Patient education: Persistent depressive disorder (The Basics)

What is persistent depressive disorder? — 

Persistent depressive disorder, or "PDD," is a type of depression that lasts for longer than 2 years. It used to be called "dysthymia."

What are the symptoms of PDD? — 

People with PDD have low mood and feel sad or down most of the day, on most days. In addition, they have at least 2 of the following:

●Decreased or increased appetite

●Sleeping too much or too little

●Feeling tired or having low energy

●Low self-esteem

●Impaired concentration or decision-making

●Trouble with concentration or memory

●Feeling hopeless

The symptoms of PDD might be less severe than those of "major depressive disorder." But they last a long time and cause distress or problems with relationships, work, and school.

A person can also have both major depression and PDD at the same time. This is sometimes called "double depression."

How is PDD diagnosed? — 

In adults, doctors diagnose PDD when the above symptoms last for 2 years or longer. A person might have periods of time without symptoms, but these do not last longer than 2 months.

To help figure out if you have PDD, your doctor or nurse will ask you questions. These include questions about your symptoms, how long you have had them, and how they affect your life. They will also do a physical exam, and might order tests.

Get help right away if you are thinking of hurting or killing yourself! — 

If you ever feel like you might hurt yourself or someone else, help is available:

●In the US and Canada, contact the 988 Suicide & Crisis Lifeline:

•To speak to someone, call or text 988.

•To talk to someone online, go to chat.988lifeline.org.

●Call your doctor or nurse, and tell them it is urgent.

●Call for an ambulance (in the US and Canada, call 9-1-1).

●Go to the emergency department at the nearest hospital.

How is PDD treated? — 

Your doctor or nurse will work with you to make a treatment plan. PDD is usually treated with:

●Medicines – Different medicines can be used to relieve depression.

●Psychotherapy – This involves talking to a therapist about your feelings, thoughts, and behavior.

Most people get treatment with both of these. This usually works better for PDD than either one alone.

Some people need to try different treatments or combinations of treatments before they find an approach that works.

What can I do on my own? — 

It's important to follow your treatment plan carefully. Take your medicines exactly as instructed, and go to all your doctor's appointments and therapy sessions.

You should also:

●Avoid alcohol and recreational drugs.

●Try to get regular physical activity or exercise. Even gentle forms of activity, like walking, are good for your health.

●Speak with trusted family or friends about your depression and how they can help.

●Try to get at least 8 hours of sleep every night. If you have trouble sleeping, you can do things to improve your sleep habits. For example, you should:

•Avoid alcohol and caffeine in the late afternoon or evening.

•Try to go to bed and wake up at the same time every day.

•Limit naps during the day, and don't nap for more than 30 minutes at a time.

●Find healthy ways to manage stress, like talking to others or hobbies you enjoy. Relaxation exercises, meditation, and activities like yoga or tai chi can help you manage stress.

●Try to eat a healthy diet that includes plenty of fruits, vegetables, whole grains, and low-fat dairy products. This can help improve your overall health.

More on this topic

Patient education: Depression in adults (The Basics)
Patient education: Screening for depression in adults (The Basics)
Patient education: Commonly used medicines for depression (The Basics)
Patient education: Exercise and other activities to help with depression (The Basics)
Patient education: When you have depression and another health problem (The Basics)
Patient education: Psychotherapy (The Basics)

Patient education: Depression in adults (Beyond the Basics)
Patient education: Depression treatment options for adults (Beyond the Basics)