Unlike Major Depression, Dysthymia is a milder mood disorder that seems characteristic of the person rather than a downward spiral into darkness. Dysthymic persons seem to be chronically gloomy and low, show little energy or drive, and have low self-esteem and little positive affect. While this low mood may sink into a full depressive episode from time to time, many people with Dysthymia show a rather static, flat unhappiness with little variation.
Only when this moody pessimism continues for 2 years or more, should the diagnosis of Dysthymia be considered. As with all depressive disorders, it is twice as common in women than men. It usually emerges in late adolescence, but can appear at any time during the adult years. It can be triggered by life events or situations (disappointments, poverty, loss), or be a family characteristic.
Because the symptoms typically do not impair the individual’s functioning in most aspects of life, diagnosis is often overlooked (“Oh, Frank’s just like that. He’s never been very excited about anything.”) and consequently, no treatment is sought. This is regrettable, since modern antidepressant medications, in combination with talk therapy, can be quite effective. Cognitive therapy is especially effective in helping the person see the pattern of pessimistic and self-critical thoughts and replace them with more realistic and positive views.