dysthymie

Dysthymia, also known as persistent depressive disorder, is a chronic form of depression characterized by a depressed mood that lasts most of the day, more days than not, for an extended period. In adults, the required duration is at least two years; in children and adolescents, the period is at least one year. The mood is typically less severe than in major depressive episodes but persists over time, causing ongoing functional impairment.

In addition to persistent low mood, individuals may experience a combination of symptoms such as poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, difficulty concentrating or making decisions, and a sense of hopelessness. Symptoms must be present most days for a majority of the time and cannot be attributed to substances or another medical condition. Major depressive episodes can occur alongside dysthymia, a pattern sometimes referred to as double depression.

Causes are multifactorial, involving genetic predisposition, neurobiological factors, and psychosocial stressors. Risk factors include a family history of depressive disorders, early adverse experiences, chronic stress, and comorbidity with anxiety or substance use disorders.

Diagnosis relies on clinical assessment, often supported by standardized questionnaires. Clinicians distinguish dysthymia from other mood disorders and rule out medical conditions or substances that could explain the symptoms. In some cases, imaging or laboratory tests are used to exclude alternatives.

Treatment typically combines psychotherapy (such as cognitive-behavioral therapy or interpersonal therapy) with pharmacotherapy (often selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors). Long-term treatment and lifestyle changes—regular exercise, sleep regulation, social support—are commonly important. With sustained treatment, many people experience symptom improvement, though dysthymia can be a chronic condition requiring ongoing management.