Dysthymia vs. Depression: Depressive Disorder Treatment And Types
You’re likely familiar with the term “depression,” but have you heard the term “dysthymia?” Also known as persistent depressive disorder (PDD), dysthymia and its side effects can impact your relationships with family and friends, your work experience, your personal life, your physical health, and even your ability to accomplish daily activities. This article explores these mental health disorders from a medical standpoint to help you learn more about dysthymia and each type of depression.
Understanding dysthymic disorder or persistent depressive disorder
Dysthymia is a type of depression, but it’s considered milder than related mental health conditions such as major depressive disorder. However, that doesn’t mean that dysthymia isn’t a serious chronic mental disorder or that the symptoms, such as depressed mood, aren’t challenging to cope with.
Mental health impact of dysthymia
Dysthymia will generally have fewer intense side effects and symptoms than those with other types of depression will face, but it’s still a clinical mental illness that generally requires treatment to resolve.
For a dysthymia diagnosis, symptoms must be ongoing for at least two years. PDD symptoms are generally milder, but last longer than those associated with major depression.
Understanding depression or major depressive disorder
As the American Psychological Association explains, depression is not just feeling sadness at times, but rather “extreme sadness or despair that lasts more than days.” It is also the most common mental disorder.
While there are several types of depression, the term is most often used to refer to major depressive disorder. This is the more extensive and more severe form of what is considered clinical depression. It tends to cause physical and emotional symptoms for individuals and it can interfere with work, family, friends, social life, and personal relationships. In extreme cases, it can lead to suicide or attempted suicide.
If you or someone you know is struggling or in crisis, help is available. Text or call 988 or chat 988lifeline.org. Support is available 24/7. If you are experiencing trauma, support is available.
Dysthymia vs. depression
The first major difference between major depressive disorder and dysthymia is that they interact with mood in slightly different ways.
Key distinctions between dysthymia vs. depression
Both those diagnosed with dysthymia and those with major depressive disorder will have times where they feel depressed. However, those with major depressive disorder will also have times where they do not experience depression. In contrast, those with dysthymia will generally experience depression symptoms at all times.
The second major difference is that major depressive disorder and dysthymia require different amounts of time to be diagnosed. Someone who is experiencing major depressive disorder must have symptoms for at least a period of two weeks in order to be diagnosed. Someone who is experiencing dysthymia or persistent depressive disorder must have symptoms for at least a period of two years to be diagnosed. These periods of time allow the mental health professional to tell whether the symptoms are persistent or not. It is possible for a major depressive disorder diagnosis to lead to a persistent depressive disorder diagnosis as time continues. Note that, despite these time frames, you can seek professional support for mental health symptoms at any time.
The intensity of the symptoms is different between major depressive disorder and dysthymia as well. Whereas someone with major depressive disorder will generally have more severity to their symptoms, someone with persistent depressive disorder will have milder, but more persistent symptoms. This means that the symptoms associated with persistent depressive disorder may not be as debilitating or as intense, but they last longer. Someone with major depressive disorder may have more intense outbursts, but the symptoms will come and go over time. This isn't to say that either one is easier to handle, but that they are different.
Symptoms of major depressive disorder and persistent depressive disorder
Both PDD and major depressive disorder have the same symptoms, just for different lengths of time and intensities. These may include:
- Anger and frustration at small inconveniences
- Loss of interest in normal daily activities, including sports and hobbies
- Increase or decrease in sleep
- Lack of energy for even simple tasks
- Increase or decrease in appetite
- Increase or decrease in weight
- Feelings of sadness, emptiness or hopelessness
- Feelings of guilt or worthlessness
- Difficulty concentrating, making decisions, or remembering things
What is “double depression?”
Because of the way that these two types of depression are defined, they are considered separate disorders and therefore can also occur concurrently in some cases. Someone who has been diagnosed with persistent depressive disorder, for example, may have a major depressive episode that then leads to a diagnosis of major depressive disorder as well. When this happens, it may be clinically referred to as “double depression.”
It is important that you communicate with your mental health professional about what you are experiencing and when so they can help you work through your symptoms and get the proper treatment for all of them.
Dysthymia and major depressive disorder treatment options
Although the two disorders are different, their treatments are generally similar. Depression of all types is typically treated through psychotherapy, sometimes in combination with medication. For each individual, the specific treatments recommended by a healthcare provider may vary somewhat.
