Dysthymia — now called Persistent Depressive Disorder in DSM-5 — is a chronically depressed mood present most of the time for at least two years, with less intense but more persistent symptoms than major depression. Many people with dysthymia do not recognize it because they have "always been this way"; their baseline way of seeing the world is already tinged with gray.
Concept origin
Akiskal (1983) proposed the distinction between characterological (dysthymia) and episodic depression. The DSM-5 revision (2013) unified dysthymia and chronic depression under "Persistent Depressive Disorder," recognizing its heterogeneity and frequent overlap with major depression (double depression).
How it manifests
- ▸ Depressed mood most days for years
- ▸ Low energy, low self-esteem, and difficulty concentrating
- ▸ Feeling that "I have always been this way" or "I am a sad person"
Therapeutic approach
Psychotherapy is the primary treatment for dysthymia. CBT and interpersonal therapy have solid evidence. Identifying the "chronic depressive schema" (Young) and modifying it requires more time than in episodic depression: it works on identity, not just symptoms.
Related concepts
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