Dysthymia Vs. Depression: What’s The Difference In Symptoms And Treatment?

Reviewed by Aaron Horn, LMFT

Published 06/27/2022

Just about everyone knows a little bit about depression. There’s a good chance that either you or someone you know has struggled with this mental disorder. However, dysthymia is not such a well-known word. Here’s what the two conditions are and how they differ.


You can begin to see the difference between the two words if you start by learning the definitions. First, you need to know that dysthymia is a type of depression. Here are the basic definitions of the two terms.


Dysthymia is a word often used to refer to a mild to moderate depressed mood. Another term for this is minor depression. However, in a more specific use, dysthymia refers to dysthymic disorder. In that sense, it’s also called a persistent depressive disorder. Dysthymia has many of the same symptoms as major depressive disorder, but it’s milder and lasts longer.


Depression can refer to any of the depressive disorders, including:

  • Dysthymia
  • Premenstrual dysphoric disorder
  • Seasonal depression
  • Atypical depression
  • Psychotic depression
  • Depression with mixed features
  • Major depressive disorder

Most people think of a person with depression as someone who is always sad or pessimistic. They may even know of someone who committed suicide because of depression. Those descriptions are the most obvious indications of depression. However, many other symptoms define depressive disorders. The symptoms can include the way you think, physical changes, and social difficulties.


Symptoms of depression vary depending on which of the many disorders you have. It might be most helpful to compare major depressive disorder to dysthymic depression first.

Signs Of Major Depressive Disorder

Here are the symptoms that help a psychiatrist or therapist recognize major depression.

  • You’re depressed almost all day long.
  • You lose interest in the activities that used to be important to you.
  • You gain or lose weight without trying.
  • Your appetite increases or decreases dramatically.
  • You have insomnia or sleep too much.
  • You’re physically agitated or slowed down.
  • You feel like you have no energy, or you’re fatigued.
  • You feel worthless, or you’re troubled by guilt when there’s no reason to think you did wrong.
  • You have trouble thinking or concentrating.
  • You have repeated thoughts of suicide or death.

Signs Of Dysthymic Disorder 

As you read through the following list of dysthymic disorder symptoms, you may notice that they’re very similar to some of the signs of depression.

  • You have a depressed mood most of the time, nearly all day.
  • You have less appetite than usual, or you eat too much.
  • You sleep too much or too little.
  • You have fatigue or low energy.
  • You have low self-esteem.
  • Concentrating or making decisions is difficult for you.
  • You have feelings of hopelessness.
  • You often feel angry or irritable
  • You avoid social situations.
  • You worry or feel guilty about the past.
  • You do less or have more trouble being productive.

Dysthymia Vs. Depression

While the symptoms are very similar, dysthymia does stand out from other depressive disorders in several ways. Most notably, it lasts longer but is milder. Here’s part of how doctors and therapists distinguish between dysthymia and major depression.


One of the key factors in distinguishing dysthymia depression and major depression is how long it lasts. A mental health professional won’t diagnose dysthymia unless you’ve had symptoms of it for at least two years straight. But they might diagnose you with major depression if you’ve had those symptoms within one two-week period.

The symptoms of dysthymia are so persistent that others may think they’re a part of your personality. They may think you’re just a gloomy, pessimistic, or overly critical person. They may think you don’t have a sense of humor or that you’re just shy, introverted, or passive. Both you and the people around you may be surprised that these things can change as you get proper treatment and begin to recover from your dysthymia.


Major depression tends to be much more severe than dysthymic depression. First, notice that the major depression symptoms include thoughts of suicide and death. In dysthymia, you may feel gloomy or even hopeless, but you probably won’t dwell on thoughts of death.

As for the other symptoms, the difference is a matter of degree. For example, while one of the symptoms of major depression is weight loss or gain, that’s not mentioned for dysthymic disorder. If you have dysthymia, you may eat too much or too little, but usually not to the extent that you gain or lose much weight.

Number Of Symptoms

Another difference may be in the number of symptoms you have. Although dysthymia can come with more or fewer symptoms than a major depressive disorder, diagnosing the condition is another matter. You can be diagnosed with dysthymia if you only have two of the symptoms of that disorder. However, for a diagnosis of major depression, you would have at least five of the symptoms listed in the DSM-5.