Medication
A number of different types of antidepressant medications have shown success in treating depression. They may be used in conjunction with talk therapy or modalities such as cognitive behavioral therapy. In general, some of the following types of medication are used to treat depression include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCAs)
The specific medication and dosage prescribed will vary from patient to patient. It's important to consult with your doctor or psychiatrist before starting, stopping, or changing any medication.
Psychotherapy for depression
The two most common types of therapy used to help treat depression are behavioral activation (BA) and cognitive behavioral therapy (CBT). Each of these focuses on the way that you feel and the way that your thought patterns can be adjusted to create positive changes in your moods or behaviors. They both have demonstrated success in treating patients with depression by helping them recognize their own influence and control over their thoughts and behaviors.
If you’re nervous about meeting with a mental health professional in person, you might consider an online therapy platform instead. With BetterHelp, you can get matched with a licensed mental health professional who you can meet with virtually from home or anywhere you have an internet connection.
Benefits of online therapy with a licensed mental health professional
Research indicates that online therapy can often be as effective for individuals with depression as in-person counseling. For example, a medically reviewed study published in the Journal of Medical Internet Research suggests that patients receiving CBT therapy via video chat experienced reductions in depression symptoms. The study’s authors conclude that online therapy for depression may be able to produce “sustained and clinically meaningful improvements.” Similarly, in a literature review, internet-based cognitive behavioral therapy was suggested to be a cost-effective option for treating patients with depression and was particularly helpful for those who lived in more rural areas.
Takeaway
With BetterHelp, you also aren’t limited by the mental health professionals who are available in your area, giving you more freedom to choose someone you trust and with whom you feel comfortable. Not only that, it allows you to review far more information and qualifications before you narrow down your choice. There's no reason to settle for a therapist with whom you aren't entirely comfortable. Through BetterHelp, you don’t have to.
Is dysthymia or persistent depressive disorder a personality disorder?
No. However, persistent depressive disorder was once called "depressive personality." This name indicated the prior belief that depression was just a part of who someone with persistent depressive disorder was, likely because the depression lasted so long. However, experts now have a different understanding of persistent depressive disorder. Instead of a personality disorder, dysthymia is considered a depressive disorder. The main difference is that dysthymia doesn't necessarily last for a lifetime. On the other hand, while treatment can help people manage their personality disorder, that type of disorder isn't likely to ever go away completely.
It is true that some experts have pushed to reintroduce the label of depressive personality disorder. If so, this personality disorder would probably include symptoms like strong tendencies to be self-critical, critical of others, have guilty feelings, and be pessimistic, gloomy, and brooding. But this is different from persistent depressive disorder, too, because this personality disorder would not include loss of interest or physical symptoms as dysthymia does.
Which antidepressant is best for dysthymic disorder treatment?
According to an article published by the National Institute of Mental Health, selective serotonin reuptake inhibitors are often the best choice for people with persistent depressive disorder. SSRIs are not only quite effective for most people with this depressive disorder, but most people also tolerate them well.
However, not everyone thrives on the same medication. For example, SSRIs may not be very effective in reducing anhedonia in elderly people. Other medication options for dysthymia include serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants.
Can dysthymia be cured with the help of a mental health professional?
Yes, in the following sense. To cure simply means to relieve the symptoms of a condition, such as physical or mental illness With a combination of medications and psychotherapy, people can find relief from the symptoms of persistent depressive disorder.
Now, that doesn't mean that if the symptoms go away, they will never come back. Think of cancer. Someone with cancer can receive treatments, and the symptoms and all the signs of cancer can be gone. Yet, they might still have cancer again at some point. The same is true of any depressive disorder. Treatment may put an end to your symptoms of persistent depressive disorder, but it can still return in the future. For example, you may begin to notice yourself feeling sad and having a poor appetite or overeating. If so, don't wait for other dysthymia symptoms to start. Instead, it's always a good idea to stay alert to warning signs of a depressive disorder. Then, find a doctor, and get help if you begin to notice they're returning.
What is the difference between persistent depressive disorder (PDD) and major depression (MDD)?
