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The symptoms of dysthymia may vary greatly from one patient to another. They may result in decreased activity, effectiveness or productivity. Most are similar to the symptoms of major depression, but not as severe. Because patients with dysthymia may consider their symptoms normal, symptoms may be noticed by others before they are recognized by the patient. Signs and symptoms of dysthymia include:

• Altered mood. The patient will usually experience feelings of sadness, hopelessness, discouragement or apathy (lack of emotion). The patient may be pessimistic (feel that everything in life will turn out badly) or discouraged and may experience crying spells or excessive emotional sensitivity. Excessive anger, irritability or crankiness may also be noticeable, particularly in children.
  
  
• Lack of interests and/or social withdrawal. Patients may have little or no interest in activities they used to find pleasurable, such as food, sex, work, friends, hobbies and entertainment (anhedonia). They may be also socially withdrawn or shy.
  
  
• Self-worth. Poor self-esteem is common in dysthymia. The patient may have feelings of worthlessness, self-reproach, inadequacy or excessive or inappropriate guilt.
  
  
• Fatigue and low energy.
  
  
• Concentration. The patient may be indecisive, have diminished ability to think, pay attention to tasks or concentrate, or have memory problems.
  
  
• Significant change in appetite or weight. Patients with dysthymia may experience reduced or increased appetite or significant weight loss or gain over a relatively short period of time.
  
  
• Changes in sleep patterns. The patient may sleep too much (hypersomnia) or be unable to sleep enough (insomnia).