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The cause of dysthymia is not completely understood. It is believed that changes in brain structures and chemistry may cause alterations in mood. Too many or too few neurotransmitters (chemicals that convey messages between nerves), particularly serotonin, are believed to play a key role.

There are many risk factors for dysthymia. These include:

• Gender. Women have about twice the risk of developing dysthymia as men. Although the reason for this is unknown, it may be due to factors such as differences in hormones in certain life stages, such as after pregnancy and menopause. It should be noted that the disparity between the genders also may be related to women being more willing to report symptoms of depression than men.
  
  
• Family history. Individuals who have relatives with a history of any form of depression, especially dysthymia or major depression, are at a higher risk of developing dysthymia. This is especially true for first-degree relatives (e.g., parents, children, siblings).
  
  
• Long-standing life stresses. Individuals who experience constant sources of major stress, such as from discrimination, poverty, constant abuse or chronic illness, have an increased risk of dysthymia.
  
  
• Marital status and quality. In general, unmarried people have a greater risk of developing dysthymia. However, unhappily married people may also have a higher risk of developing the disorder. Whether these are actual risk factors for developing dysthymia, or if they are due to the fact that people with chronic depression may be less likely to marry and when they do marry are more likely to have unhappy marriages, is unclear. Individuals who feel rejected or depreciated by a loved one or are isolated are also at an increased risk.