Understanding Depression: Dysthymia vs. Major Depressive Disorder

To say that a person is depressed can mean a few different things. Some people casually (and maybe mistakenly) use it to refer to a low mood they might be experiencing that day. However, the clinical definition of depression refers to a low mood and other symptoms that persist for weeks, months, or even years. Read on to understand the differences between dysthymia and major depressive disorder (MDD), the two main forms of depression, their root causes, and how they’re treated.

Defining dysthymia and MDD

According to Harvard Health, the two chief forms of clinical depression are dysthymia and major depressive disorder, or MDD. A study from the National Institute of Health defined MDD as a depressive episode lasting at least two weeks, and involving one or more of the following symptoms: persistently low or depressed mood, decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances, or suicidal thoughts.

Meanwhile, the American Psychiatric Association defines dysthymia as a depressed mood most of the time for at least two years, along with at least two of the following symptoms: poor appetite or overeating; insomnia or excessive sleep; low energy or fatigue; low self-esteem; poor concentration or indecisiveness; and hopelessness.

In some ways, dysthymia is thought of as the more difficult of the two to recognize, because it can manifest itself in subtler but more long-lasting ways, according to the Mayo Clinic. Additionally, its low-level nature can make it more destabilizing than major depression.

Looking for root causes

According to Johns Hopkins, both forms of depression can be triggered by events in one’s life, such as the delivery of a baby (i.e. postpartum depression), the loss of a loved one, or another such event; or it may be a function of chemical imbalances in the brain, genetic makeup, or other predetermined factors.

In particular, dysthymia seems to be caused by a stressful event in one’s life that persists because of poor emotional regulation. There is also a clear genetic component, with the rate of depression in families of people with dysthymia as high as 50%. Dysthymia may also persist alongside chronic physical or mental illnesses such as anxiety disorders, drug addiction, or alcoholism. 

Identifying symptoms and differences

As discussed above, distinguishing between dysthymia and MDD can be difficult. The primary difference seems to be time, according to the National Alliance on Mental Illness (NAMI), which says that while someone with major depressive disorder typically “cycles” through episodes of feeling severely depressed, dysthymia comes with persistent symptoms for years.

What treatments are available?

The Mayo Clinic lists a number of ways that MDD can be treated, ranging from a variety of medications, to forms of psychotherapy, to brain stimulation therapies like electroconvulsive therapy and another called transcranial magnetic stimulation.

Like major depression, dysthymia may be treated with psychotherapy and medications. If any of the above resonates with you, and you’ve been feeling low, reach out to a medical professional today through national organizations like SAMHSA or local organizations such as the New York State Office of Mental Health. You can also dial 988, a recently established hotline for individuals experiencing mental distress or suicidal thoughts.