Dysthymia (Persistent Depressive Disorder)

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Persistent Depressive Disorder Treatment

Selective Serotonin Reuptake Inhibitor Drugs (SSRIs)

SSRIs were developed more recently than TCAs and are the most widely used class of antidepressants. They work by increasing the level of serotonin in the brain. Unlike MAOIs and TCAs, they do not significantly affect norepinephrine levels in the brain. SSRIs also have fewer and milder side effects, fewer drug interactions, and are much less likely to be associated with suicide than TCAs.

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Depression Myths: Overwork, Recklessness and More in Pictures

Persistent depressive disorder (dysthymia) facts

  • Dysthymia, now referred to as persistent depressive disorder, is a form of depression that lasts more than two years at a time in adults and more than one year at a time in children and adolescents.
  • Dysthymia can afflict 3%-6% of the United States population -- women more than men and more African-Americans than Caucasians and some groups of Hispanic people.
  • Persistent depressive disorder usually co-occurs with other disorders, like major depression, anxiety, personality or somatic symptom and related disorders, and with substance abuse.
  • People with dysthymia tend to have a number of biological, psychological, and environmental predisposing factors that contribute to its occurrence rather than one single cause of the condition.
  • In order to meet criteria for the diagnosis of persistent depressive disorder, an individual must have symptoms of sadness most of every day, more days than not, for at least two years in a row in adults, or one year for children and teens.
  • Health-care professionals will likely conduct or refer for an extensive medical interview and physical examination and will perform a thorough mental-health evaluation as part of establishing the diagnosis of dysthymia.
  • The treatment of persistent depressive disorder tends to be most effective when it includes both medication treatment and several weeks of talk therapy (psychotherapy).
  • Serotonergic medications (SSRIs) are often the first-line medication treatment for dysthymia due to their effectiveness, safety, and high tolerability.
  • Cognitive behavioral psychotherapy (CBT) is effective as part of treatment for persistent depressive disorder.
  • People with dysthymia are at risk for having a compromised life adjustment, marital problems, and generally having low social support, even more so than people with major depression.
  • Attempts at prevention of persistent depressive disorder tend to focus on both specific and nonspecific risk factors and strengthen protective factors.
Medically Reviewed by a Doctor on 4/8/2016

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