Defining and Diagnosing Dysthymia

The easiest way to categorize depression and dysthymia is to think of depression as the flu and dysthymia as a cold. Dysthymia is like a low-grade fever that you can't get rid of, and it's more chronic in its course. This means that it lasts longer but the symptoms are less severe. Many children have described it by saying that until they got treatment, they thought feeling dysphoric was “just the way it is.” It became part of them to the extent that they had forgotten feeling any other way.

An Important Distinction

One of the most important differences between depression and dysthymia is the length of time the symptoms have been present before a diagnosis can be made. In depression, the symptoms have to be present for at least two weeks.

For dysthymia in children, the symptoms have to be present for a year, more days than not, and the child cannot have had a major depressive episode during that time. The DSM-IV dysthymia diagnostic criteria states that the child must exhibit two or more of the following symptoms:

  • Poor appetite or overeating

  • Insomnia or hypersomnia

  • Low energy or fatigue

  • Low self-esteem

  • Poor concentration or difficulty making decisions

  • Feelings of hopelessness

You can see why it may be hard to distinguish whether your child is suffering from major depression or dysthymia. The easiest way is to consider the length of time your child has shown signs of feeling depressed. Although depression is difficult to endure, dysthymia is no less ravaging, especially since it lasts so much longer.


Dysthymia and depression have as a component dysphoria. Dysphoria comes from the Greek word that means “poor attitude.” In dysthymia, it means a poor mood. A child with dysthymia often describes herself as sad or down in the dumps. For depression, the mood is more severely unhappy, hopeless, and blue.

Depression That Becomes Dysthymia

For many children and teens, the symptoms of depression will go away with treatment. Sadly, for others, some of their symptoms will linger and remain long after the major depressive episode is over. At that point, they are diagnosed as having dysthymia. So don't be alarmed if your treating professional changes the diagnosis of your child. The diagnostic label might float between these two disorders.

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