Dysthymia vs. Depression: What’s the Difference?

Today’s world is fast-paced, rapidly evolving, and incredibly demanding. Stress and mental health conditions like depression and anxiety are pervasive. In fact, statistics show that about 21 million adults in the United States have had a depressive episode in recent years [*]. There is also depression in teens and children. Given this, it only makes sense that we treat depression and its related illnesses, such as dysthymia, seriously. But what is dysthymia vs. depression in the first place? Here, we’ll differentiate the two and elaborate on the symptoms, treatment, and other aspects of these conditions.

What’s the Difference Between Dysthymia and Depression?

It is important to first define what dysthymia and depression are if we are to determine the difference between them.

Depression, often referred to as major depressive disorder (MDD), is a mental health condition characterized by extreme sadness or despair that lasts more than just a few days. It interferes with daily life and can cause various negative symptoms, including lack of energy, sleep pattern disruptions, or changes in appetite [*].

Dysthymia, now known as persistent depressive disorder (PDD), is a mental health condition that is similar to depression but is a milder and longer-lasting form of the illness [*].

Mental health professionals usually use PDD to describe someone who experiences depression chronically or over a long period.

Both conditions are characterized by low mood, but they differ in terms of duration and severity.

To be diagnosed with MDD, symptoms must be present for at least two weeks. For a diagnosis of PDD, symptoms must be present for at least two years. Though people with PDD experience depression for longer periods than someone with MDD, their symptoms may not be as severe as someone with MDD. However, people with PDD can still be susceptible to major depressive episodes.

Dysthymia vs. Depression Causes

There are no specific causes of dysthymia or depression. However, researchers think that it may be due to a combination of the following factors:

• Family History. You are more likely to develop depression if you have close relatives who also have the condition.
• Genetics and Biology. Disturbances in biological rhythm can disrupt your mood. Genes may also lead to individuals developing depression [*].
• Life Events. Negative life experiences, such as trauma, money problems, or the death of a loved one, can trigger depression.

Related Worksheet: Understanding Causes Of Depression Worksheet

Dysthymia vs. Depression Risk Factors

Several risk factors influence both dysthymia and depression, as they are very similar illnesses. A risk factor is something that increases the chance of developing a disease or a disorder [*].

Here are some of the risk factors for dysthymia and depression:

• Gender. Women are twice as likely to develop depression than men in their lifetime [*].
• Trauma. Stressful life events, such as death or money problems, can influence the development of dysthymia. For depression, some risk factors could include things like physical or sexual abuse.
• Personality Traits. Being overly self-critical or having low self-esteem can increase the chances of developing dysthymia or depression.
• Other Mental Health Disorders. Having other mental health disorders, such as bipolar disorder or an eating disorder, can affect the likelihood of developing dysthymia or depression.

Other risk factors include:

• Misusing alcohol or drugs
• Serious illnesses, like stroke or cancer
• Taking some medications, such as sleeping pills or some high blood pressure medicines

Dysthymia vs. Depression Symptoms

The symptoms of dysthymia are almost the same as those of major depressive disorder. As mentioned above, the main difference is in how severe the symptoms are and how long they last.

The symptoms are:

• Problems with sleep
• Loss of interest or pleasure in previously pleasing activities
• Changes in appetite (overeating or undereating)
• Low self-esteem
• Exhaustion or low energy
• Difficulty concentrating or making decisions
• Feelings of hopelessness

Thoughts of death/suicide

These symptoms cannot disappear for longer than two months at a time.

Patients with dysthymia usually present with a low mood and these other symptoms as well.

Related Worksheet: Depression Symptoms Worksheet

Dysthymia vs. Depression Diagnosis

To be diagnosed with dysthymia, you must exhibit the symptoms and have a depressed mood most of the day and for most days for at least two years [*]. For those younger than age 19, depressed mood can be replaced by irritability, and the time requirement is one year instead of two.

To be diagnosed with depression, at least five of the aforementioned symptoms must be present, along with the depressed mood. Depression lasts for at least two weeks and should be different from the individual’s previous functioning [*].

Dysthymia vs. Depression Treatment

The treatment for dysthymia is nearly the same as the treatment for MDD.

Each individual with dysthymia or depressive disorder requires an individualized plan based on the number and type of symptoms, their severity, and duration. But generally, the recommendations for psychotherapy and medication are the same.

The most effective treatment for both PDD and MDD is a combination of antidepressants and psychotherapy. Depending on your illness, CBT for depression, DBT for depression, or other types of therapy (like psychodynamic therapy) may be most helpful. For antidepressants, selective serotonin reuptake inhibitors (SSRIs) are a typical class of medicines that are often prescribed to people with depressive disorders.

The mental health professional you are consulting may also suggest certain lifestyle changes that have been shown to help alleviate the symptoms of depressive disorders. These include getting enough exercise, eating nutritious foods, and other self-care techniques. You may also use tools such as depression worksheets.

Related Handout: Depression Treatments (PDF)

Dysthymia vs. Depression Outlook

The outlook for patients with dysthymia depends on whether they receive a proper diagnosis and how well they adhere to a treatment plan. If you complete your therapy sessions, take medications as directed, have a strong support system, and follow the prescribed lifestyle changes, then you can expect a good prognosis.

However, other factors may negatively affect the outlook of your condition. If you have other disorders, a history of trauma, poor family relationships, or develop dysthymia at an older age, then your prognosis may not be as positive.

The same goes for depression. Its outlook depends on several factors, including its severity, whether or not it is treated, and if you have other mental health conditions. The prognosis for depression is better in individuals who have mild episodes, seek treatment, and have support systems. The prognosis is worse in people who have other disorders and who are older when they are diagnosed.

If left untreated, clinical depression can range from six to 12 months. And about 10% to 15% of people diagnosed with depression die by suicide. This is why it is important to adhere to treatment and use coping skills for depression.

The good news is that clinical depression is one of the most treatable mental health conditions. Approximately 80% to 90% of people with the condition who seek treatment eventually respond well to treatment.

Frequently Asked Questions

Here are some commonly asked questions about dysthymia and depression.

What is the difference between dysthymia and major depression?

Duration and severity are the main differences between these two very similar illnesses. Dysthymia is a chronic condition that lasts for at least two years. Depression can be episodic, with symptoms lasting for weeks or months. Dysthymia is generally less severe than major depression. Depression can significantly impair daily functioning.

Can you have dysthymia and depression at the same time?

While dysthymia is a milder but more long-lasting form of depression, it is possible for people with this illness to develop major depression. This is sometimes referred to as double depression.

Can dysthymia turn into depression?

Dysthymia can turn into depression, especially if it is left untreated.

The Bottom Line

Having dysthymia or depression does not have to be a completely negative thing. There is still hope in the form of treatment, lifestyle changes, and support. The important thing is that you get diagnosed if you think you have either of these conditions and get help from a mental health professional. By doing so, you’re investing in your health and well-being for the better.

References:

1. National Institute of Mental Health. Major Depression. July 2023.
2. American Psychological Association. Depression. 2024.
3. John Hopkins Medicine. Dysthymia. 2024.
4. Levinson D & Walter M. Major Depression and Genetics. 2024.
5. Mrazek PJ & Haggerty RJ. Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. 1994.
6. Kuehner C. Why is depression more common among women than among men? February 2017.
7. Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance. June 2016.
8. O'Connor EA, Whitlock EP, Gaynes B, et al. Screening for Depression in Adults and Older Adults in Primary Care: An Updated Systematic Review. December 2009.