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Dysthymia vs Major Depression

Jan 23, 2023

For many individuals living with depression, their illness responds well to treatment and is highly manageable — regardless of which type of mental health condition they’re dealing with. 

Several types of depression or depressive disorders produce similar symptoms, making it difficult for healthcare professionals to come up with a diagnosis. Two of the most common that are frequently compared are dysthymic disorder vs major depression. 

Estimates show that over 7% of adults in the U.S. will have struggled with major depression (also called Major Depressive Disorder or MDD) in the previous year, while around 2.5% will have struggled with dysthymia (also called Persistent Depressive Disorder or PDD), at least once in their lifetime.

What is Dysthymia? 

Dysthymia, or PDD, is a long-lasting, but milder form of persistent depression. People with dysthymia may also experience bouts of MDD at times.

Symptoms of dysthymia include:

  • Low appetite or overeating
  • Low mood more frequently than not over two years
  • Low self-esteem
  • Fatigue
  • Feeling hopeless
  • Poor decision-making skills
  • Too much or too little sleep

An individual would only need to experience two or more of these symptoms to meet the PDD criteria. However, the duration of the symptoms is the most important component of the condition.

What is Major Depressive Disorder? 

When individuals say “depression”, they’re typically referring to Major Depressive Disorder or major depression. Sometimes it’s even referred to as clinical depression. Major depression is more severe than dysthymia, but episodes of MDD don’t usually last as long as those of PDD.

Even so, without treatment, MDD can become recurrent (can return). A 2015 study involving female twins showed various factors that may increase the likelihood of a recurrence of MDD. 

These include the following:

  • Family history
  • Psychiatric history
  • Problems with friends
  • Financial troubles
  • Being unmarried
  • Adverse life events, both recent and early

Some Depression symptoms include:

  • Unintended and significant changes in weight or changes in appetite
  • An irritable or depressed mood most of the day for most days
  • Low motivation and energy
  • Sleeping too little or too much
  • Less pleasure or interest in activities once thought of as engaging and fun
  • Limited ability to focus, think clearly, or concentrate
  • Feeling very slowed down or sped up behaviorally
  • Thinking of dying, death, and suicide
  • Feeling worthless or very guilty
  • More likely to develop a substance abuse issue
  • Suicidal thoughts

An individual will need to show five or more of the above symptoms for two weeks in order to receive a diagnosis of MDD.

So, now let’s compare and contrast major depression with dysthymia depression. Below are the similarities and differences between dysthymia vs depression.

Similarities Between Dysthymia vs Major Depression 

Both dysthymia and major depression can interfere with relationships, work, and school. Symptoms can cause physical illness since they can interfere with a person’s ability to care for themselves.

Treatments for PDD and MDD are extremely similar. Healthcare professionals will base treatment on the severity of the patient’s symptoms. The two disorders do share one particular symptom. This symptom is a depressed mood on most days.

Individuals are more likely to struggle with either PDD or MDD if they’re female. Both types of depression can occur at any age, however, PDD tends to show up earlier in life. 

Both MDD and PDD are likely caused by a combination of physical problems and life events. More than one of the following could affect a person and lead to PDD or MDD:

  • Heredity: Individuals have a higher risk of depression if they have close relatives with the condition.
  • Biology: Brain changes can occur from stress. Also, natural chemicals in the brain and how these chemicals function can influence a person’s mood.
  • Stress: Trauma in a person’s life, such as the death of a loved one or money problems, can trigger depression.

Both PDD and MDD are serious forms of depression that require a person to seek treatment. 

Differences Between Dysthymia vs Major Depression

While MDD and PDD overlap in some ways, there are key differences. Dysthymia involves fewer symptoms. But these symptoms last longer and for a minimum of two years. 

A person can receive a diagnosis of MDD if they’re experiencing symptoms for two weeks. Again, both types of depression are serious, but sometimes PDD will disrupt a person’s life more, even when there are fewer symptoms.

Even though both forms of depression share similar symptoms, some big differences between the two include:

  • Onset: With dysthymia, the onset is adolescence and onward, whereas the average age of onset is 40 years old with MDD.
  • Duration: Individuals experience dysthymia for most days, for at least two years, while with MDD it’s at least two weeks.
  • Prevalence: As stated above, over 2% of U.S. adults will experience PDD in their lifetime — over 7% will experience MDD. 

If a person has dysthymia, they’ll have a minimum of two of the above-mentioned symptoms along with a depressed mood. They’ll experience the symptoms for a minimum of two years without experiencing much relief. If a person has MDD, they’ll have a minimum of five of the above-mentioned symptoms, and their symptoms will last for a minimum of two weeks. While some of the symptoms of MDD are similar to those of PDD, they’re often worse.

For instance, a person with dysthymia might notice some changes in their eating habits. But, if they have MDD, those changes might cause them to lose or gain a lot of weight.

Treatments for Depression 

A healthcare professional may recommend several types of depression treatment for both versions of depression. Sometimes treatments are combined, including:


The healthcare provider can prescribe medications known as antidepressants that help to rebalance the natural chemicals in the patient’s brain. What the doctor prescribes will depend on a few things, including whether or not the patient is taking other medications and what those medications are.

Some antidepressants take a few weeks before they start to work. It’s important that individuals do not stop taking the medication without talking with their doctor first. With certain medications, missing doses or stopping altogether can make the person’s depression worse or can cause a withdrawal reaction.


Individuals learn different ways to cope with their chronic depression and depressive symptoms better with cognitive behavioral therapy. They may learn how to identify harmful thoughts and prevent them. People with depression can learn how to improve their social skills and manage stress better. Or, they may work through longtime challenges like early painful childhood memories.


Individuals should never skimp on lifestyle changes that can help their mind and body, such as:

  • Exercising regularly
  • Keeping up with a healthy diet
  • Avoiding illegal drugs and alcohol, which can impact their mood
  • Getting enough sleep
  • Surrounding themselves with supportive family and friends
  • Spending time engaging in hobbies and other activities they enjoy

In some cases, individuals can have both dysthymia and major depression. This is referred to as “double depression.” 

Neither PDD nor MDD is considered minor. It can take different treatments and time before individuals begin feeling better with either. But once they and their healthcare professionals settle on the ideal support and mental illness treatment plan, they’ll likely begin feeling their mood improve shortly after.

TMS for Depression 

TMS is short for Transcranial Magnetic Stimulation. TMS for depression has been approved by the FDA for treating resistant depression. It’s a drug-free and non-invasive treatment that helps stimulate brain regions with a magnetic pulse. This helps the brain to release the “feel-good” chemicals that make people happy.

During a TMS session, the health professional will place an electromagnetic coil on the individual’s scalp near the forehead. The electromagnet will deliver a painless magnetic pulse that will stimulate the nerve cells in the individual’s brain region that is involved in depression and mood control. It’s said to activate brain regions that have reduced depression activity. At Brain Therapy TMS in San Diego, our healthcare and mental health professionals specialize in TMS therapy. We help enhance the lives of our clients who are struggling with either dysthymia or major depression and who haven’t responded to traditional treatment approaches.

Considering TMS Treatment? Schedule a Consultation!

Tired of the results you’re getting from your standard treatment? Transcranial Magnetic Stimulation may be able to increase your chances of long-term remission, reducing your symptoms and allowing you to live a more joyful life.




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