PDD, or persistent depressive disorder, is typically longer lasting than MDD, or major depression. Major depressive disorder is characterized by depressed mood, decreased interest, and other symptoms during the same two-week period, although major depressive episodes often last several months. Persistent depressive disorder, on the other hand, involves symptoms like depressed mood, loss of enjoyment, and other signs of depression for most of the day, more days than not, for at least two years. In other words, while major depression is an acute disorder, PDD is a chronic form that lasts for a long time.
Symptoms of MDD may also be more severe than those of PDD. Major depression is more disabling. But that doesn't mean that PDD is mild. It can be extremely distressing and disrupt your work, family, and social life.
Sometimes, people can have both PDD and MDD. This may happen when someone experiences persistent dysthymia symptoms in the long term but also has an acute depressive episode at some point. This is called double depression because the person has both the chronic form and an acute, severe episode of depressive disorder.
Dysthymia symptoms include:
- Depressed or sad mood
- Loss of pleasure in things once enjoyed
- Weight loss or weight gain of more than 5% in a month
- Increased appetite or overeating, or decreased appetite and undereating
- Insomnia or oversleeping
- Restlessness or feeling run-down
- Lack of energy or fatigue
- Feelings of hopelessness, worthlessness, or guilt
- Problems making decisions or concentrating
- Thoughts of death or suicide
These same symptoms are present in both mental health conditions. It's the severity and intensity of the symptoms that are different in major and persistent depressive disorder. It's important to get help if you suspect you have either of these types of depression. If you notice these warning signs of a depressive disorder, it's critical that you find a doctor who can tell you what kind of depression it is and offer effective treatments.
Risk factors for depressive disorder are the same for both persistent depressive disorder and MDD, as well as for nearly any other depressive disorder. According to the National Institute of Mental Health, these risk factors include:
- Personal history of depression
- Family history of depression
- Major life changes, stress, or trauma
- Some physical illness and medications
Both kinds of depressive disorder can also co-occur with other mental illnesses, such as anxiety disorders.
Is MDD worse than PDD?
No, not necessarily. Although major depressive episodes are acute and severe, the seemingly never-ending depressive symptoms that come with persistent depressive disorder can have lasting effects on an individual’s life. Both disorders can affect a person’s health, relationships, career, and quality of life.
How long does dysthymia last?
Dysthymia, or persistent depressive disorder, is a long-term form of depression. People with dysthymia or persistent depressive disorder often experience depressive symptoms for at least two years.
Is dysthymia a form of bipolar disorder?
Dysthymic disorder and bipolar disorder are two separate mental health conditions with different symptoms and diagnostic criteria.
How do you deal with dysthymia?
Psychological treatment may be beneficial for different forms of depression. The Institute of Mental Health recommends antidepressants and psychotherapy as the first-line treatments for a depressive disorder.
Other things you can do to manage persistent depressive disorder include:
- Avoiding substance use
- Getting treatment for other health conditions
- Getting therapy for anxiety disorders
- Living a healthy lifestyle
- Getting enough sleep
- Developing a strong social support system
- Making sure to avoid alcohol and illegal drugs, which can make depression worse
- Getting regular exercise
- Seeking support from friends and family members
- Have the number of a crisis lifeline on hand for if you contemplate self harm
While it may not be possible in some cases to prevent persistent depressive disorder, following the suggestions outlined above can help you maintain your sense of well being. And if you have a new diagnosis of dysthymia, it is important to see a mental health professional and keep all your follow up appointments.
What does dysthymia feel like?
Dysthymic disorder can be characterized by low mood, low self-esteem, and poor concentration. Its main symptom is a persistent feeling of low-level depression for an extended period. Persistent depressive disorder can be managed through therapy and medication.
How does dysthymia differ from depression?
Dysthymia and depression are both mood disorders. They may share common symptoms such as altered sleep patterns, appetite changes, negative thoughts, and depressed mood. The difference between dysthymia and regular depression is that episodes of depression are typically acute and last for weeks or months, whereas dysthymia symptoms are typically milder but last for a longer period. Treatment for persistent depressive disorder and major depressive disorder may include modalities such as cognitive behavioral therapy and interpersonal therapy.
Harvard Medical School has published information on dysthymia, its symptoms, and possible causes. The Cleveland Clinic, while acknowledging that the exact cause of dysthymia is unknown, suggests that it may be caused by abnormal brain connections. Possible risk factors include family history, stressful life events, certain medical conditions, and chronic stress.
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