But when a major depressive episode is effectively treated, treated, the mood should return to normal as the other symptoms resolve. There is also often an awareness during treatment that depression is not the normal state and that things can improve.

Some of the symptoms of major depression are also present in people who have dysthymia, but they are fewer in number, less severe, and not as debilitating. They typically don't interfere with a person's day-to-day functioning as they can in major depression. As a result, people with dysthymia tend to view their symptoms as normal for them. Some may regard the low mood as a part of their personality or as simply a part of life and out of their control.

When a major depression occurs on top of a chronic depressed mood, some people with dysthymia accept it as inevitable. This causes them to delay seeking treatment and makes them more resistant to normal treatment when it does start. Plus, unless the dysthymia is addressed along with the major depression, they are not really cured when the major depression is relieved. They go back to being chronically down with the accompanying risk of a new episode of double depression.