Persistent Depressive Disorder

In DSM-5, dysthymia was replaced with the term, "persistent depressive disorder," which includes both chronic major depressive disorder and the previous dysthymic disorder. Because this condition is a chronic but less severe form of depression that's present for at least 2 years, some people think this is just the way they are (low in energy) or part of their personality (gloomy).

"Although millions of people suffer from dysthymia, most don't know it," says Michael Thase, M.D., a professor of psychiatry at the University of Pittsburgh School of Medicine and coauthor of Beating the Blues: New Approaches to Overcoming Dysthymia and Chronic Mild Depression. "It is one of the most under-recognized and under-treated mood disorders because it creeps in so insidiously that people often don't notice anything is wrong. They simply come to accept life through a gray-tinted lens." But dysthymia can increase a person's chances of developing substance abuse, heart disease, stroke, and compromised immune function, Dr. Thase notes. Plus, someone with dysthymia is at risk for developing major depression on top of it—what’s often called "double depression."

For dysthymia alone, "there’s less scientific evidence regarding the efficacy of antidepressants," says Andrew Winokur, M.D., Ph.D., a professor of psychiatry and director of psychopharmacology at the University of Connecticut Health Center in Farmington. "Cognitive-behavioral therapy or interpersonal therapy [which focuses on improving relationships] is often considered the first-line choice with the possibility that adding in an antidepressant might be helpful for some individuals."

Updated by Remedy Health Media

Publication Review By: the Editorial Staff at

Published: 13 Dec 2010

Last Modified: 10 Sep 2015