An individual with chronic depression suffers from physical and emotional symptoms for an extended period of time for two years of more, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) published by the American Psychiatric Association.
Symptoms vary with the multiple chronic depression types. For some people, symptoms may be milder than those of a major depressive episode, while they may be more severe in others. Like many other chronic conditions, people can also experience periods of remission and relapse in chronic kinds of depression.
Compared to other chronic kinds of depression, dysthymia is a milder form, sometimes called minor depression or dysthymic disorder. The main symptom of dysthymia is a saddened mood for two years or more, as well as:
- Avoidance of social interaction
- Chronic fatigue
- Difficulty concentrating
- Feelings of guilt or hopelessness
- Irritability or anger
- Loss of interest
- Low self-esteem and tendency toward self-criticism.
Like other people affected by chronic depression, dysthymia sufferers are often described as negative or constantly down. Dysthymia symptoms may also vary in severity over a prolonged period of time.
As with other forms of chronic depression, dysthymia tends to appear early in life, and it can progress into major depression if left untreated. Dysthymia cases fit into two categories:
- Early-onset dysthymia appears before age 21
- Late-onset dysthymia appears at age 21 or later.
Some individuals with dysthymia also experience recurring major depressive episodes. When these two kinds of depression occur together, it is sometimes called double depression. Chronic depression symptoms intensify during these experiences, and most people with dysthymia initially seek treatment due to these intense experiences. Defined in the DSM-IV as “dysthymia with superimposed major depressive episode,” this condition can evolve from dysthymic disorder.
Chronic Major Depression
The DSM-IV states that a major depressive episode must last for at least two weeks to meet diagnosis criteria. However, major depression can sometimes last for long periods of time. When it persists for two years or more, it is classified as chronic major depression.
Some patients with chronic major depression will experience a partial remission of symptoms after treatment. Although symptoms are still present, they don’t meet the threshold criteria to be considered a result of the major depressive episode. This partial remission is not considered dysthymic disorder, but rather as a partial remission from chronic major depression. This differs from double depression, in that double depression requires a prior history of dysthymic disorder.
Harvard Health Publications Staff. (2009). Managing chronic depression. Retrieved May 30, 2010, from the Harvard Health Publications website: www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2009/December/managing-chronic-depression.
Mayo Clinic Staff. (n.d.). Dysthymia (dysthymic disorder). Retrieved May 30, 2010, from the Mayo Clinic website: www.mayoclinic.com/health/dysthymia/DS01111.
Medline Plus Staff. (n.d.). Dysthymia. Retrieved May 30, 2010, from the Medline Plus website: www.nlm.nih.gov/medlineplus/ency/article/000918.htm.
Penn State University – Milton S. Hershey Medical Center College of Medicine (n.d.) Chronic depression. Retrieved May 30, 2010, from the Penn State University – Milton S. Hershey Medical Center College of Medicine website: www.hmc.psu.edu/healthinfo/d/depression.htm.