Johns Hopkins Health Alerts | Depression and Anxiety | Don't Overlook Dysthymia

Left untreated, dysthymia can lead to major depression, or worse.

It is far better to treat dysthymia (recurrent, mild depression; also called subclinical depression) than to think of it as a minor condition. That reminder comes from a seven-year prospective study of more than 1,000 young people in New Zealand, reported in the Archives of General Psychiatry.

People with dysthymia have some, but not all, of the symptoms of major depression. But as this study indicates, bypassing treatment places them at increased risk of subsequently developing major depression. The study followed 17- and 18 year-olds, 18.4% of whom had a diagnosis of major depression and 7.3% who had a diagnosis of subclinical depression. Seven years later, the rate of depression and suicidal behavior was similar between the two groups.

These findings make a strong case that people with dysthymia should not be treated as though their projected outcome is similar to that of people with no symptoms of depression, the researchers say. They caution that the effects of subclinical depression are not transitory— people with the disorder face future health risks similar to those experienced by people with major depression.

So how do you know if you or a loved one suffers from dysthymia? Dysthymia is characterized by the presence of depressed mood for most of the day for more days than not, over a period of at least two years. It may be intermittent and interspersed with periods of feeling normal, but these periods of improvement last for no more than two months.

Like major depression, dysthymia is twice as common in women as in men. People who have dysthymia before age 21 tend to have a higher incidence of personality disorders. Because the onset of symptoms is insidious, dysthymia often goes unnoticed—and because of its chronic nature, the person may come to believe, “I’ve always been this way.”

In addition to depressed mood, dysthymia symptoms include two or more of the following:

• Poor appetite or overeating
• Insomnia or hypersomnia (excessive sleeping)
• Low energy or fatigue
• Low self-esteem
• Poor concentration or difficulty making decisions
• Feelings of hopelessness

Johns Hopkins Health Alerts | Depression and Anxiety | Don't Overlook Dysthymia