Persistent depressive disorder (formerly known as dysthymia) is a continuous long-term, chronic state of low-level depressed mood. The depressed state of persistent depressive disorder is not as severe as with major depression, but can be just as disabling.

Symptoms of Persistent Depressive Disorder

Symptoms of persistent depressive disorder include

  • low self-esteem or self-confidence, or feelings of inadequacy;
  • feelings of pessimism, despair or hopelessness;
  • generalized loss of interest or pleasure;
  • social withdrawal;
  • chronic fatigue or tiredness;
  • feelings of guilt or ruminating about the past;
  • subjective feelings of irritability or excessive anger;
  • decreased activity, effectiveness or productivity; and
  • difficulty in thinking: poor memory, poor concentration or indecisiveness.

Persistent depressive disorder is diagnosed when these symptoms last for more than two years in adults (or one year in children) and a person has not been symptom-free for more than two months at a time.

People with persistent depressive disorder may be unaware that they have a health condition. They might be able to go to work and manage their lives to some degree. However, they may be irritable, stressed, or sleepless much of the time. Many people with persistent depressive disorder believe their symptoms are just part of their personality. It may be more difficult for them to seek treatment.

About 3-6% of the population has persistent depressive disorder. People with persistent depressive disorder often have their first symptoms earlier in life than those with major depressive disorder or bipolar disorder.

Some people have persistent depressive disorder along with periodic episodes of major depression. Martin B. Keller, M.D coined the term “double depression” to describe this.

How is persistent depressive disorder different from depression?

Symptoms of depression and persistent depressive disorder overlap, but symptoms such as weight change or sleep disturbance are less likely to be found in people with persistent depressive disorder. These symptoms are more prevalent in people with chronic major depression. Other symptoms which are more psychological in nature such as feelings of hopelessness, helplessness, and worthlessness are common to people with both persistent depressive disorder and chronic major depression.

Looking at family history may help with diagnosis. Another recent report suggested that the family histories of people with persistent depressive disorder and chronic major depression were more similar to each other than to the family histories of people with an acute episode of major depression.

Treatments and therapies that are effective for treating depression, such as medication, psychotherapy, and peer support can also work for people with persistent depressive disorder. As with depression, people with persistent depressive disorder may need to try more than one treatment or medication, and it may take several weeks for medication to work. During this time, it is important to seek support from friends, family, and a DBSA support group. People in DBSA support groups have “been there” and can offer support, understanding, inspiration and hope.