Site Map

Persistent depressive disorder

PDD; Chronic depression; Depression - chronic; Dysthymia

Persistent depressive disorder (PDD) is a chronic (ongoing) type of depression in which a person's moods are regularly low.

Persistent depressive disorder used to be called dysthymia.

Causes

The exact cause of PDD is unknown. It can 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 may have difficulty caring for themselves, struggle with isolation, or have medical illnesses.

Symptoms

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.

Exams and Tests

Your health care provider will take a history of your mood and other mental health symptoms. The provider may also check your blood and urine to rule out medical causes of depression.

Treatment

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 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 provider first.

When it's time to stop your medicine, your provider 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. It can also help to understand how your PDD has affected your life and to cope more effectively. 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.

Outlook (Prognosis)

PDD is a chronic condition that can last for years. Many people recover fully while others continue to have some symptoms, even with treatment.

PDD also increases the risk of suicide.

When to Contact a Medical Professional

Call for an appointment with your provider if:

Call for help right away if you or someone you know develops signs of suicide risk:

Related Information

Chronic
Depression

References

American Psychiatric Association. Persistent depressive disorder (dysthymia). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing, 2013;168-171.

Fava M, Østergaard SD, Cassano P. Mood disorders: depressive disorders (major depressive disorder). In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 29.

Schramm E, Klein DN, Elsaesser M, Furukawa TA, Domschke K. Review of dysthymia and persistent depressive disorder: history, correlates, and clinical implications. Lancet Psychiatry. 2020;7(9):801-812. PMID: 32828168 pubmed.ncbi.nlm.nih.gov/32828168/.

BACK TO TOP

Review Date: 9/7/2020  

Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

ADAM Quality Logo

A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complies with the HONcode standard for trustworthy health information: verify here.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2021 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.