Persistent depression disorder formerly referred to as dysthymic disorder differs from major depressive disorder in that the symptoms usually wax and wane over the years. In other words, it is a form of chronic depression but with symptoms that range in severity overtime from nonexistent to severe. To diagnosis persistent depressive disorder, adults must exhibit a depressed mood for the majority of the day for at least two years whereas children must exhibit these symptoms for at least one year.

Signs and symptoms of persistent depression disorder

Persistent depression disorder symptoms usually come and go for years, and their intensity can change over time; however, symptoms typically do not disappear for more than two months at a time. Also, major depression episodes may occur before or during persistent depressive disorder, often called double depression.

Symptoms of persistent depressive disorder can cause significant impairment in daily functioning and may include:

  • Loss of interest in daily activities
  • Sadness, emptiness or feeling down
  • Hopelessness
  • Tiredness and lack of energy
  • Low self-esteem, self-criticism or feeling incapable
  • Trouble concentrating and trouble to make decisions
  • Irritability or excessive anger
  • Decreased activity, effectiveness, and productivity
  • Avoidance of social activities
  • Feelings of guilt and worries over the past
  • Poor appetite or overeating
  • Sleep problems

Causes and risk factors of persistent depression disorder

The persistent depressive disorder often begins early in childhood, the teen years or young adult life and is chronic. Certain factors appear to increase the risk of developing or triggering the persistent depressive disorder, including:

  • Having a first-degree relative with major depressive disorder or other depressive disorders
  • Traumatic or stressful life events, such as the loss of a loved one or financial problems
  • Personality traits that include negativity, such as low self-esteem and being too dependent, self-critical or pessimistic
  • History of other mental health disorders, such as a personality disorder

Living with persistent depression disorder

While individuals with major depressive disorder will typically “cycle” through episodes of feeling severely depressed and then be symptom-free for periods, dysthymia presents with persistent symptoms for years. This disorder can be difficult to diagnose because its less severe and lingering nature can make the condition feel “normal” for that individual.

Seeking treatment for persistent depression disorder

A persistent depressive disorder is similar to major depression in the sense that treatment encompasses both medication and psychotherapy. Antidepressants, more specifically selective serotonin reuptake inhibitors, are the first-line medications used to treat the persistent depressive disorder. Selective serotonin reuptake inhibitors commonly referred to as SSRIs block the reuptake of serotonin, therefore increasing the amount in the brain. Serotonin is a neurotransmitter that is known to regulate and elevate the mood. Psychotherapy such as cognitive behavioral therapy, interpersonal therapy, and dialectical behavioral therapy are used in combination with SSRIs to teach clients appropriate coping skills to handle the underlying triggers associated with their depression. Although SSRIs may treat the symptoms, most individuals have some underlying cause for their depression such as past trauma, low self-esteem, or a co-occurring disorder, which can be overcome with the correct psychotherapy approaches. SSRIs usually take on average, four to six weeks, to have an effect and during this time clients are at an increased risk of unwanted side effects including headaches, nausea, loss of appetite, decreased sex drive, irritability, and suicidal ideations. Clients should be aware of these side effects and have an open line of communication with their healthcare provider if they are experiencing any of these side effects. Often, medications regimens must be changed to find the most appropriate dosage and medication that works for each particular client.