goals:

• Equip children to respond better to crises or trauma
• Identify issues that contribute to the child’s dysthymia
• Identify negative thought patterns, beliefs, and behaviors
• Improve the child’s relationships with others and enhance their interpersonal skills
• Help the child regain control over various aspects of their lives
• Help the child set realistic goals for themselves in all aspects of life

Occasionally, healthcare providers may also encourage family therapy to allow parents, siblings, and other family members to adjust.

Can Dysthymia in Children Be Prevented?

While depression isn’t necessarily preventable, you can take steps to reduce your child’s risk of developing it. Introduce healthy habits like regular physical activity, meditation, journaling, and positive interactions with peers.

If you notice that your child is developing signs of dysthymia, early detection can make or break their progress. Contact your child’s healthcare provider immediately to develop a workable treatment plan.

How Can Parents and Caregivers Support a Child With Dysthymia?

Parents play a significant role in helping their child live with dysthymia. As a parent or caregiver, here are a few ways you can support your child:

• Learn more about dysthymia. Dysthymia is a multifaceted condition with many layers. Learning more about its symptoms and causes can help you anticipate episodes in your child and find better ways to offer support. You can learn more about the condition by reading literature, watching videos, or speaking with their healthcare provider.
• Schedule talks with your child. Make your child feel heard. Host a “debrief” every week and discuss potential concerns your child might have. If they report improved symptoms, offer lots of praise and encouragement. Use this time to introduce depression coping skills.
• Keep your child occupied. Enrich your child’s life with activities they enjoy. If they show interest in a sport or a craft, encourage it. Provide options for extracurricular activities or find community groups where your child may feel at home.
• Get protection. If your child’s dysthymia becomes disruptive to their daily life, consider reaching out for additional protections or considerations through the Americans with Disabilities Act (ADA) or Section 504 of the Civil Rights Act [*]. Section 504 of the Rehabilitation Act of 1973 also requires educational institutions to provide reasonable accommodations for children with dysthymia and similar conditions [*].
• Inform others about your child’s condition. Making your child’s friends, other family members, and the school community aware of their condition can help them be more sensitive and accommodating.

The Bottom Line

Dysthymia in children can feel crippling or overwhelming, but it doesn’t have to take over your child’s life. With the appropriate avenues for support, your child can live a perfectly fulfilling life without feeling handicapped.

Browse our comprehensive catalog of worksheets for managing depression to help your child overcome obstacles related to dysthymia.

Sources:

1. Elzamzamy K, Khan YS. “Major depressive and dysthymic disorders.” EBSCO, 2022.
2. Nobile M, Cataldo GM, Marino C, Molteni M. “Diagnosis and Treatment of Dysthymia in Children and Adolescents.” CNS Drugs, 2003.
3. Hofmann SG, Anu Asnaani, Vonk J, Sawyer AT, Fang A. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses.” Cognitive Therapy and Research, 2012.
4. “Americans with Disabilities Act.” DOL, 2024.
5. “Protecting Students With Disabilities.” U.S. Department of Education, 2024.