Persistent depressive disorder is a chronic (ongoing) type of depression in which a person's moods are regularly low. But, symptoms are not as severe as with major depression.
Persistent depressive disorder used to be called dysthymia.
The exact cause of persistent depressive disorder (PDD) is unknown. It tends to run in families. PDD occurs more often in women.
Most people with PDD will also have an episode of major depression at some point in their lives.
Older people with PDD often have difficulty caring for themselves, isolation, or medical illness.
The main symptom of PDD is a low, dark, or sad mood on most days for at least 2 years. In children and teens, the mood can be irritable instead of depressed and lasts for at least 1 year.
In addition, two or more of the following symptoms are present almost all of the time:
People with PDD will often take a negative or discouraging view of themselves, their future, other people, and life events. Problems often seem hard to solve.
Your health care provider will take a history of your mood and other mental health symptoms. The health care provider may also check your blood and urine to rule out medical causes of depression.
There are a number of things you can try to improve PDD:
Medicines are often effective for PDD, though they sometimes do not work as well as they do for major depression and they may take longer to work.
Do not stop taking your medicine on your own, even if you feel better or have side effects. Always call your doctor first.
When it is time to stop your medicine, your doctor will instruct you on how to slowly reduce the dose instead of stopping suddenly.
People with PDD may also be helped by some type of talk therapy. Talk therapy is a good place to talk about feelings and thoughts, and to learn ways to deal with them. Types of talk therapy include:
Joining a support group for people who are having problems like yours can also help. Ask your therapist or health care provider to recommend a group.
PDD is a chronic condition that can last for years. Though many people completely recover, others continue to have some symptoms, even with treatment.
PDD also increases the risk of suicide.
Call for an appointment with your health care provider if:
Call for help right away if you or someone you know develops signs of suicide risk:
PDD; Chronic depression; Depression - chronic
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing, 2013.
Fava M, Cassano P. Mood disorders: major depressive disorder and dysthymic disorder. In: Stern TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Mosby Elsevier; 2008:chap 29.
Updated by: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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