SymptomsBy Mayo Clinic staff
Dysthymia symptoms in adults may include:
- Loss of interest in daily activities
- Sadness or feeling down
- Tiredness and lack of energy
- Low self-esteem, self-criticism or feeling incapable
- Trouble concentrating and trouble making decisions
- Irritability or excessive anger
- Decreased activity, effectiveness and productivity
- Avoidance of social activities
- Feelings of guilt and worries over the past
- Poor appetite or overeating
- Sleep problems
In children, dysthymia sometimes occurs along with attention-deficit/hyperactivity disorder (ADHD), behavioral or learning disorders, anxiety disorders, or developmental disabilities. Examples of dysthymia symptoms in children include:
- Behavior problems
- Poor school performance
- Pessimistic attitude
- Poor social skills
- Low self-esteem
Dysthymia symptoms usually come and go over a period of years, and their intensity can change over time. But typically symptoms don't disappear for more than two months at a time. In general, you may find it hard to be upbeat even on happy occasions — you may be described as having a gloomy personality.
When dysthymia starts before age 21, it's called early-onset dysthymia. When it starts after that, it's called late-onset dysthymia.
When to see a doctor
It's perfectly normal to feel sad or upset sometimes or to be unhappy with stressful situations in your life. But with dysthymia, these feelings last for years and interfere with your relationships, work and daily activities.
Because these feelings have gone on for such a long time, you may think they'll always be part of your life. But if you have any symptoms of dysthymia, seek medical help. If not effectively treated, dysthymia commonly progresses into major depression. Sometimes, a major depression episode occurs in addition to dysthymia — this is called double depression.
Talk to your primary care doctor about your symptoms. Or seek help directly from a mental health provider. If you're reluctant to see a mental health professional, reach out to someone else who may be able to help guide you to treatment, whether it's a friend or loved one, a teacher, a faith leader, or someone else you trust.
- Dysthymic disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Oct. 23, 2012.
- Ebert MH, et al. Current Diagnosis & Treatment: Psychiatry. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=10. Accessed Oct. 24, 2012.
- Cuijpers P, et al. Psychotherapy for chronic major depression and dysthymia: A meta-analysis. Clinical Psychology Review. 2010;30:51.
- Understanding major depression. National Alliance on Mental Health. http://www.nami.org/Template.cfm?section=Search&Template=Search/SearchDisplay.cfm. Accessed Oct. 24, 2012.
- Depression and complementary health practices: What the science says. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/providers/digest/depression-science.htm. Accessed May 10, 2012.
- Depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml. Accessed Oct. 23, 2012.
- Marchand WR. Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression. Journal of Psychiatric Practice. 2012;18:233.
- Tanyi RA, et al. The effects of psychoneuroimmunology (PNI)-based lifestyle intervention in modifying the progression of depression in clinically depressed adults. International Journal of Psychiatry in Medicine. 2011;42:151.
- Cuijpers P, et al. Personalized treatment of adult depression: Medication, psychotherapy, or both? A systematic review. Depression and Anxiety. 2012;29:855.
- VonWolff A, et al. Selective serotonin reuptake inhibitors and tricyclic antidepressants in the acute treatment of chronic depression and dysthymia: A systemic review and meta-analysis. Journal of Affective Disorders. In press. Accessed Oct. 24. 2012.
- Hourani LL, et al. Influence of spirituality on depression, posttraumatic stress disorder, and suicidality in active duty military personnel. Depression Research and Treatment. 2012;2012:1.
- Wu J, et al. Acupuncture for depression: A review of clinical applications. Canadian Journal of Psychiatry. 2012;57:397.
- Chi J, et al. Tai chi and reduction of depressive symptoms for older adults: A meta-analysis of randomized trials. Geriatrics & Gerontology International. In press. Accessed Aug. 28, 2012.
- Chan MF, et al. The effectiveness of music listening in reducing depressive symptoms in adults: A systemic review. Complementary Therapies in Medicine. 2011;19:332.
- McCaffrey R, et al. Garden walking and art therapy for depression in older adults: A pilot study. Research in Gerontological Nursing. 2011;4:237.
- Carpenter DJ. St. John's wort and s-adenosyl methionine as "natural" alternatives to conventional antidepressants in the era of the suicidality boxed warning: What is the evidence for clinically relevant benefit? Alternative Medicine Review. 2011;16:17.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 26, 2012 & Nov. 18, 2012.
- Kung S (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 26, 2012.