Dysthymic Disorder

Dysthymic disorder is a form of mood disorder that is characterized by mild, chronic depression. The current diagnostic criteria require chronic depressed mood (i.e., depressed most of the day, for more days than not, for at least two years). In addition, the individual must experience at least two of the following six depressive symptoms: (1) low self-esteem, (2) feelings of hopelessness, (3) low energy or fatigue, (4) difficulty concentrating or making decisions, (5) sleep disturbance (insomnia or sleeping too much), and (6) appetite disturbance (poor appetite or overeating). The symptoms must be persistent (i.e., never without depressive symptoms for more than two months at a time during this period), have a gradual (or insidious) onset (i.e., no major depressive episode during the first two years), and cause significant distress or impairment in social or occupational functioning. Finally, the diagnosis cannot not be made if the individual has a psychotic or bipolar (manic-depressive) disorder, or if the symptoms are due to medication, substances of abuse, or a general medical condition (American Psychiatric Association, 2000).