Dysthymia vs Depression: Symptoms, Severity, and Treatments

Dysthymia and depression are two types of depressive disorders. Although similar, they have some key differences.

For many people with depression, their condition is manageable and responds well to treatment, regardless of the type of depression they live with.

There are several types of depressive disorders with similar symptoms that can complicate diagnosis for healthcare professionals. Dysthymia and major depression are the two most common.

Understanding the type of depression you have can help you better manage your condition and find the support that’s right for you.

Dysthymia is an older term for chronic depression. It is now called Persistent Depressive Disorder (PDD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).

Unlike other types of depressive disorders which involve periods of typical, non-depressive moods, PDD is continuous.

Symptoms of dysthymia

The symptoms of PDD are not always as noticeable as the symptoms of major depressive disorder. Instead, the symptoms may resemble gloom or pessimism.

Symptoms can change and evolve but are present most of the time. They include:

  • lack of humor
  • lingering gloom
  • pessimism
  • passivity
  • lethargy
  • introversion
  • self-criticism
  • judgement
  • dissatisfaction

In the United States, PDD affects approximately 1.5% adults. It is diagnosed more often in women than in men.

When people talk about “depression,” they usually mean major depressive disorder (MDD), sometimes called clinical depression. MDD is more severe than PDD, but major depressive episodes usually don’t last as long.

However, without treatment, MDD can come back or become recurrent.

In a 2015 study twins, the researchers noted several factors that may increase the risk of recurrence of MDD:

Depression symptoms

If you have MDD, it may seem difficult to do typical activities because the symptoms may interfere with your ability to function.

Symptoms may include:

  • prolonged depressed mood
  • fatigue
  • feelings of worthlessness or guilt
  • unintended weight fluctuations
  • sleep changes
  • hustle
  • psychomotor impairment
  • loss of interest or pleasure in most activities
  • thoughts of death or dying

MDD is more common than dysthymia. It affects approximately 8.4% American adults. It is also more often diagnosed in women than in men.

MDD is more often diagnosed in people:

  • lack of close interpersonal relationships
  • divorce
  • separate
  • widow
  • living with other mental health issues

According to National Institute of Mental Healthin 2020, major depressive episodes occurred most often among people aged 18 to 25 and those who reported being of two or more races.

Despite the shared symptoms between PDD and MDD, there are crucial differences.


Mental health professionals use several tools and information to diagnose depressive disorders.

They will ask you about your background and likely give you a mental health questionnaire. Then they usually compare your answers to the criteria laid out in the DSM-5.


To be diagnosed with PDD, you must be in a depressed mood:

  • most of the day
  • for more days than they feel well
  • for 2 years or more

You would also not have a symptom-free period lasting more than 2 months throughout the 2-year period.

You must also have at least two of the following:

  • feelings of hopelessness
  • low self-esteem
  • sleep disturbances (too much or too little sleep)
  • changes in appetite (over or underfeeding)
  • fatigue or lack of energy
  • difficulty making decisions or lack of concentration


For a diagnosis of MDD, you must meet at least five of the following:

  • depressed mood most of the day
  • loss of energy or fatigue
  • noticeable loss of interest or pleasure in most activities
  • increase or decrease in physical movement
  • too much or too little sleep
  • trouble thinking or concentrating
  • changes in appetite or weight
  • feelings of guilt or worthlessness
  • suicidal thoughts

These signs must last at least 2 weeks, and one of them must be depressed mood or loss of pleasure or interest.

When diagnosing MDD, a doctor may ask you questions to make sure you don’t have another condition. They will try to determine if you have had episodes of mania or hypomania, or if your symptoms are the result of substance use or another medical condition.


Dysthymia and major depression can interfere with work, school, and relationships. Symptoms can lead to physical illness because they can interfere with your ability to care for yourself.

MDD has more severe effects, but they are short-lived compared to the long-lasting symptoms of PDD.


The treatments for MDD and PDD are very similar.

Doctors suggest a treatment plan based on the severity of symptoms.

For mild depression, psychotherapy is often the first-line treatment. For moderate depression, your doctor might recommend medication in addition to therapy.

A person with severe symptoms, including suicidal thoughts, will likely need more intensive care to prevent a mental health crisis.

Research in 2019 suggests the therapy works for mild to moderate depression in about 48% of cases.

The types of therapy included in the study were:

When treating depression, if no improvement occurs after about 6 weeks, your doctor may suggest another type of therapy or medication.

There are many types of antidepressants available. The most common include:

Depending on the type of medication you are prescribed, it may take several weeks for the medication to take effect. Most doctors will prescribe a low dose and gradually increase as needed.

Other types of depression

The DSM-5 lists several other types of depressive disorders, including:

Dysthymia and major depression are two types of depressive disorders that can affect your ability to function in daily life. But they are also both treatable.

Dysthymia – or persistent depressive disorder – is a long-lasting form of depression. The symptoms are less severe but they last a long time. Major depressive disorder is often more severe than PDD.

Regardless of the type of depression, if you think you have symptoms of depression, you can seek help. A diagnosis can help you find the treatment options that are right for you. The first step is to see a doctor or seek mental health support.

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