Persistent Depression

(previously called Dysthymic Disorder)

When depression has been long-standing, it can bring deep-seated changes to a person’s life.  Depression keeps people stuck in the same ways of thinking about themselves and the world around them, and these ways can become ingrained. 

Previously, people with mild but long-lasting depression were said to have “dysthymic temperament”, while those with severe and long-lasting depression were diagnosed with “chronic depression.”  In the new DSM-5, these categories have been merged into one: Persistent Depressive Disorder.

This change helps validate the real suffering that both conditions bring.  Indeed, 90% of people with dysthymic temperament do experience full depression at some point in their life.  Even if it is mild, dysthymia can be very disabling because its consequences build up without relief over the life span, such as broken relationships and missed opportunities.

On the other hand, dysthymia is a real temperament, a part of our personality – of who we are.  It carries strengths as well, and it’s important to recognize these so they don’t get lost in the treatment:

Potential Strengths:
Dedicated, hard-working, conscientious
, moral, dependable, organized, humble.  Your ability to see your own faults clearly can be a strength or a set-back.

Potential Limitations:
Sad, low energy, self critical, worried/anxious, difficulty adjusting to change, high need for sleep (9 or more hours/day).

There is a psychotherapy designed for dysthymia which we practice at the Mood Treatment Center called Cognitive Behavioral Analysis System of Psychotherapy. 



—Updated 2/28/13 by Chris Aiken, MD