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Dysthymia and Social Security Disability

Dysthymia, as a depressive psychological disorder, presents with extended periods of depression and anhedonia, which is a pronounced inability to find enjoyment or pleasure in anything. Other symptoms include sleep disturbances, insomnia, inability to concentrate, appetite changes, fatigue, and low self esteem.

How to Apply for Social Security Disability with Dysthymia

While more chronic in nature than many forms of depression, dysthymia is generally considered to be less severe in nature than clinical depression. Individuals that suffer from this condition often find it difficult or impossible to participate in routine, daily activities, including work. It’s not uncommon for dysthymia sufferers to experience worsening symptoms and to eventually develop major depressive disorder.

The Social Security Administration (SSA) has no unique listing for dysthymia in its “Blue Book”, the manual used by Social Security Disability (SSD) staff to determine if an application for benefits meets the eligibility criteria. Instead, dysthymia is evaluated under the Blue Book listing for major depression. Major depression is considered an “Affective Disorder” and as such appears in the Mental Disorders section of the Blue Book manual, specifically, section 12.04.

To meet the listing criteria for Affective Disorders, your application for SSD benefits and your medical records must show you suffer from severe depression and exhibit at least four of these common symptoms:

  • Appetite changes, which can include overeating and poor appetite
  • Loss of engagement, including disinterest in daily activities and/or inability to find pleasure in everyday life
  • Fatigue and decreased overall energy levels and physical activity
  • Sleep issues, which can include sleeping excessively, insomnia as well as other sleep disruptions
  • Inability to think clearly and/or concentrate
  • Feelings of worthlessness, hopelessness, or guilt
  • Hallucinations, paranoia, delusional thoughts
  • Suicidal thoughts or suicide attempts

Additionally, to meet the Affective Disorders listing, your application and corresponding medical records must also show:

  • Your dysthymia severely affects your ability to perform everyday activities, which the SSA classifies as Activities of Daily Living or “ADLs”.
  • You experience repeated and extended periods during which your symptoms worsen, which are termed “Episodes of Decompensation” by the medical community and by the SSA.

If your dysthymia does not meet the listed criteria for eligibility under the Major Depression entry in the Blue Book, you may still be found eligible for benefits, if your medical records and other application documentation show that you meet the requirements for a “Medical Vocational Allowance”. A medical vocational allowance essentially means that your symptoms, while not matching any listed condition in the Blue Book, are still severe enough to prevent you from maintaining gainful employment.

Medical documentation is the biggest part of meeting SSD eligibility criteria, whether under a listed condition or as a medical vocational allowance. Your medical records must be extensive and clearly show:

  • a history of repeated episodes of decompensation
  • the persistent presence of common major depression symptoms
  • a clinical diagnosis from a qualified medical professional
  • statements from your treating physician(s) regarding your symptoms and their severity, frequency and duration
  • any medications you take or have taken in the past

Your medical documentation should also show that despite seeking help for your condition and following prescribed treatment regimens, your dysthymia remains severe enough to prevent you from getting and keeping a job.

Your Dysthymia Social Security Disability Case

Proving any disability claim can be challenging, and this is especially true for psychological conditions. As dysthymia is generally considered to be less severe in nature than depression, substantiating your disability can be difficult, even with extensive medical records. You’ll need to work closely with your treating physician to document the severity of your condition and the symptoms you experience. You may also want to consider seeking the assistance of a Social Security advocate or Social Security Disability attorney when filing your initial application for SSD in order to increase the chances you’ll be approved for benefits.

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