In mental health clinics, the incidence has been reported at 22 to 36 percent or greater. Some individuals can trace dysthymia to a specific event, such as the death of a loved one or the divorce of parents during adolescence. Many times, however, dysthymic disorder has no easily identified beginning or end. It's a slow, smoldering gloom that ebbs and flows but never seems to give up. The average duration, however, is 16 years.
Some patients also suffer from physical complaints such as headaches, upset stomach or back pain.
While these symptoms can cause significant distress and impairment, they are often not severe enough to keep the person from functioning. Mary, for example, worked in a series of low-paying jobs for which she was overqualified, and she constantly complained to family and friends about her poor working conditions. About 50 percent of cases of dysthymia begin before age 25. When it begins in childhood or adolescence, symptoms may take the form of social withdrawal, shyness, poor school performance and conflicts with parents. Older persons often develop dysthymia as a result of a series of personal losses or grief.