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(Dysthymic Disorder; Persistent Depressive Disorder)

How to Say It: Dis-thigh-mee-uh


Dysthymia is long term, mild-to-moderate depression. It lasts for at least two years in adults. In children and teens, it lasts for one or more years.


The cause of dysthymia is not known. A brain chemical called serotonin may play a role.

Brainstem—Location of Serotonin Production
Brainstem and brain

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Risk Factors

Dysthymia is more common in women than in men. Other things that raise the risk are:

  • Loss and grief
  • Child abuse
  • Partner abuse
  • Stress, trauma, and life changes
  • Family history of depression or dysthymia
  • History of substance abuse
  • Long term illness
  • Brain injury


Symptoms of dysthymia and depression overlap. They may be:

  • Feeling sad or hopeless
  • Lack of hunger or overeating
  • Problems focusing
  • Sleeping too little or too much
  • Feeling tired
  • Low self-esteem
  • Problems at work or school

Bouts of major depression may also occur.


The doctor will ask about your symptoms and health history. A physical and mental health exam will be given.

The doctor may refer you to a specialist. Tests may be done to look for causes like thyroid problems or anemia. Dysthymia is diagnosed after ruling out other causes.


The goal is to ease symptoms and improve function. Severe symptoms may need hospital care. Care is urgent if someone might hurt themselves or others.

A number of treatments may be used. Options may be:


There are no current guidelines to prevent dysthymia. However, early care may help those at risk.


National Institute of Mental Health

National Mental Health Association


Canadian Mental Health Association

Canadian Psychiatric Association


Depression. Mental Health America website. Available at: Accessed March 12, 2021.

Depressive disorders. Merck Manual Professional Version website. Available at: Accessed March 12, 2021.

Major depressive disorder (MDD). EBSCO DynaMed website. Available at: Accessed March 12, 2021.

Persistent depressive disorder. EBSCO DynaMed website. Available at: Accessed March 12, 2021.

Persistent depressive disorder. Family Doctor—American Academy of Family Physicians website. Available at: Accessed March 12, 2021.

Schramm E, Klein DN, et al, Domschke K. Review of dysthymia and persistent depressive disorder: history, correlates, and clinical implications. Lancet Psychiatry. 2020;7(9):801-812.

Last reviewed January 2021 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 03/12/2021