Dysthymia vs Depression: Symptoms and Treatment

We all experience sadness or might feel more down than usual.

But when these feelings keep us down for long periods or keep us from enjoying our usual activities, it may be a depressive disorder.

There are several kinds of depressive disorder with similar symptoms that can make it hard for medical professionals to diagnose, with dysthymia and major depression being the two most common.

However, dysthymia vs depression has enough differences, namely in the consistency of symptoms and severity.

Understanding these differences can be an important first step toward getting the right treatment.

Read on to learn more about how dysthymia vs depression differs in symptoms and what treatment options are available for each mood disorder.

While the terms above may be used, the medical classifications for dysthymia and depression are persistent depressive disorder (PDD) and major depressive disorder (MDD), respectively.

Both conditions are quite common. Over eight percent of U.S. adults were estimated to have experienced a depressive episode in 2020.

Meanwhile, around 2.5 percent of adults in the U.S. will experience persistent depressive disorder at some point in their lives.

Major Depressive Disorder

Major depressive disorder — commonly known as clinical depression or simply, depression — is a mood disorder that causes negative changes to how you feel, think or behave.

Common symptoms of depression include:

• Persistent feelings of sadness, tearfulness, hopelessness and/or an “empty” mood

• Loss of interest in normally pleasurable activities

• Irritability and anger, frustrated outbursts over minor issues

• Lack of energy or fatigue

• Reduced or increased appetite

• Weight gain or loss

• Insomnia

• Oversleeping and struggling to wake up

• Feelings of restlessness, anxiety and agitation

• Difficulty focusing, recalling information and making decisions

• Noticeably slower speech and movement

• Recurrent thoughts of death, suicidal thoughts and suicide attempts

Major depressive disorder is more prevalent in women than men, with just over 10 percent of adult females experiencing a depressive episode.

A 2015 study of female twins found several factors that increased major depressive disorder becoming recurrent, including:

• Psychiatric history

• Family history

• Adverse life events, both early and recent

• Financial difficulties

• Problems with friends

If you struggle with major depression, it can feel difficult to go about your normal day as depressive symptoms may interfere with your ability to function and do typical activities.

Persistent Depressive Disorder

Dysthymia, or persistent depressive disorder, is a chronic or long-term form of depression.

Comparing dysthymia vs major depression, episodes of major depression are more severe but don’t last as long. Dysthymia, however, is characterized as low-level depression that lasts for at least two years.

People with persistent depressive disorder often feel as if they are constantly going in and out of depression.

Dysthymia and major depression have several symptoms in common, such as disrupted sleep, depressed mood, fatigue and poor concentration.

Other symptoms of dysthymia may include:

• Persistent gloom

• Pessimism

• Lethargy

• Introversion

• Self-criticism

• Low self-esteem

Women are almost twice as likely as men to develop persistent depressive disorder.

Dysthymia vs high functioning depression is often seen as interchangeable conditions. High-functioning depression may be less debilitating than other forms and allow a person to live a relatively “normal” life.

Persistent depressive disorder is poorly understood as a diagnosis though and, as such, some people may use the term “high-functioning depression” instead.

Dysthymia vs high-functioning depression may be misleading as interchangeable names though as high-functioning depression is neither a clinical disorder nor a diagnosis.

One of the most significant differences between dysthymia vs depression is how long a person experiences symptoms.

Medical professionals characterize dysthymia as a clinically significant depression over a long period. A diagnosis of persistent depressive disorder requires experiencing depressive symptoms for two years or more.

A diagnosis of major depressive disorder requires that symptoms last at least two weeks.

Dysthymia vs major depression also differs in severity.

While people with persistent depressive disorder typically experience depression for longer than someone with major depression, the symptoms are less severe.

How often dysthymia vs depression reoccurs is another difference between the two mood disorders.

Those diagnosed with major depressive disorder may cycle through depressive episodes and may return to a regular mood baseline between episodes. Dysthymia, however, is characterized by persistent symptoms lasting for years.

These long-lasting depressive symptoms can affect someone with dysthymia’s outlook and overall life as they experience symptoms for such long periods.

Diagnosing dysthymia vs depression can also differ.

While a diagnosis of major depression is relatively clear (symptoms lasting at least two weeks and a depressive episode may be shorter), dysthymia can sometimes be a little more difficult to diagnose.

Due to the long-lasting and less severe symptoms, someone with dysthymia may feel like their condition is “normal” and accept this is just how they will feel all the time.

Another challenge that makes it difficult to diagnose is that about 75 percent of people with dysthymia also experience a major depressive episode. This condition is known as double depression.

Most people return to usual dysthymia symptoms after an episode of double depression.

Another difference between persistent depressive disorder and major depressive disorder is the age at which each condition typically begins.

Dysthymia in adolescent years or before 21 years old is early-onset dysthymia, while late-onset dysthymia is diagnosed after 21 years of age.

In studies that compared dysthymia and depression patients, more had been diagnosed with early-onset dysthymia instead of late-onset. However, not as many studies have compared the number of early-onset diagnoses with late-onset dysthymia patients.

While the average age of depression is around 40 years old, recent surveys have shown younger people are also developing depression.

While medical professionals tailor treatment programs for any type of depression, the treatments for dysthymia and depression are similar.

Two main treatment options include medications and psychotherapy, which are more effective when used together.

Medications

Your healthcare provider may prescribe antidepressants for either condition.

Typical antidepressants used to treat depressive symptoms include:

• Selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft®)

• Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta®)

• Tricyclic antidepressants (TCAs)

• Atypical antidepressants, such as bupropion

Our Full List of Antidepressants guide goes into more detail about how these medications work on depression.

Therapy

Alongside medication, psychotherapy (also known as talk therapy) may be recommended.

Psychotherapy involves one-on-one sessions with a mental health professional.

One common type of therapy for the treatment of dysthymia and depression is cognitive-behavioral therapy (CBT).

CBT is a combination of cognitive and behavioral therapy, focusing on your thoughts and emotions as well as your actions. This form of therapy helps develop ways to identify, understand and deal with the factors causing depression as well as create safer coping habits to deal with existing depressive symptoms.

Cognitive-behavioral therapy may also help reduce the risk of relapse in the future.

Whether you’re experiencing dysthymia vs depression, both are serious conditions that can be treated. With a proper diagnosis and treatment plan, many people with depression can learn to manage their symptoms.

If you recognize symptoms of depression in your mood, behavior and outlook, you can talk with a mental health professional through our online mental health services.