Persistent Depressive Disorder
A chronic depressive condition involving a depressed mood that occurs for most of the day, for more days than not, for at least two years.
Overview
Persistent depressive disorder, also called dysthymia, involves a chronic depressed mood occurring for most of the day, for more days than not, for at least two years (one year in children and adolescents), along with additional depressive symptoms.
Signs and Symptoms
Symptoms can include poor appetite or overeating, sleep difficulties, low energy, low self-esteem, poor concentration, and feelings of hopelessness, present on a chronic, lower-grade basis. Experiencing one or more of these symptoms does not necessarily mean that a person has this condition. Diagnosis requires an appropriate clinical evaluation.
Causes and Risk Factors
The exact cause is not fully understood. Genetic factors, brain chemistry, and chronic stress or early adversity are each associated with risk.
Diagnosis
A diagnosis should be made by a qualified healthcare professional following a comprehensive clinical assessment. Clinicians may use established diagnostic frameworks such as DSM-5-TR and/or ICD-11 as part of a comprehensive assessment.
Treatment
Treatment depends on the individual’s symptoms, clinical history, severity, age, co-occurring conditions, and other relevant factors.
Psychotherapy
Cognitive behavioral therapy and other evidence-based psychotherapies have evidence supporting their use for chronic depressive symptoms.
Medication
Antidepressant medications are commonly used and FDA-approved options exist, often more effective when combined with psychotherapy. Medication decisions should be made with a qualified prescribing healthcare professional. Do not start, stop, or change a prescribed medication based solely on information on this page.
Living With Persistent Depressive Disorder
Because symptoms are long-standing, they may be mistaken for personality traits; regular treatment engagement is important.
When to Seek Professional Help
Professional evaluation may be appropriate if symptoms persist, worsen, cause significant distress, or interfere with work, school, or relationships.
Emergency Situations
If a person may be in immediate danger, is experiencing a medical or psychiatric emergency, or may harm themselves or another person, seek immediate assistance through appropriate local emergency services.
Outlook
Many individuals experience significant improvement with sustained combined treatment, though the chronic nature may require ongoing management.
Related Conditions
Medical Information Disclaimer
Ratel Health provides general educational information and does not provide medical diagnosis, treatment, or individualized medical advice. Information on this page is not a substitute for evaluation or care from a qualified healthcare professional. Do not use this information to diagnose yourself or another person, or to start, stop, or change treatment or medication without consulting an appropriately qualified healthcare professional.
References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
- National Institute of Mental Health.
- U.S. Food and Drug Administration.
- World Health Organization. International Classification of Diseases, 11th Revision.