How does dysthymia feel?


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Written by Wiebke Posmyk • Medical editor

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Dysthymia is a persistent (chronic) depressive mood. The symptoms are less pronounced than in depression, but very stressful - because they last for years. Read about how to treat dysthymia and how it differs from depression.

One speaks of a dysthymia (also: dysthymia, dysthyme disorder) if

  • Symptoms of a depressed mood occur,
  • that are almost permanently available for at least two years.

Most days, people with dysthymia feel down, listless, and inadequate. They are prone to self-doubt and feelings of inferiority. They rarely feel joy. Even small activities are exhausting for them and they often feel weakened. In addition, there are unspecific physical complaints such as tiredness, sleep disorders, loss of appetite or headaches.

It is estimated that around 3 to 5 in 100 people have dysthymia. Women are slightly more likely to receive this diagnosis than men. The first symptoms often appear in adolescence or early adulthood. Basically, however, people of any age can get sick. Older people are more likely to develop dysthymia after depression or severe psychological distress.

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To date, the causes of dysthymia have not yet been conclusively researched. Scientists assume that various factors interact to trigger the disease. These include psychosocial influences such as social isolation. Learning psychological factors also play a role - for example, dependency due to an overprotective parental home and the resulting self-devaluation. Genetic factors could also be important.

By the way: the term Dysthymia comes from the Greek and means something like discontent.

Dysthymia: symptoms

The symptoms of dysthymia / dysthymia are similar to those of depression. However, they are milder and last longer.

Possible symptoms are:

  • Dejection
  • Feelings of emptiness and / or hopelessness
  • Joylessness
  • Lack of energy, exhaustion
  • Feelings of fear, fear of failure
  • sensitivity
  • Brooding
  • limited performance
  • Self-esteem problems; Feeling inadequate
  • Listlessness
  • Difficulty concentrating
  • social withdrawal
  • Sleep disorders, e.g. B. Problems falling asleep, insomnia, increased need for sleep
  • persistent fatigue
  • unspecific physical complaints
  • lack of sexual desire
  • Weight gain or loss; Loss of appetite or increased appetite

Usually there are phases of days or weeks in which those affected are doing well. Most of the time, however, they experience discomfort to varying degrees.

Dysthymia and depression

Even if it is difficult for them, people with dysthymia are usually able to cope with everyday life. For example, you can have a job in most cases. Nevertheless, dysthymia is associated with high levels of suffering - mainly because the symptoms persist almost continuously over a very long period and hardly change in their intensity.

Depression, on the other hand, is associated with more severe symptoms. In addition, it often runs in phases (so-called episodes). This means that those affected feel better again after a certain period of time - usually weeks or months. A depressive episode can occur once, but can also recur at intervals. In the case of dysthymia, on the other hand, the symptoms last more or less permanently, but less often.

Double Depression: Depression and Dysthymia in a double pack

People with dysthymia can also have a depressive episode. Experts then also speak of one Double depression or Double depression. The depressive episode then superimposes the symptoms of the dysthymia. If the depressive episode subsides, the depressive mood remains.

Dysthymia: diagnosis

Many diseases can hide behind symptoms such as listlessness, tiredness or joylessness and they are not proof of dysthymia. It is therefore important to rule out other possible physical or psychological causes for the symptoms, for example

The first point of contact can be the family doctor. If he is of the opinion that the symptoms are psychological, he may refer his patient to a psychotherapist. Alternatively, you can contact a psychotherapist directly. Before any psychotherapy, however, a medical examination is necessary so that a possible physical illness is not overlooked.

Dysthymia is often associated with other mental illnesses - such as an anxiety disorder - so that it can go undetected for a long time. In the course of the sessions, however, an experienced therapist usually succeeds in recognizing dysthymia and differentiating it from a depressive episode.

Dysthymia: therapy

Psychotherapy can help with dysthymia. Which form of therapy is most suitable depends, among other things, on the preferences of the patient / client. In a psychodynamically oriented therapy such as deep psychological psychotherapy, for example, it can be about uncovering and dealing with stressful conflicts from childhood. In a cognitive behavior therapy, on the other hand, unfavorable thought and behavior patterns could be in the foreground, which are analyzed and restructured step by step.

In addition to psychotherapy, other offers can be helpful, for example exercise therapy, music therapy and / or regular exercise.

In certain cases, drug treatment with antidepressants can be useful in addition to psychotherapy - for example at the beginning of treatment or when the patient is in an acute crisis. Even in the case of dysthymia overlaid by a depressive episode (double depression), psychotherapy is often combined with drug treatment.

Dysthymia: course

Dysthymia lasts for many years. With psychotherapeutic help, many of those affected can develop more joy in life again. On the other hand, if the disease is left untreated, it can develop into chronic depression.

Many people with dysthymia also have another mental illness. Mental disorders that often occur with dysthymia include, for example, anxiety disorders such as social phobia, agoraphobia or generalized anxiety disorder.

The symptoms of dysthymia lead to high levels of distress, especially because they persist over a long period of time. The risk of suicide (thoughts) and addictions is increased.

Help in an emergency

Thoughts of suicide are part of the disease. Specific suicidal thoughts are aemergency. Anyone who has such thoughts should not hesitate to contact the nearest psychiatric clinic or to dial the emergency number (112).

Another point of contact is the anonymous and free telephone counseling.

For people in Germany:

For people in Austria:

People in Switzerland can contact the facility "Die Dargebotene Hand" on the telephone number143 or at Help.

Guideline of the German Society for Psychiatry, Psychotherapy and Neurology (DGPPN): Unipolar Depression (PDF). AWMF Reg. No. nvl / 005 (as of 2017)

Payk, T., Brüne, M .: Checklist psychiatry and psychotherapy. Thieme, Stuttgart 2017

Möller, H., et al .: Dual Series Psychiatry, Psychosomatics and Psychotherapy. Thieme, Stuttgart 2015

Robert Koch Institute (ed.): Depressive diseases. Federal Health Reporting, Issue 51 (September 2010)

additional Information

ICD-10 Diagnostic Key:

You can find the appropriate ICD-10 code for "Dysthymia" here:

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Last content check:07.07.2020
Last change: 26.10.2020