Definition: Depressed mood for most of the day, for more days than not, as indicated by subjective account or observation by others. During a 2 year period (1 year for children/adolescents), individual has never been without symptoms for more than 2 months at a time. The symptoms are not due to the physiological effects of a substance. Women are 2-3 times more likely to develop persistent depressive disorder (dysthymia) than men.

Symptoms: Presence of at least 2 of these symptoms while depressed: poor appetite or overeating; insomnia or hypersomnia; low energy or fatigue; low self-esteem; poor concentration or difficulty making decisions; or feeling of hopelessness. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Causes: Cause is unknown, but brain chemistry studies have shown reduced serotonin levels in these individuals. The onset of persistent depressive disorder (dysthymia) can come from the loss of a loved one, a traumatic event, severe financial problems, relationship problems, trouble at work or a chronic illness.

Treatment: Individuals with persistent depressive disorder may respond to psychotherapy, medications, or the combination of both. Cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and cognitive behavioral analysis system of psychotherapy (CBASP) are effective in treating patients with this disorder. The medications used in the treatment of major depressive disorder (MDD) are also effective in treating persistent depressive disorder (dysthymia). Relapse/recurrence of symptoms has been shown to be reduced with a combination of antidepressant medication and psychotherapy.