Chronic depression or persistent depressive disorder (PDD) is a long-term type of depression. Adult symptoms typically persist for at least 2 years. Treatment for PDD usually involves a combination of psychotherapy and medication.
This article discusses PDD in more detail, including its symptoms, causes, treatments, and diagnosis. The article also answers some of the most common questions about chronic depression.
PDD is the new Diagnostic and Statistical Manual of Mental Disorders, 5th edition text revision (DSM-5-TR) term for dysthymia or chronic depression. This type of depression lasts a minimum of 2 years but can usually last longer. It is the only depressive disorder where symptoms last this long.
Often, the onset of PDD occurs during childhood, adolescence, or early adulthood. It may be difficult for a person to detect PDD since its symptoms are less severe than major depressive disorder (MDD). Its persistent nature can also cause people to normalize symptoms.
Symptoms of PDD are similar to those of MDD,
- low energy
- appetite changes
- difficulties with concentration
- feelings of hopelessness
- sleep disturbances
However, people with MDD usually alternate between periods of severe depression and periods with no symptoms. A depressive episode is a change from a person’s usual outlook and daily routine to a low mood and accompanying symptoms of depression.
Conversely, people with PDD usually have ongoing symptoms that persist for at least 2 years. Though these symptoms may be less severe than MDD symptoms, they can significantly affect a person’s mindset and overall well-being. They may cause a significant change in how a person views the world.
Symptoms of PDD are similar to other types of depression, though they last longer and tend to be less severe.
In addition to a depressed mood for
- sleep issues
- self-esteem issues
- lack of concentration
- feeling hopeless
- decreased appetite or overeating
It is also possible for a person to experience symptoms of PDD and MDD simultaneously.
Researchers are still learning more about the causes of PDD, which
- gamma-aminobutyric acid
Researchers have also discovered areas of the brain showing a significant loss in volume in people with PDD. These include the frontal areas of the brain, principally the anterior cingulate and the orbitofrontal cortex, and the hippocampus.
Additional risk factors for PDD include:
- genetics and epigenetics
- previous mental disorders
- high anxiety states
- psychological health
- life stressors
- social determinants of health
To help treat and manage PDD, a person can
Individual treatment plans will vary depending on the causes of depression, the severity of symptoms, and how many symptoms are present.
Interpersonal therapy and cognitive behavioral therapy (CBT) are common psychotherapy types for PDD.
In the near future, doctors
Usually, the first-line antidepressant medications are selective serotonin reuptake inhibitors (SSRIs) due to their effectiveness and tolerability. Atypical antidepressants and serotonin-norepinephrine reuptake inhibitors (SNRIs) may also be effective.
Learn more about the differences between SSRIs and SNRIs here.
For a doctor to diagnose PDD in adults, a person must have a depressed mood for
Along with a depressed or irritable mood, a person must have at least two of the following symptoms:
- decreased appetite or overeating
- insomnia or oversleeping
- lack of energy or fatigue
- low self-esteem
- difficulty concentrating and making decisions
A doctor may also rule out medical and organic causes. They may screen for additional DSM-5-TR diagnoses such as:
- bipolar disorder
- psychotic disorders
- substance-induced states
- personality disorders
Below are some of the most common questions and answers about chronic depression.
What are the different types of depression?
- seasonal affective disorder (SAD)
- postpartum depression
- depression with symptoms of psychosis
People with bipolar disorder also experience depressive episodes.
Can MRI detect depression?
Healthcare professionals do not use MRI scans
Researchers often use MRI scans to learn more about depression in scientific studies. However, these scans cannot help doctors diagnose depression.
Can a blood test detect depression?
However, research into chemicals in the bloodstream and depression is ongoing.
PDD or chronic depression is a depressive disorder that lasts at least 2 years. People with PDD have ongoing symptoms that are usually milder in severity than MDD. Treatment and management of PDD typically involve a combination of psychotherapy and medications.
A person should speak with a healthcare professional if they are experiencing symptoms of PDD. Healthcare professionals can accurately diagnose mental health conditions and recommend suitable treatments.