The patient has had no Manic , Hypomanic or Mixed Episodes. The patient has never fulfilled criteria for Cyclothymic Disorder . The symptoms are not directly caused by a general medical condition or the use of substances, including prescription medications. The symptoms cause clinically important distress or impair work, social or personal functioning. Specify whether Early onset, if it begins by age 20 Late onset, if it begins at age 21 or later The only specifier that can apply is With Atypical Features.
Some disorders have similar or even overlapping symptoms.
The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Often, antidepressant medication is also recommended because of the chronic nature of the depression in dysthymia. Second, cognitive therapy is used to change the pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that create the depression and sustain it. Cognitive therapy can help the depressed person recognize which life problems are critical, and which are minor. It also helps them to learn how to accept the life problems that cannot be changed.