The symptoms of dysthymia and major depressive disorder are similar. Both disorders can have serious effects on the body, mind, and emotions. Physical symptoms can include changes in appetite, low energy, feeling tired, and trouble sleeping. Mental symptoms include difficulty making decisions or concentrating. Emotionally, people with either disorder often feel hopeless and have low self-esteem. However, even though both disorders have similar symptoms, these symptoms are usually less severe with dysthymia.