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.

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What is persistent depressive disorder (dysthymia)?

Persistent depressive disorder, formerly called dysthymia, is a form of depression that tends to be characterized by fatigue, low energy, low self-esteem, and changes in appetite or sleep. This mood disorder tends to be less severe than major depression. However, persistent depressive disorder is chronic, in that despite potential brief periods of normal mood, symptoms last at least two years at a time in adults and more than one year at a time in children and adolescents.

The impact of persistent depressive disorder to people with the disorder, their families, and society is significant. For example, people with this illness can be twice as likely to develop dementia and therefore be unproductive and otherwise unable to care for themselves or others compared to those without persistent depressive disorder.

Statistics on persistent depressive disorder include its affecting 3%-6% of the population and up to one-third of those people receiving outpatient mental-health services in the United States. It tends to afflict women more often than men. While elderly individuals seem to be less likely to develop major depression compared to younger people, senior citizens are more at risk for developing the less severe but chronic persistent depressive disorder. In contrast to the prevalence of major depression in ethnic groups in the United States, persistent depressive disorder tends to be more common in African-Americans than in Caucasians and some Hispanic-Americans in most age groups. In the elderly, older, non-Hispanic Caucasians are thought to experience persistent depressive disorder and other depressive disorders more often than African-American and Asian people but of equal frequency as older Latino individuals.

Persistent depressive disorder usually co-occurs (is comorbid) with other disorders, most commonly with major depression, anxiety, personality, or somatic symptom and related disorders, as well as with alcohol or other drug abuse.

What are causes and risk factors for persistent depressive disorder?

As with most mental-health disorders, persistent depressive disorder does not have a single definitive cause. Rather, people with this illness tend to have a number of biological, psychological, and environmental contributing factors that contribute to its occurrence. Different parts of the brain of people with persistent depressive disorder tend to respond differently to negative emotions like fear and sadness, as well as to some physical sensations compared to the brains of people without the disorder. Genetic risk factors for developing persistent depressive disorder include the tendency for those who suffer from this illness to have a family member who also suffers from either persistent depressive disorder, major depression, or a personality disorder. Significant stress during childhood or adulthood (like exposure to neglect, abuse, or community violence) and having negative social supports are some psychosocial risk factors for persistent depressive disorder.

Medically Reviewed by a Doctor on 4/8/2016

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