January 17, 2018

By Luna Greenstein


If someone mentioned that they have depression, most people would likely have some idea of what that means. They might imagine a person feeling tired, gloomy or empty. They might even know some of the accompanying symptoms such as changes in weight or sleep patterns. But what many people don’t know is that there are actually different types of depression.

The most common form is major depressive disorder, which affects about 16 million adults in the U.S. This is what most people associate with the term “depression.” Other forms  include depression with a seasonal pattern, which usually occurs in late fall and winter; postpartum depression, affecting women after childbirth; and dysthymia, which is a long-term form of depression that lasts for years.

All forms of depression have similar symptoms: issues with sleep, low energy, low self-esteem, poor concentration, difficulty making decisions, feelings of hopelessness. What distinguishes them is timing and consistency of symptoms. And the primary distinction with dysthymia (also known as persistent depressive disorder) is that it’s the only depressive disorder where symptoms are present for at least two years, and typically longer.

What is Dysthymia Like?

While someone with major depressive disorder will typically “cycle” through episodes of feeling severely depressed and then be symptom-free for periods of time, dysthymia presents with persistent symptoms for years.

An episode of depression usually represents a break from someone’s normal life and outlook, while dysthymia is often embedded into a person’s life and outlook because they experience symptoms for such prolonged periods of time. In fact, an adult must experience depression for at least a two-year period to receive a diagnosis (one year for children and teenagers).

Dysthymia often has an early and subtle onset during childhood, adolescence or early adulthood. However, it can be challenging to detect because its less severe and lingering nature can make the condition feel “normal” for that person.

Also making it a challenge to diagnose is the fact that about 75% of people with dysthymia will also experience a major depressive episode. This is referred to as “double depression.” After the major episode ends, most people will return to their usual dysthymia symptoms and feelings, rather than feel symptom-free.

What Can I Do?

If you think you may have dysthymia, it’s essential to seek help. Seeing a mental health professional is the first step to recovery. Taking the time to go to therapy is an investment in your health and well-being; the condition will not go away on its own. Typically, a combination of both psychotherapy and medication leads to the best outcomes.

Further, according to a study that followed people experiencing dysthymia for nine years, one of the most important factors of recovery is having confidence in your health care providers. This may mean trying out different therapists and psychiatrists until you find one that best fits your needs.

The study also notes that participants who recovered felt like they gained “tools to handle life,” including understanding themselves and their condition, having self-acceptance and self-compassion and focusing on solving problems that create distress.

Learning these tools and preparing yourself to handle difficult symptoms requires patience. It can be challenging to have hope for recovery when depression is your norm—when feeling good seems more like a memory than a possibility. But recovery is possible. It takes effort and commitment, but you deserve to feel better.


Laura Greenstein is communications manager at NAMI.

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