dysthymic

Dysthymic is an adjective used in psychiatry to describe mood or symptoms associated with dysthymia. In modern clinical practice, the condition formerly called dysthymia is classified as persistent depressive disorder (PDD) in the DSM-5 and ICD-11. Dysthymic symptoms are typically milder in intensity than those of a major depressive episode but are more persistent, often lasting many years.

Diagnosis is based on a long history of depressive symptoms lasting at least two years in adults (one year in children and adolescents) and the presence of at least two associated symptoms such as poor appetite or overeating, insomnia or hypersomnia, low energy, low self-esteem, poor concentration, or feelings of hopelessness. The mood is chronically low, described as sad or empty, and functioning may be impaired.

Clinically, people described as dysthymic may experience double depression if a major depressive episode occurs on top of chronic dysthymia. Comorbidity with anxiety disorders, substance use disorders, and other medical conditions is common.

Treatment typically involves a combination of psychotherapy and pharmacotherapy. Cognitive-behavioral therapy, interpersonal therapy, or other evidence-based psychotherapies can improve symptoms and functioning. Antidepressant medications, particularly selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors, are commonly used, sometimes in combination with therapy. Long-term treatment and lifestyle adjustments, such as regular exercise and sleep regulation, may be important for management.

Prognosis varies; many individuals experience symptom fluctuation over time. With appropriate treatment, functioning and quality of life can improve, though dysthymic symptoms may persist for extended periods.