Curriculum · Mental Health / Psychiatry
Dysthymic disorder (persistent depressive disorder)
What it is
Dysthymia, also called persistent depressive disorder, consists of a pattern of ongoing, mild depressive symptoms that have been present for at least 2 years and are less severe than those of major depression. The pattern is depressed mood for most of the day, for more days than not, for 2 years or longer, together with 2 or more of the following: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, impaired concentration or indecisiveness, and hopelessness. The patient is never without symptoms for more than 2 months. In children and adolescents mood can be irritable and the duration must be 1 year or longer.
How it presents
The picture is one of years rather than weeks. A man of 32 may come to the psychiatric clinic with a 4 years history of low self-esteem, lack of initiative, chronic fatigue and social withdrawal, and with a history of always feeling low, guilt, angry and inadequate since childhood. That timeline indicates dysthymia rather than an episode with a beginning and an end.