What Is Dysthymia? Learning More About Persistent Depressive Disorder

Updated February 10, 2023by BetterHelp Editorial Team

Depression is a widespread disorder that affects millions of people throughout the United States. But not everyone experiences depression in the same way, or for the same length of time. In fact, there are several different types of depression. When depression isn't particularly severe or marked with clear episodes, it can sometimes be easy to miss it or leave it untreated. This article is going to focus on persistent depressive disorder, previously called dysthymia, to help you understand more about this form of depression and how it can be treated.

Depression Can Come In Different Forms

Persistent Depressive Disorder Versus Major Depressive Disorder

There are different types of depression, including major depressive disorder, persistent depressive disorder, seasonal affective disorder, and postpartum depression. To better understand persistent depressive disorder, it can be helpful to examine the difference between persistent depressive disorder and major depressive disorder in particular. We’ll dive further into both types below:

Major Depressive Disorder (MDD)

Major depressive disorder (MDD) is a serious mood disorder marked by low mood and loss of interest in previously enjoyable activities. To be diagnosed with MDD, an individual would have five or more symptoms, one of which would be a depressed mood or the loss of interest in pleasurable activities. The symptoms would be present for at least two weeks.

According to the American Psychiatric Association, the characteristics of MDD include:

  • Low or depressed mood

  • Loss of interest in prior activities that brought enjoyment

  • Changes in appetite 

  • Sleep disturbances

  • Fatigue or lack of energy

  • Feelings of guilt or worthlessness

  • Difficulty concentrating

  • Slowed thought and reduced physical movement 

  • Thoughts of death or suicide

If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The 988 Suicide & Crisis Lifeline can be reached at 988 and is available 24/7. 

Persistent Depressive Disorder (PDD)

Persistent depressive disorder (PDD) is a relatively new term. Previously, this disorder had been called dysthymic disorder or dysthymia. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), it is identified as persistent depressive disorder.

So, what is persistent depressive disorder? It is a long-term form of depression. An individual with persistent depressive disorder may feel persistent sadness, emptiness, or hopelessness, and they may lose interest in daily activities. With persistent depressive disorder, these feelings can last for years. 

Persistent depressive disorder differs from major depressive disorder in two main ways: length of time and severity. Persistent depressive disorder is not as severe as MDD, but it lasts for over two years. Meanwhile, MDD is more severe but may last a shorter time, such as around two weeks. The symptoms of persistent depressive disorder tend to be less severe and less intense than those experienced by individuals with MDD. However, persistent depressive disorder is a long-term disorder that can negatively impact quality of life over a long period.

Additionally, someone with persistent depressive disorder can also experience a major depressive episode at the same time. This is referred to as double depression.

Depression Can Come In Different Forms

Persistent Depressive Disorder Causes And Symptoms

With these different forms of depression in mind, now let’s explore more about persistent depressive disorder in particular, starting with its possible causes and symptoms. 

What Causes Persistent Depressive Disorder?

It is not known what exactly causes persistent depressive disorder. However, some factors may contribute to an individual developing the condition. These factors include:

  • Brain chemistry

  • A family history of the condition

  • A personal history of other mental health conditions

  • Trauma or major stressors

  • Long-term physical illness

  • Physical trauma to the brain

Symptoms And Signs Of Persistent Depressive Disorder

While it's unclear exactly what causes this form of chronic depression, it may be easier to identify the symptoms characteristic of persistent depressive disorder. By exploring these symptoms, you can better identify this disorder in yourself or others, and work to find ways to manage this depression.

In fact, cognitive symptoms are believed to be more common in persistent depressive disorder. So, for example, things like low self-esteem and social withdrawal may be more prevalent in individuals with this condition, than symptoms like irregular sleep and significant changes in weight or appetite, which are more common in MDD.

Some of the symptoms of persistent depressive disorder can include: 

  • Feelings of sadness or emptiness

  • Loss of interest

  • Changes in appetite

  • Sleep problems

  • Fatigue 

  • Feelings of low self-esteem

  • Difficulty focusing

  • Hopelessness

  • Avoiding social activities 

  • Difficulty getting things done

  • Irritability 

  • Feeling guilty or worried about the past

Treatment Options

Having persistent depressive disorder can be frustrating sometimes, but there are treatment options available that you can consider. 


Talk therapy is a commonly recommended form of treatment for persistent depressive disorder. In therapy, the individual can discuss their emotions, thoughts, and behaviors, and learn ways to cope with negative emotions healthily and manage symptoms. Talk therapy can give the individual the opportunity to set goals and regain a sense of control.

Individuals with persistent depressive disorder may feel frequently fatigued and low energy, and so the thought of leaving the house to seek therapy in an office setting may feel exhausting. In these cases, online therapy may be a convenient option. With online therapy through BetterHelp, you can speak with a licensed therapist from the comfort of home, without having to leave the house.

Research has shown that online therapy can be an effective option for reducing symptoms of depression. One such study examined the effectiveness of an online therapy program for improving symptoms of depression and anxiety, and it found that the program delivered significant reductions in symptoms of depression and anxiety.

Medication And Other Ways To Manage Persistent Depressive Disorder

Besides therapy, certain medications can also be used to treat persistent depressive disorder. Antidepressant medications that are commonly used for this condition include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). If you are interested in exploring medication options, speak with your doctor to determine what might be best for you. 

In addition to professional treatment, there are also lifestyle changes that an individual can try to help cope with this condition. These can include:

  • Getting regular exercise

  • Avoiding alcohol and drugs

  • Eating a balanced diet

  • Cultivating a meditation practice


Persistent depressive disorder, previously called dysthymia, is a long-term form of depression. It tends to involve symptoms that are less severe than major depressive disorder, but it can last for years. If you have persistent depressive disorder, you may consider some of the treatment options listed above, including online therapy. 

You Don’t Have To Face Depression Alone. Our Experienced Counselors Can Help.

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