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Dysthymic Disorder

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My son, who is now 18, was very withdrawn, low self-esteem, socially awkward, etc. when he was younger. He was tested through the school and found to have Dysthymic Disorder.

As he has grown, his social awkwardness seems to be a thing of the past (at least he is better at hiding any self loathing or self-esteem issues he had and is able to carry on a normal conversation with those around him).

He still has issues with insomnia, holding grudges (he is still angry at a teacher he had in middle school who promised him a pop if he participated in his school program) and some self-worth issues.

In your opinion, have you found it beneficial to use antidepressants in patients with similar symptoms? He is so leery about taking any medications, but I feel he may be amazed at the benefit of an antidepressant.

He has a much better outlook on life than he did, but still struggles with periods of depression and low self-esteem.

He does not seem very sensitive to those around him unless he is in a direct relationship with them. (Like if he feels his girlfriend’s parent/parents are treating her unfairly). Is this a common symptom of Dysthymia or could there be more to this?

I know there are really two questions, but I just want him to be healthy and feel happy and content.

Thank you for your time.

Dysthymic Disorder

Answered by on -


I am very glad your son has improved, and yes, these are things that may go along with dysthymia, but it is too difficult to tell if they are characterological or part of the condition. A therapist or psychiatrist may be able to sort that through for you.

As far as the medications go, the research seems pretty clear that antidepressants and therapy together have the greatest impact with this condition. I think an evaluation by a psychiatrist to see what medicine might be appropriate, as well as asking the questions about his lack of sensitivity to others, seems the best route.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

Dysthymic Disorder

Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

Dan Tomasulo Ph.D., TEP, MFA, MAPP teaches Positive Psychology in the graduate program of Counseling and Clinical Psychology at Columbia University, Teachers College and works with Martin Seligman, the Father of Positive Psychology in the Masters of Applied Positive Psychology (MAPP) program at the University of Pennsylvania. He is Director of the New York Certification in Positive Psychology for the Open Center in New York City and on faculty at New Jersey City University. Sharecare has honored him as one of the top 10 online influencers on the topic of depression. For more information go to: He also writes for Psych Central's Ask the Therapist column and the Proof Positive blog.

APA Reference
Tomasulo, D. (2018). Dysthymic Disorder. Psych Central. Retrieved on March 21, 2019, from
Scientifically Reviewed
Last updated: 8 May 2018
Last reviewed: By a member of our scientific advisory board on 8 May 2018
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