Persistent Depressive Disorder: An Overview

Depressed people often feel disconnected from others because they're not able to express their feelings or be themselves around other people. They may feel isolated and lonely even when surrounded by friends or family members who love them deeply.

What is Persistent Depressive Disorder?

Persistent depressive disorder formally known as dysthymia is a chronic form of depression in which a person loses interest in normal day-to-day activities. Such people have low self-esteem, lacks productivity and energy, increased eating habit, and changes in sleeping patterns with various physical symptoms and hopelessness. This feeling lasts longer than a year and interferes with other areas of an individual's life. Persistent depressive disorder can affect one's relationships, abilities at work and school, and overall quality of life.

A common symptom of persistent depressive disorder is low self-esteem (feeling like an undesirable person), which makes it difficult for those with this condition to form healthy relationships with others. This can lead to marital difficulties because one partner may feel threatened by the other's depression or withdraw from their spouse due to fear of being rejected. A lack of motivation associated with depression often causes a person's performance at work or school to deteriorate over time. This disorder manifests mainly in mood irritability, dysphoria, and anxiety symptoms. Persistent depressive disorder is a complex mood disorder. The exact cause of the persistent depressive disorder isn't known.

It is likely to be a combination of genetics, biology, and the environmental factors. And it's possible that while certain people are born with genetic predispositions or other inherited flaws that make them more susceptible to developing depression, others may experience different symptoms depending on their environment or circumstances.

The stigma surrounding people who are diagnosed with PDD may have three components: knowledge barriers (ignorance or false information), attitude problems (prejudice), and behavior problems (discrimination). They are stigmatized not only by others but by themselves as well, because they may feel ashamed of their condition and fear that others will see them as weak or lacking in willpower. This makes it harder for them to seek help from professionals or family members, which can be crucial to getting better. Bullying and discrimination are a reality for people with persistent depressive disorder, whether they are at school, at work, or home. People with it may also be misunderstood by close members who don't know how to respond to their symptoms. Individuals may even feel like they're being blamed for the condition, which can lead to isolation.


Persistent depressive disorder (PDD) is a condition that is sometimes difficult to be diagnosed because it shares many symptoms with major depression but its severity is milder than major depression. The symptoms are present for such a long period that the individual begins to believe that these symptoms are simply a part of their personality. It’s being who they are and not a result of a condition such as PDD, whereas some attribute these symptoms to a feeling of being stuck in one phase of life rather than a serious mental health condition. For a diagnosis of persistent depressive disorder:

  • For an adult, a depressed mood occurs most of the day for two or more years.
  • For a child, depressive episode or irritability occurs most of the time for at least one whole year.

A mental health professional usually makes the diagnosis based on the individual's symptoms, which would have lasted for a long period and is less severe than those with major depressive disorder. Physical conditions such as hypothyroidism are also looked at to rule out other possibilities.


Symptoms caused by persistent depressive disorder can vary from person to person. When persistent depressive disorder starts before age 21, it's called early-onset; if it starts at age 21 or later, it's called late onset.

Depressive symptoms include :

  • Sadness, worthlessness, or an emptiness.
  • Having low self-esteem or being conscious of one's own unpleasant sentiments or ideas.
  • Reduced interest in rewarding activities and loss of pleasure from formerly pleasurable activities (e.g. hobbies).
  • The symptoms can be so intense that the individual appears to have lost interest in life as it was.

Conditions that are linked with persistent depressive disorders which can result in complications are :

  • Major depression with other disorders or anxiety disorder.
  • Hard time managing personal relationships and family conflicts.
  • Personality disorders.
  • Substance abuse.
  • Reduced quality of life.
  • General medical illness or chronic pain.
  • Thoughts of dying.


Medication and psychotherapy (talk therapy) are the two basic therapies for persistent depressive disorder. The treatment strategy is determined by several factors :


The following antidepressants are the most typically used to treat persistent depressive disorder:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Tricyclic antidepressants (TCAs)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs)


Cognitive behavioral therapy (CBT) and interpersonal therapy are two treatments that are frequently employed (IPT).

Ways to cope when living with persistent depressive disorder

Persistent depressive disorder is a chronic condition that can be hard to live with. It's not just sadness or low energy, but a deep and pervasive feeling of sadness or loss of interest in activities that used to bring joy. Living with dysthymia isn't easy, but there are things one can do to cope with one's symptoms and get the most out of life :

  • Self-care : when feeling down, taking good care of oneself by eating well and on time, getting enough sleep, pursuing hobbies that one has, etc.
  • Having support : keeping in touch with friends and family is critical for recovery from any mental illness. Talking about one's symptoms and asking for help if needed should not be a second thought.
  • Lifestyle changes : physical exercise, participating in activities involved in an individual's social and personal lives, a healthy diet, and avoiding alcohol or other recreational drugs are beneficial in such cases.


Dysthymia refers to as mild chronic depression which is less severe and has fewer symptoms than major depressive disorder, an individual with dysthymia displays depressive symptoms for a long period often 2 years or longer where they also experience major depression along with PDD, which is sometimes terms as "double depression". It can cause significant problems in a person's life, interfering with both work and social activities. Feelings of sadness, anxiety, or hopelessness are all depressive symptoms. The illness can also impair thinking, memory, eating, and sleeping. A significant depressive illness (clinical depression) prognosis suggests that a person has felt sad, gloomy, or worthless on most days for at least two weeks, in addition to other symptoms such as insomnia, loss of interest in activities, or appetite changes. There is no one treatment course for PDD. However, most people with persistent depressive disorder respond well to antidepressant medication, psychotherapy, or a combination of the two.



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