Minor Depression (Dysthymia): Living Under a Gray Sky

Dysthymia, or mild depression, increases your risk for major depression. Learn how to recognize and treat this insidious condition.

Dysthymia is one of the two main types of depression. Compared to major depression, dysthymia has milder symptoms but it can last longer. It's sometimes called minor depression or dysthymic disorder. Whatever you call it, it is a serious condition.

Mood can be thought of as a line, with mania at one end, depression at the other end and normal mood in the middle. Dysthymia falls in between normal mood and depression. Depression is sometimes described as like being in a dark room. Dysthymia is more like living under a constant gray sky.

People who have dysthymia may not be disabled by their illness. But they may not feel well or really enjoy their lives. They may drag through their days, feeling tired and irritable. They're also at high risk for major depression. People who have both dysthymia and episodes of major depression are said to have "double depression."

People with dysthymia often don't realize they have a problem because the symptoms may creep up on them gradually. If you think you have dysthymia, talk to your doctor or see a mental health professional. Treatment could lift your mood and help you avoid a slide into full-blown depression.

What are the symptoms?
Dysthymia is more than just feeling sad or "blue" for a while. It is diagnosed if a person has a depressed mood most of the time for at least two years that occurs with at least two of the following:

  • Lack of appetite or overeating
  • Sleeping too little or too much
  • Low energy or fatigue
  • Low self-esteem
  • Trouble concentrating or making decisions
  • Feeling hopeless

What causes it?
Like major depression, dysthymia runs in families, so it is probably partly the result of inherited genes. It can also be brought on by trauma, stress or isolation.

Dysthymia often starts during childhood or the teen years, but it may start in later life. It's more common in women than men.

How is it treated?
The same treatments that are used for depression can be used to treat dysthymia. These include:

  • Antidepressant medication. Antidepressants called SSRIs (such as Prozac and Paxil) or tricyclics (such as amitriptyline or desipramine) are often prescribed for dysthymia. It may take several weeks to see results. Dysthymia is a chronic condition, so it often requires long-term treatment. If medication is stopped too soon, the depression may return.
  • Psychotherapy. Cognitive-behavioral therapy and interpersonal therapy may be used to treat dysthymia. Cognitive-behavioral therapy can help identify and correct negative thought patterns. This can improve your outlook and sense of self-worth. Interpersonal therapy can help you improve relationships and roles that may have added to your depression.

Combining medication with psychotherapy may give the best results.

NOTE: Anyone being treated with antidepressants, particularly people being treated for depression, should be watched closely for worsening depression and for increased suicidal thinking or behavior. Close watching may be especially important early in treatment or when the dose is changed (either increased or decreased). Discuss any concerns with your doctor.

NOTE: SSRI antidepressants, such as sertraline, citalopram and paroxetine, may slightly increase the risk of congenital heart defects if taken during the first trimester of pregnancy. Discuss the benefits and risks of antidepressants with your doctor if you are pregnant or plan to get pregnant. Do not stop taking these medications without first talking to your doctor.  

What can I do to feel better?
It may take a while for treatment to help you feel better. But there are steps you can take right away to help push back depression:

  • Get some physical activity every day. Exercise can help fight depression, give you more energy and help you sleep better. Always check with your doctor first before you increase your activity level.
  • Eat a healthy diet that's low in fat, salt and sugar.
  • Limit or avoid alcohol. It can make depression worse.