Major Depression vs. Dysthymia
Have you felt tired, unmotivated, and disengaged from life for as long as you can remember? You might think that this is just the way you're wired. But you could have something called dysthymia or persistent depressive disorder (PDD).
PDD is a type of depression. It's a relatively new term to cover what was originally thought of as a personality disorder. PDD is similar to major depressive disorder (MDD), also known as major depression (or informally as "depression"), in a lot of ways. But one key difference is duration. Someone with dysthymia may have fewer symptoms than someone with depression, but these chronic depression symptoms last longer (at least 2 years). You could have had dysthymia from childhood and not even realize it because the condition comes and goes.
Experts estimate that in the U.S., 17% of the population has MDD, while just 3% has PDD, though that could be underreported. Often, people have both. Sometimes, dysthymia can disrupt your life more than major depression, even with fewer symptoms. The good news is that both conditions can be treated.
Dysthymia vs. Depression Symptoms
The two disorders share several symptoms. The main one is a depressed mood on most days. To figure out if you have dysthymia, your doctor will ask about other possible signs:
- Loss of appetite or overeating
- Problems sleeping
- Low energy or tiredness
- Low self-esteem
- Difficulty concentrating or making decisions
- Feelings of hopelessness
If you have dysthymia, you’ll have at least two of these symptoms, along with a depressed mood. The symptoms will have hung on for at least 2 years without much relief. (For children, it needs to be only 1 year.) If you do get relief, it lasts no longer than 2 months.
If you have MDD, you’ll have more symptoms, at least five, and they'll last at least 2 weeks, but not necessarily for years. Some symptoms are like those of dysthymia. But they may be worse.
For example, someone with dysthymia may notice changes in eating habits. But if you have major depression, those changes may cause you to gain or lose a lot of weight.
The nine symptoms of major depression are:
- Depressed mood
- Loss of interest or pleasure in many or all activities
- Sleep problems
- Noticeable weight loss or gain
- Faster or slower movements that others notice
- Tiredness or low energy
- Problems thinking or making decisions
- Thoughts of guilt or worthlessness
- Repeated thoughts of death or suicide, or a suicide attempt
Dysthymia vs. Depression Causes
You're more likely to get either type of depression if you’re female. (It's twice as common in women as men.) Both types can start at any age, but PDD often shows up earlier in life.
There's no exact cause for PDD or MDD. Experts think both are probably caused by a mix of factors, including:
Biology. Stress may cause changes to your brain. Changes to natural brain chemicals (called neurotransmitters) and how they function can influence your depression.
Family history. Depression is more likely when you have close relatives with the condition.
Life events. Trauma in your life, such as money problems or the death of a loved one, can trigger depression.
Depression vs. dysthymia risk factors
Risk factors for developing dysthymia and depression include:
Heredity. Having a parent or sibling with a history of depression, bipolar disorder, or alcoholism.
Trauma. Stressful life events, such as death or money woes; for depression, risk factors could include events such as physical or sexual abuse.
Personality traits. Having low self-esteem or being overly self-critical.
Other mental health disorders. Having bipolar disorder or an eating disorder, for instance.
Other risk factors for depression include:
- Abusing drugs or alcohol
- Serious illness, such as cancer or stroke
- Taking certain medicines, such as some high blood pressure medication or sleeping pills
Depression vs. Dysthymia Diagnosis
No lab test can diagnose depression or dysthymia. But your doctor may order tests to make sure there isn’t another medical reason for your low mood, tiredness, and other symptoms. For instance, they may order a blood test to make sure you don't have hypothyroidism, a condition where your body doesn't make enough thyroid, a hormone that keeps the body running normally. Depression can be a side effect of hypothyroidism.
Your doctor will ask a lot of questions about your symptoms, your thoughts and feelings, how long you've had them, and how much they affect your daily life to make a mood disorder diagnosis. They may also refer you to a psychiatrist or psychologist.
Dysthymia vs. Depression Treatment
Your doctor can recommend several methods for treating dysthymia and depression. Often, they’re used together. These usually include:
Medication. Your doctor can prescribe drugs called antidepressants to rebalance the natural chemicals in your brain. The ones your doctor will prescribe depend on several things, including what other medications you're taking.
Some antidepressants need several weeks to work. Don’t stop taking one without talking to your doctor first. Sometimes, stopping or missing doses can cause a withdrawal reaction or make your depression worse. It's common to have to try more than one type of antidepressant before finding the right drug for you.
Therapy. This involves talking with a psychologist or a mental health counselor about your thoughts and feelings. With therapy, you can learn ways to deal better, such as how to identify and prevent harmful thoughts. You could learn to manage stress or improve your social skills. Or you may work through longtime challenges, such as painful childhood memories.
