Medical Review by Jennie Stanford, MD, FAAFP, DipABOM
Summary
- Dysthymia is a persistent form of depression that currently falls under the umbrella of persistent depressive disorder (PDD).
- Recent research has identified specific genes that may be linked to PDD, which could help clarify the link between genetics and some depressive disorders.
- Distinguishing dysthymia from chronic major depression can be challenging—but it’s important because the potential impact can be severe.
- Dysthymia is associated with a higher suicide risk than major depression and is less likely to resolve over time.
- New approaches like infra-low frequency neurofeedback, amantadine, and lamotrigine show promise for treating dysthymia. Always talk to a healthcare provider before attempting any type of treatment.
Stay up-to-date with the latest research on this persistent form of depression
Dysthymia is one of two conditions (along with chronic major depressive disorder) that fall under the umbrella of persistent depressive disorder (PDD). It causes low mood for most of each day, during a period of at least two years in adults who suffer from it. This condition is often chronic—and while it can be treated and managed, symptoms may not ever resolve fully.
Staying aware of the most recent research about this condition can make it easier to have informed conversations with your healthcare provider and create an effective plan for treatment. Below, we summarize the current research about dysthymia so you can get the depression support you need.
The role of genetics in persistent depressive disorder
Research has already suggested that depressive disorders have a genetic component, but more recent evidence points to several specific candidate genes for PDD. In this case, candidate gene means a gene associated with a particular disease.
According to this research, candidate genes for PDD could include these:
- CRY1
- CRY2
- MAOA
- 5-HTT
- BDNF
- IL
- FKBP5
These findings could lead towards a better understanding of depression’s genetic causes—and the same study, which is from 2021, goes on to suggest that these genes could be linked to anxiety as well. However, it’s important to remember that anxiety and depression are different conditions that require distinct approaches to treatment.
Learn more: Understanding the Similarities & Differences Between Anxiety & Depression
What new diagnostic techniques tell us about dysthymia
Dysthymia is less severe than major depressive disorder—but it can significantly affect your social life, work, and daily activities. Still, distinguishing these two conditions has frequently been challenging in the past, even for medical professionals.
In 2013, the DSM-5 introduced the term persistent depressive disorder (PDD) to include both dysthymia and chronic major depression disorder. This remains in the most current version of the DSM, which is the DSM-5-TR.
More recent information about how dysthymia affects your life
Before the early 2000s, dysthymia was widely believed to have a minimal impact on the lives of people who had it—but this changed with a study conducted from 2001 to 2003, during which patients with dysthymia were observed while performing in a variety of different jobs.
The study not only showed that dysthymic patients were more likely to switch jobs than people without the condition—but that they were more likely to have significant problems at work. Loss of productivity was noted as one of the most obvious impacts the study measured.
More recent research shows that the complications associated with PDD may be even greater than previously thought. Specifically, PDD is associated with a higher risk of suicide than major depression, and it’s less likely to resolve over a given time period—so just because the symptoms aren’t as severe, that doesn’t mean PDD isn’t serious.
Emerging treatment approaches for dysthymia
PDD is a challenging and potentially serious condition, but science is exploring several new ways to treat it. Here are a few that show some promise:
Infra-low frequency neurofeedback treatment
Neurofeedback gained traction as a potential treatment for depression in the early 2020s, although its effectiveness was previously debated for many years.
This type of treatment is a kind of biofeedback that measures brain waves and creates a feedback signal—usually via audio or video. By matching positive feedback to desirable brain activities and negative feedback to undesirable ones, the goal is to promote and develop self-control for different brain functions.
Infra-low frequency (ILF) neurofeedback is a newer type of neurofeedback based on slow brain activity and targeting lower-frequency brainwaves (below 0.1 Hz). A case study published in 2023 showed the first indications that this could be an effective treatment method specifically for dysthymia.
Amantadine
Most types of medication prescribed to treat dysthymia are also used to treat major depressive disorder. These include the SSRIs fluoxetine (sold under the brand name Prozac®) and sertraline (sold under the brand name Zoloft®), as well as numerous other antidepressants.
Learn more:
- Fluoxetine (Prozac®): Uses, Benefits, Side Effects, & More
- Sertraline (Zoloft®): Uses, Benefits, Side Effects, & More
Amantadine is a drug that has recently gained attention specifically because of its potential for treating dysthymia. In particular, amantadine has been studied for its use in treating dysthymia when other drugs have failed. One 2023 study compared the well-being of patients taking sertraline to a group taking amantadine after at least one other antidepressant had failed to improve their symptoms.
At the end of the study, the results for the group taking amantadine were shown to be similar to those of the group taking sertraline. The amantadine group also seemed to experience positive effects even after their treatment stopped—suggesting that amantadine may be a particularly effective way to treat dysthymia in people whose symptoms don’t improve from taking sertraline.
Lamotrigine
Lamotrigine is another medication that shows potential as an effective treatment for dysthymia when other antidepressants have failed. One case report from 2022 describes a 38-year-old woman whose symptoms of dysthymia did not respond to numerous antidepressants, including the SNRI duloxetine and the SSRI paroxetine.
The patient in question was given lamotrigine, a drug approved in the US to help prevent seizures and epilepsy. Her other antidepressants were gradually discontinued until she was only taking lamotrigine. While taking antidepressants and lamotrigine, her symptoms appeared to get better and then come back regularly—but when the antidepressants were discontinued and she was only taking lamotrigine, they continued to improve steadily.
Although this case study only involved a single person, it suggested that further research into lamotrigine as a potential second-line treatment for dysthymia would be worth conducting.
Prozac® is a registered trademark of Eli Lilly and Company. Zoloft® is a registered trademark of Viatris Specialty LLC, a Viatris Company.
