GAD Treatment Dysthymia in Children as a Depressive Disorder By Lauren DiMaria linkedin Lauren DiMaria is a member of the Society of Clinical Research Associates and childhood psychology expert. Learn about our editorial process Lauren DiMaria Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Review Board Steven Gans, MD Updated on February 25, 2020 Print JPCreative / Getty Images Dysthymia, also known as dysthymic disorder or DD, is a milder but chronic depressive disorder that is sometimes seen in children. The Course of Dysthymia Like other depressive disorders, the course of dysthymia varies in children. While the DSM-IV criteria require a child to experience symptoms for at least one year to be diagnosed with dysthymia, the median dysthymic episode for children is 3.9 years. Approximately 3 percent of children meet the criteria for dysthymia. However, some researchers argue that an even higher percentage of children have DD. The chronic nature of dysthymia makes it easy for parents to mistakenly attribute the symptoms to a child's personality. Children with DD may not complain of feeling depressed or sad because they do not recognize their mood as being different from what they normally feel. Symptoms Symptoms of DD are similar to those of major depressive disorder, but are less severe and are less likely to impair daily functioning. Symptoms of Dysthymic Disorder in Children Depressed moodSadnessFeelings of hopelessness and/or worthlessnessWithdrawal from friends and familyLow self-esteemEating or sleeping pattern changesUnexplained physical ailmentsLack of concentrationThoughts or action of self-harm or suicideInability to experience pleasure or joyIrritabilityRestlessness or fatigue Despite the milder symptoms of dysthymia, it is still thought that its chronic nature may interfere with a child's development of interpersonal relationships, positive self-esteem, and problem-solving skills. Signs Your Child Is Depressed Recovery and Double Depression Recovery for children with dysthymia is likely. However, the majority of children will have another dysthymic episode in the future. Approximately 75 percent of children who experience a dysthymic episode will also experience a major depressive episode, a shorter but more severe depressive disorder. When a child who has dysthymia experiences a major depressive episode, the combination is called double depression. Factors that may increase a child's likelihood of developing double depression were identified by Dr. Daniel Klein and colleagues in a 10-year follow-up of children with dysthymia. Identified risk factors were: First dysthymic episode at a young ageCo-existing anxiety disorderStrong family history of major depressive disorderPoor early relationship with motherHistory of sexual abuseUnderlying personality disorder It has been noted that children with double depression may have shorter episodes of major depressive disorder. According to Dr. Kovacs and colleagues, this is because it is easier for a child to return to a baseline mood of dysthymia, or mild depressive symptoms, than a baseline with no presence of depressive symptoms. Nonetheless, all depressive disorders require treatment in children. What Parents Should Know About Childhood Depression Seeking Help Like other depressive disorders, dysthymic disorder is associated with serious short- and long-term consequences, such as poor academic and social performance, substance abuse, and increased risk of suicide. If you or your child are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see our National Helpline Database. Of course, not all children with dysthymia will experience negative outcomes, but given the association, treatment is recommended. Treatment options for children with dysthymia are typically psychotherapy, medication, or a combination approach. Be sure to talk to your child's pediatrician or other mental health providers if she has symptoms of dysthymia or another depressive disorder. Depressive disorders should never be left untreated in children. The Consequences of Untreated Childhood Depression Was this page helpful? Thanks for your feedback! Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC: American Psychiatric Association: 2000. Daniel N. Klein, Ph.D., Stewart A. Shankman, Ph.D., Suzanne Rose, M.A.Dysthymic Disorder and Double Depression: Prediction of 10-Year Course Trajectories and Outcomes. Journal of Research Psychiatry April 2008 42(5): 408-415. Depression and Suicide in Children and Adolescents. Mental Health: A Report of the Surgeon General. Hana M. Vujeva, Wydol Furman. Depressive Symptoms and Romantic Relationship Qualities from Adolescence Through Emerging Adulthood: A Longitudinal Examination of Influences. Clinical Child & Adolescent Psychology. 40(1): 123-135. Kovacs M, Obrosky DS, Gatsonis C, Richards C. First-Episode Major Depressive and Dysthymic Disorder in Childhood: Clinical and Sociodemographic Factors in Recovery. Journal of the American Academy of Child and Adolescent Psychiatry. 1997, 36:777-784.