The fact that people with dysthymia may accept these worsening symptoms as inevitable can delay treatment.
When and if such people seek out treatment, the treatment may not be very effective if only the symptoms of the major depression are addressed, but not the dysthymic symptoms.
Patients with double depression tend to report significantly higher levels of hopelessness than is normal.
This can be a useful symptom for mental health services providers to focus on when working with patients to treat the condition.
A "double depression" is the occurrence of episodes of major depression in addition to dysthymia.
However, there are some indications that there is a genetic predisposition to dysthymia: "The rate of depression in the families of people with dysthymia is as high as fifty percent for the early-onset form of the disorder".Diagnosis of dysthymia can be difficult because of the subtle nature of the symptoms and patients can often hide them in social situations, making it challenging for others to detect symptoms.Additionally, dysthymia often occurs at the same time as other psychological disorders, which adds a level of complexity in determining the presence of dysthymia, particularly because there is often an overlap in the symptoms of disorders.A combination of antidepressants and cognitive therapies can be helpful in preventing major depressive symptoms from occurring.Additionally, exercise and good sleep hygiene (e.g., improving sleep patterns) are thought to have an additive effect on treating dysthymic symptoms and preventing them from worsening.In a study using identical and fraternal twins, results indicated that there is a stronger likelihood of identical twins both having depression than fraternal twins.This provides support for the idea that dysthymia is in part caused by heredity.In the DSM-5, dysthymia is replaced by persistent depressive disorder.This new condition includes both chronic major depressive disorder and the previous dysthymic disorder.As a result, they may believe that depression is a part of their character, so they may not even discuss their symptoms with doctors, family members or friends.Dysthymia often co-occurs with other mental disorders.