Due to having some common features, many people have misconceptions about dysthymia, whether it is the belief that this disorder is simple depression (or other dysthymia myths) there is a need to understand this disorder.
1. Myth: Dysthymia Is Easy to Diagnose
Fact: Dysthymia can be hard to diagnose because many people with this disorder are high functioning.
The dysthymia diagnostic criteria require a persistently depressed mood state for at least two years. Prior to this two year period, this disorder is often mistaken for major depressive disorder. Dysthymia also mimics the partial remission of major depressive disorder.
Another obstacle to an accurate dysthymia diagnosis is the tendency for many people with this condition to be very high functioning. Dysthymia does not lead to as severe depressive episodes as are experienced with major depressive disorder. As a result, many people with dysthymia falsely believe that they are not depressed enough to seek help. Instead, these people push themselves exceptionally hard to try to cover up their persistent feeling of depression.
Other people with dysthymia may doubt their own depression due to their ability to function in their daily lives. While a person with dysthymia may function relatively well, they are unable to reach their potential optimum level of functioning.
Unlike major depressive disorder, diagnostic criteria for dysthymia does not require that a person feel significantly distressed or impaired by their depressive state. Though some may be distress or impairment, it is not a requirement to receive this diagnosis. Adding to the complication of diagnosing dysthymia, it may occur along with major depressive disorder. In these cases, sometimes called double depression, a person may not receive an accurate diagnosis for several years.
2. Myth: Individuals With Dysthymia Constantly Feel Miserable
Fact: People with dysthymia have good days and bad days.
While dysthymia symptoms for diagnosis do include having a persistently depressed mood for two or more years, this does not necessarily mean that a person with dysthymia will feel miserable at all times.
One reason dysthymia is sometimes called high-functioning depression is the fact that the level of depression is milder than other depressive disorders, allowing people to push through their depressed mood. Dysthymia is sometimes described as a depressed personality, but this description incorrectly suggests that depression is constantly present.
A person with dysthymia will have days that are better than others, including some days where depressive symptoms may be minor or even completely absent. If a person feels well on some days but experiences depressive symptoms on more days than not, with the depressive state lasting the majority of the day, it is probable that they have dysthymia.
3. Myth: Dysthymia Usually Occurs Independently of Other Conditions
Fact: Dysthymia frequently co-occurs with other mental health conditions.
Dysthymia co-occurs with many other mental health conditions. It may present more often as a co-occurring disorder versus a single condition. Dysthymia frequently co-occurs with the following conditions:
- Major depressive disorder
- Substance use disorders
- Anxiety disorders
- Personality disorders including borderline personality disorder
Dysthymia and major depressive disorder are often confused with one another. However, these conditions are not mutually exclusive. A person with dysthymia may experience major depressive episodes in addition to the persistent depressive state characteristic of dysthymia.
Dysthymia and substance abuse frequently co-occur with either disorder taking the role of the precipitating disorder in different cases. Some people may develop dysthymia following chronic substance use while other people may turn to substances to relieve the symptoms of dysthymia.
Anxiety disorders and personality disorders also may occur either before or following dysthymia. In some cases, a person might develop anxiety as a result of added stress from lowered performance ability with dysthymia. In other cases, dysthymia may grow out of an anxiety disorder. Personality disorders can cause a great amount of disruption to a person’s life, which has been thought to be a potential cause for the frequent co-occurrence of dysthymia with these disorders. However, dysthymia may occur prior to the development of a personality disorder as well.
4. Myth: Because Dysthymia Is Mild, It’s Not Very Serious
Fact: Untreated dysthymia can be just as serious as major depressive disorder.
Despite being considered by many as a mild form of depression, dysthymia is a serious condition that should be given adequate attention. People who are diagnosed with dysthymia have a higher suicide risk than the average population. In situations where a person has both dysthymia and major depressive episodes as a result of co-occurring major depression, suicide risk is especially high.
Treatment is crucial to avoid suicidal ideation or other thoughts of harming oneself. A person with dysthymia may also experience other complications as a result of the lack of motivation associated with dysthymia. If a person chronically feels depressed and lethargic, other health conditions may go ignored and healthy habits may fall by the wayside. It is important for people with this condition to consciously incorporate self-care into their routines to ensure better health outcomes.
5. Myth: Dysthymia Is Difficult to Treat
Fact: Dysthymia responds well to treatment.
Dysthymia treatment, in many cases, is similar to the treatment of major depressive disorder. Psychotherapy may be beneficial for some people with dysthymia, especially with concern to learning self-care practices and coping strategies.
Cognitive behavioral therapy (CBT) is considered one of the most effective psychotherapy treatments for major depressive disorder. The approaches of CBT appear promising with regards to treating dysthymia.
Treatment of dysthymia with medication appears to be especially promising with a high rate of dysthymia treatment success. While dysthymia may be more difficult to treat than the episodic nature of major depressive disorder, it is nonetheless treatable. With proper treatment, dysthymia prognosis is positive. For the best results, a person with dysthymia can combine psychotherapy and medication as advised by a doctor.
If you or a loved one is experiencing depressive symptoms such as those occurring with dysthymia as well as a substance use disorder, help is available. The Recovery Village provides treatment for adults with substance use and co-occurring disorders. Contact a representative today to learn more.
Stiehl, Christina. “The Difference Between Depression and Persistent Depressive Disorder, aka Dysthymia.” Self, May 4, 2018. Accessed June 7, 2019. The Mayo Clinic. “Persistent depressive disorder (dysthymia).” December 8, 2018. Accessed June 7, 2019. Uher, Rudolf. “Persistent Depressive Disorder, Dysthymia, and Chronic Depression: Update on Diagnosis, Treatment.” Psychiatric Times, July 31, 2014. Accessed June 7, 2019.
Stiehl, Christina. “The Difference Between Depression and Persistent Depressive Disorder, aka Dysthymia.” Self, May 4, 2018. Accessed June 7, 2019.
The Mayo Clinic. “Persistent depressive disorder (dysthymia).” December 8, 2018. Accessed June 7, 2019.
Uher, Rudolf. “Persistent Depressive Disorder, Dysthymia, and Chronic Depression: Update on Diagnosis, Treatment.” Psychiatric Times, July 31, 2014. Accessed June 7, 2019.