If your depression is very serious, you may need a hospital stay, but this is unlikely to happen with dysthymia.
Lifestyle. Some changes can help your body as well as your mind:
- Keep up a healthy diet.
- Get enough sleep.
- Exercise regularly.
- Avoid alcohol and illegal drugs, which can affect your mood.
- Spend time on hobbies and other things you enjoy.
- Surround yourself with supportive friends and family.
Living With Depression or Dysthymia
You may get both types of depression at some point in your life.
About 3 out of 4 people with PDD will have at least one period of MDD at the same time. Doctors call that double depression.
Neither type of depression is minor. It may take time and different treatments before you start to feel better. But once you and your doctor settle on the right medication and support, you'll likely feel your mood improve. Be sure to stick to your treatment plan.
Having depression or dysthymia can make it hard for you to engage with life. Here are some ways to deal with it on a daily basis:
Keep a journal. Just writing down your thoughts and emotions can go a long way toward getting them out of your head.
Simplify your life. Cut down on obligations. Make a list of things you must do to keep track. If taking a shower feels like too much work, use wet wipes, for instance.
Learn how to manage your stress. What makes you feel better? Is it drawing a picture, taking a walk in nature, or reading a good book? Have one or two go-to activities. Some people find learning something new or volunteering boosts their mood. Others find prayer or meditation helps.
Stay connected. People with depression or dysthymia often say "no" to invitations to join others or to go somewhere because it just feels like too much work. But being around other people can do a lot for their well-being. So, try to let others in. You might find it helpful to join a support group for people dealing with MDD or PDD.
Put off making big decisions. For instance, deciding whether to leave your spouse or move to another state is something you'll want to do after your treatment is working and you can think more clearly.
Tips for Friends and Family
If your loved one is dealing with depression or dysthymia, here are some ways you can help:
Be open. Many people feel embarrassed to admit that they have depression. Let them know it's OK and you'll listen. At the same time, some people who have depression don't realize it. So, if you see that your loved one has the symptoms, suggest they get help. They may not take you up on it, but sometimes putting the idea out there paves the way for a later visit to a doctor or counselor.
Check for suicide risk. If your loved one is expressing suicidal thoughts, buying guns or pills, or giving away belongings, call their doctor and/or 988 (the Suicide & Crisis Lifeline) for advice. Express your concerns to your loved one as well. If you think they're about to self-harm or attempt suicide, call 911.
Stay in touch. Send a call or a text to let them know you care. Invite them to events but don't put pressure on them to attend. At the same time, don't stop inviting them even if they always turn you down. A connection will help keep them from feeling that "nobody cares about me."
Be willing to listen. It may be hard just to hear them out and not offer advice or tell them to snap out of it. But active listening (paying attention, giving eye contact, asking questions such as "How do you feel about that?") can be the most powerful thing you can do. You often don't need to say anything much at all.
Offer help. Your loved one may benefit from help with meals or housework. Or these activities may be something you can do together.
Take care of yourself. If you live with someone who has depression, you may need a break yourself. Take time for activities you enjoy. Find support from friends or other family members.
Takeaways
Dysthymia (also known as persistent depressive disorder) is a type of depression. You might have fewer symptoms than someone with major depression, but your depression will be longer-lasting. You need to have symptoms for at least 2 years to be diagnosed with dysthymia. Treatment for both conditions is similar and includes antidepressants, talk therapy, and lifestyle changes, such as eating right and getting enough exercise and sleep.
Dysthymia vs. Depression FAQs
What is the difference between depression and dysthymia?
The main difference is that dysthymia is ongoing (chronic), while depression might be periodic. To be diagnosed with dysthymia, your symptoms should happen most days for 2 or more years. Depression symptoms need to last at least 2 weeks but are usually more serious. There's a lot of overlap in symptoms of both conditions.
Can dysthymia turn into depression?
Yes, it can, especially if left untreated. Most people with dysthymia (PDD) have another disorder at the same time, such as major depression (MDD), anxiety, substance abuse, or a personality disorder. Often, one feeds into the other. For instance, someone may develop dysthymia because of their persistent anxiety. Or they may turn to drugs to self-medicate themselves and ease the symptoms of dysthymia.
What are the symptoms of dysthymia?
The symptoms are similar to those of depression and include appetite changes, changes in sleep patterns, low energy/fatigue, low self-esteem, poor concentration, and feelings of hopelessness. You may have times when you feel energetic and cheerful, but PDD should still be taken seriously, especially if you have it alongside MDD. This is because people with both these disorders have a high suicide risk.
