The 3rd subtype of Depression is Dysthymic Disorder, also known as Dysthymia. Dysthymia is a chronic, smoldering form of Major Depressive Disorder. While not as severe and dramatic as Major Depression, Dysthymia lasts a long time, greater than two years in adults, and greater than one year in adolescents. Dysthymia affects 3% to 6% of people. It is one of the 7 subtypes of Depression.
For Dysthymia, you need to experience depressed mood, and at least two of the following symptoms:
- Sleep: insomnia or hypersomnia
- Esteem: low self esteem
- Hopelessness: feelings of hopelessness
- Energy: low energy or fatigue
- Concentration: poor concentration or difficulty making decisions
- Appetite: poor appetite or overeating
People who have Dysthymia experience these symptoms most of the day, most days of the week. In Dysthymic Disorder, if you feel any periods of normal mood, these do not last for more than two months, and there are no major depressive episodes.
You’ll notice that there is a difference for the symptoms of Dysthymia versus a major depressive episode. For Dysthymia, you will use the mnemonic SEHECA, versus the mnemonic SIGECAPS for a Depressive Episode. In Dysthymia, you will see more soft symptoms such as low self-esteem, feelings of hopelessness, and accompanying neurovegetative symptoms with insomnia, low energy, poor concentration, and poor appetite. Major Depressive Disorder (MDD) is more dramatic, and it is easier to pick out the Depressive Episode symptoms such as suicidal ideations, anhedonia, feelings of guilt, and psychomotor agitation/retardation.
The difference is that Dysthymic Disorder is more subtle and exhibits the soft symptoms of SEHECA, while MDD is more dramatic and the depressive symptoms of SIGECAPS are more defined and therefore easier to identify.
Doctors often overlook the diagnosis of Dysthymic Disorder, as they are well-trained to pick out the dramatic neurovegetative symptoms of Major Depressive Disorder, while overlooking the more subtle and covert symptoms of Dysthymic Disorder. Using the mnemonic SEHECA can help to uncover and diagnose Dysthymic Disorder.
The treatments for MDD, which include psychotherapy and antidepressant medications, also work for Dysthymic Disorder. Please review the rest of Depression Boss to learn about the identification and treatment of Dysthymic Disorder and other Depression subtypes.
Sansone, R. A., & Sansone, L. A. (2009). Dysthymic Disorder: Forlorn and Overlooked? Psychiatry (Edgmont), 6(5), 46–51.
Carlo Carandang, MD, is a psychiatrist and licensed physician, who has over 15 years experience treating patients with depression and anxiety. In addition, Dr. Carlo has done research and taught students and doctors about depression and anxiety. His other popular website, AnxietyBoss.com, has received over 4 million views to date.