You might begin to have symptoms of either dysthymia or major depression at any time in your life. They can happen when you’re a child, a teen, or a young, middle-aged, or older adult. However, the most common age of onset for dysthymia is in late adolescence or early adulthood.


Treatment for dysthymia may not provide a cure. Still, it can significantly reduce both the symptoms and how long they last. For both dysthymia and depression, mental health professionals typically recommend a combination of medications and psychotherapy.


Many medications can be used to reduce the symptoms of depression. The most commonly prescribed medications for depression are antidepressants. That’s true for both dysthymic depression and other forms of depression.

Medications For Depression 

Here are the types of antidepressants often used for depression.

  • Selective serotonin reuptake inhibitors (SSRI), such as Paxil, Prozac, Zoloft, Celexa, and Lexapro
  • Serotonin and norepinephrine reuptake inhibitors (SNRI), such as Cymbalta, Effexor XR, Pristiq, and Fetzima
  • Atypical antidepressants, such as Remeron, Trintellix, Vibryd, and Wellbutrin SR
  • Tricyclic antidepressants, such as Tofranil, Pamelor, and Norpramin
  • Monoamine oxidase inhibitors (MAOI), such as Parnate, Nardil, and Marplan

Your doctor may prescribe you more than one of these antidepressants. They may also recommend a mood stabilizer if you have bipolar depression. Also, many people have anxiety with depression, especially during the first phases of treatment. If so, your psychiatrist may prescribe an anti-anxiety med during that time.

Medications For Dysthymia

Any of the medications for depression may prove beneficial for someone with dysthymia. However, psychiatrists typically recommend the following medications for dysthymia.

  • SSRIs
  • SNRIs
  • Mirtazapine
  • Bupropion

Another difference related to medications is how long you have to take them. If you have major depression, your doctor might wean you off of them after you’ve been in remission for a while. With dysthymia, you might have to take the antidepressants longer.


You and the mental health professional who treats you can choose from several different psychological methods to treat your dysthymia. Which is best for you depends on many factors, including:

  • Your mental health history and family background
  • How much social support you have
  • What types of stressful situations you’re facing
  • What type of therapy you prefer

There’s no difference in the types of therapy available for depression and dysthymia, and any of them might work. Therapists often recommend the following types of psychotherapy for people with dysthymia.

  • Supportive therapy
  • Psychoeducation
  • Cognitive-behavioral therapy
  • Psychodynamic therapy
  • Insight-oriented therapy
  • Interpersonal therapy

Therapy for depression and dysthymia may have several goals. Here are some of the improvements you can work towards in psychotherapy for dysthymic depression:

  • Learning to think more realistically and positively
  • Learning to be less critical of yourself
  • Reducing your symptoms of dysthymic disorder
  • Making better choices in thoughts, words, and actions
  • Connecting with others and improving relationships
  • Dealing with negative issues and stressors from the past or present

How To Know If You Have Depression Or Dysthymia

Even when you read the symptoms and compare the treatments, it still might not be clear whether you have depression or dysthymia. That’s okay. No one is expected to have the same diagnostic insights as a mental health professional who has studied these disorders and treated patients. But there are some things you can do to find out.

First Step: Screening 

Maybe you’re not sure whether you have any depressive disorder. If that’s true, there’s an easy way to find out. You can take a test online to check your symptoms. The depression screening test has several questions that you can answer quickly. You don’t have to remember what the symptoms are. Just answer the questions honestly based on your feelings and experiences. At the end of the test, you get an instant visual representation of the likelihood of depression.

Dysthymia Vs. Depression

A screening test can let you know you have a problem worth checking out further. At that point, you need to talk to a psychiatrist or counselor to get a definitive diagnosis. That’s when you’ll learn whether you have major depression, dysthymia, or some other depressive disorder. Then, you can work with your therapist and doctor to find the best treatment for you.


Recognizing the difference between dysthymia and other depressive disorders can be a first step to solving your mental health issues. But don’t stop there. If you think you might have any depression, take a screening test for an objective assessment. Then, if the results reveal that you might have depression, seek diagnosis, and treatment. No matter what type of mental disorder you might have, therapy and medications can help you overcome it.