Psych Central

Dysthymic Disorder (formerly known as dysthymia, and more recently, according to updated DSM-5, as Persistent Depressive Disorder) is characterized by an overwhelming yet chronic state of depression, exhibited by a depressed mood for most of the days, for more days than not, for at least 2 years.

In children and adolescents, the mood can be irritable and it must have lasted at least one year.

The person who suffers from this disorder must not have gone for more than 2 months without experiencing two or more of the following symptoms:

  • Poor appetite or overeating
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness

Furthermore, in order to be diagnosed with Dysthymic Disorder, there has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode in the first 2 years, and criteria have never been met for Cyclothymic Disorder. This generally means that the person needs to have had an uncomplicated, long-term, low-grade depression for two or more years in order to meet this diagnosis.

In order to meet the diagnostic criteria for Dysthymic Disorder, the symptoms may not be due to the direct physiological effects of a the use or abuse of a substance (for instance, alcohol, drugs, or medications) or a general medical condition (e.g., cancer or a stroke). The symptoms must also cause significant distress or impairment in social, occupational, educational or other important areas of functioning.


Updated 2013 DSM-5 criteria indicate that the diagnosis can have an add-on specifer. These include Persistent Depressive Disorder :

  • with pure dysthymic syndrome (i.e., full criteria for a Major Depressive Episode have not been met)
  • with major depressive episodes (MDE). This can take several forms, including persistent depression with intermittent, more-severe depressive episodes (i.e., bouts of major depression plus persistent low-grade depression), or with chronically severe major depression


General Treatment for Dysthymic Disorder




APA Reference
Psych Central. (2014). Dysthymic Disorder (Persistent Depressive Disorder) Symptoms. Psych Central. Retrieved on April 21, 2014, from

Symptom criteria summarized from:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.

Scientifically Reviewed
    Last reviewed: By John M. Grohol, Psy.D. on 21 Apr 2014
    Published on All rights reserved.