Do You Have Mild, Low-Grade Depression?

Depressed young man
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People with mild, low-grade depression may not even realize they are depressed. In fact, the chronic feelings of sadness and low mood they experience may have been around for so long that they feel normal.

However, it is not normal to go through life feeling unhappy all of the time. Everyone experieces occasional bouts of low mood in response to sad or stressful life events, but constantly feeling depressed does not have to be the story of your life.

Symptoms of Chronic Low-Grade Depression

Chronic low-grade depression is a symptom of dysthymic disorder, also called dysthymia. The mood disorder can also go by the name Persistent Depressive Disorder (PDD).

Dysthmia was previously listed separately from chronic major depression, but the disorders have been combined, as no scientifically meaningful difference was found between them.

The signs and symptoms of dysthymic disorder are very similar to major depressive disorder, except that they tend to be milder and are chronic in nature.

Symptoms of dysthmia include:

  • Fatigue
  • Restlessness
  • Sleep problems
  • Changes in weight or appetite
  • Low energy and reduced motivation
  • Sadness, tearfulness, frequent crying
  • Feelings of hopelessness, worthlessness, or guilt
  • Trouble concentrating, focusing, and making decisions
  • No longer enjoying things that used to bring pleasure
  • Thoughts of death or suicide

Causes

As with major depressive disorder, dysthymic disorder is also believed to be a multifactorial condition—meaning they are likely caused by a combination of genetic susceptibility, biochemical imbalance, life stress, and environmental circumstances.

In about three-quarters of patients with dysthymia, the primary cause of the disorder is not clear. These patients tend to have other complicating factors, such as chronic illness, another psychiatric disorder, or substance abuse.

In these cases, it becomes very difficult to say whether the depression would exist independently of the other condition. In addition, these comorbid conditions often create a vicious cycle wherein each illness makes the other more difficult to treat.

Diagnosis

Like other forms of depression, there isn't really a blood test or brain scan that can be used to make a diagnosis of dysthymic disorder. Instead, doctors must go by the signs that they can observe, as well as any symptoms patients report to them.

Doctors and mental health professionals can check to see if a patient's symptoms fit into a pattern laid out by the Diagnostic and Statistical Manual of Mental Disorders (DSM), a guidebook for diagnosing mental disorders such as depression.

With dysthymic disorder, doctors will need to determine if the patient's symptoms (from the above list) have been present for an extended period of time. In addition, they will consider whether the severity of the symptoms is less than what a patient might experience with a major depressive disorder.

Doctors will also use blood and urine tests to try to rule out possible medical conditions, such as hypothyroidism, that could cause chronic mild depression.

Other factors a doctor will consider when making a diagnosis include a patient's medical history, as well as whether there is a history of depression in their family.

Treatment

Dysthymic disorder responds to the same treatments that are used to treat major depression. Antidepressant medications are generally prescribed, with selective serotonin reuptake inhibitors (SSRIs) being a popular choice.

In addition, talk therapy such as psychotherapy or cognitive behavioral therapy can often be quite helpful for those with dysthymic disorder. You'll have to work with your mental health care provider to develop a treatment plan that's most appropriate for you.

Depression Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

Mind Doc Guide

There are also several self-care treatments that can help treat chronic mild depression. Here are a few suggestions to keep in mind.

  • Eat a varied and nutritious diet.
  • Avoid alcohol and illegal drugs.
  • Find things to do that you enjoy.
  • Get enough sleep and ensure you have a restful sleeping environment.
  • Aim for 30 minutes of moderately-intense exercise most days of the week, and add vigorous exercise if you are able to do so.
  • Seek out people for friends who are positive, supportive, and show that they care about you.
  • Be sure that you are taking your medications correctly. Tell your doctor about any supplements or herbal remedies you take.

If you have been diagnosed you with dysthymia, but your depression symptoms are getting worse, make sure you talk to your doctor. The will reevaluate your symptoms and adjust your treatment if necessary.

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Article Sources

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  • Persistent Depressive Disorder. MedlinePlus. https://medlineplus.gov/ency/article/000918.htm.
  • American Psychiatric Association. Persistent depressive disorder (dysthymia). Diagnostic and Statistical Manual of Mental Disorders 5th ed. Arlington, VA: American Psychiatric Publishing, 2013;168-171.