Dysthymia

If your child has dysthymia, an important first step is familiarizing yourself with the basics about the condition and how it could affect her. 

Children with dysthymia:

• are in a depressed (and sometimes irritable) mood for most of the day, more days than not
• feel an ongoing sense of worthlessness
• lose interest in activities and hobbies they once enjoyed
• are more likely to develop major depression in their teen or early adult years

Unfortunately, many children with dysthymia don’t get the help they need: 60 to 80 percent of children with depressive disorders either are not diagnosed, or do not receive the treatment they need. If left untreated, dysthymia can lead to:

• deteriorating schoolwork
• frequent absences from school
• dropping out of school
• substance abuse and other destructive behaviors
• strained relationships with family and friends
• potential risk of suicide 

What is dysthymia?

Like major depression, dysthymia is a mood disorder. The condition:

• is less severe than major depression, but lasts for longer periods of time
• may affect a child for as long as one to five years
• is not necessarily present every day, hour in hour out.
• is marked by a chronic feeling of mild depression, but may cause more extreme feelings from time to time
• has no single, identifiable cause; it may be linked to a family history of depression, factors in a child’s environment, or specific traumatic experiences

Children with dysthymia:

• are in a depressed (and sometimes irritable) mood for most of the day, more days than not
• feel an ongoing sense of worthlessness, low self-esteem and hopelessness
• lose interest in activities and hobbies they once enjoyed
• are more likely to develop major depression in their teen or early adult years 

Is dysthymia common? Who gets it?

About four out of 100 children and adolescents have dysthymia. 

Here at Children’s Hospital Boston, we understand that a timely, effective treatment plan makes all the difference for a child facing dysthymia. Our psychiatrists, psychologists and social workers are here to provide compassionate, knowledgeable care for your child and support for you and your family.

Causes

What causes dysthymia?
The exact cause of dysthymia is not known, but experts point to several risk factors for childhood depression, including:

• a family history of depression (children with a depressed parent have more than a 40 percent chance of also developing a depressive disorder) 
• excessive stress 
• a traumatic experience (physical and/or emotional) 
• other mental health problems, such as anxiety
• abuse or neglect 
• death of a parent, relative, friend or other loved one 
• a divorce or illness in the family 
• loss of an important relationship (e.g., a romantic breakup) 
• chronic social or academic difficulties 
• dealing with a chronic medical illness
• feeling “left behind” or “not good enough” when compared to peers 

Signs and symptoms

What are the symptoms of dysthymia?
Symptoms of dysthymia may be very different from one child to another, so it is important to know your child’s usual moods, routines and habits in order to detect the possible onset of depression.

Common warning signs are: 

• persistent sadness or “moping”
• sleeping too much or too little
• feeling hopeless or helpless
• low self-esteem
• feeling inadequate compared to friends and peers
• excessive guilt
• feeling or expressing a desire to die, “disappear” or “just sleep forever”
• loss of interest in usual activities and favorite hobbies
• difficulty with relationships
• withdrawing from friends and family
• changes in appetite or weight
• decreased energy
• difficulty concentrating
• difficulty making decisions
• suicidal thoughts or attempts
• frequent physical complaints such as headache, stomachache or fatigue
• running away or threats to run away  
• hypersensitivity to failure or rejection
• irritability, hostility or aggression

If any or all of these symptoms are ongoing—meaning they last for at least two weeks—and noticeably disrupt your child’s home, school and social life, your child is likely to have a depressive disorder requiring prompt medical treatment.

If your child expresses a desire or plan to die, “disappear,” or “just sleep forever,” you should always take his feelings seriously and seek immediate help.  Learn more about recognizing the warning signs of suicide.