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Persistent Depressive Disorder (PDD)

If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others.

OVERVIEW

What is persistent depressive disorder?

Persistent depressive disorder (PDD, formerly known as dysthymia, or Dysthymic Disorder) is chronic depression that lasts a long time.  A person’s moods are generally affected for at least 2 years (1 year for children and adolescents). Some people suffer from PDD for many years. Their depression is usually mild or moderate, rather than severe. Most people who have PDD can’t tell for sure when they first became depressed.

PDD is a common type of depression. It can begin in childhood or in adulthood. No one knows why. It appears to be more common in women.

Symptoms

The main symptom of PDD is a sad, low, or dark mood on most days. This lasts for at least 2 years. Children and teens with PDD can feel irritable instead of depressed. Their symptoms last for at least 1 year.

Other symptoms that happen much of the time include:

  • poor appetite or overeating
  • difficulty sleeping or sleeping too much
  • low self-esteem
  • poor concentration
  • low energy
  • fatigue
  • feelings of hopelessness.

Most, people who have PDD may have periods of normal mood that can last up to 2 months. Family members and friends may not even know that their loved one is depressed. This type of depression is mild, but it may be difficult for a person to function at home, school, or work.

CAUSES & RISK FACTORS

What causes PDD?

No one knows for sure what causes PDD. It may be related to some changes in the brain that involve a chemical called serotonin (say: seer-uh-tone-in). Serotonin helps your brain handle emotions and make judgments. Other medical problems and ongoing life stress may also play a role.

You may be at higher risk of developing PDD if you are a woman. It also tends to run in families. If a family member has it or another type of depression, you could be more likely to get it.

DIAGNOSIS & TESTS

How is PDD diagnosed?

If you think you have PDD, discuss your concerns with your healthcare provider. Your healthcare provider will ask you questions to find out if you have depression and what type you have. Your healthcare provider may ask you questions about your health and your symptoms. This may include how well you’re sleeping, if you feel tired a lot, and if you have trouble concentrating. Your healthcare provider will also consider medical reasons that may cause you to feel depressed.  These could be problems with your thyroid or a certain medicine you may be taking.  Your healthcare provider might order blood or urine tests to check for these or other causes.

PREVENTION

Can PDD be prevented or avoided?

In general, PDD and other forms of depression are conditions that cannot be prevented. There are lifestyle changes you can make that can boost your mood and minimize symptoms, including:

  • Get enough sleep.
  • Follow a healthy diet.
  • Reduce or avoid your alcohol consumption.
  • Do not take illegal drugs.
  • Take medicines as prescribed by your doctor.
  • Watch for changes in your PDD. Talk to your doctor about changes.
  • Engage in activities that bring you enjoyment.
  • Talk to someone you trust about how you feel.
  • Be around people who are positive and uplifting.

TREATMENT

What is the treatment for PDD?

PDD can be treated with an antidepressant medicine. This type of drug helps relieve depression. Antidepressants don’t cause people to feel “high,” and they are not habit-forming.

It may take a number of weeks, or even several months, before you and your healthcare provider know whether an antidepressant is helping you. It is important for you to take the medicine exactly as your healthcare provider tells you. If the antidepressant helps you feel better, you may need to take this medicine for several years. You should continue to take the medicine, even if you begin to feel better. Never stop the medicine without first discussing it with your healthcare provider.

Sometimes there are side effects from stopping antidepressant medicine suddenly. If you want to stop taking your medicine, contact your healthcare provider first.

Should I see a counselor too?

Some patients find that counseling can help them deal with specific problems. It’s a safe place where you can talk about your thoughts and feelings. Many doctors believe that combining talk therapy with medicine is the most effective way to treat PDD and other types of depression.

 Living with PDDPDD is a chronic condition. It can last for many years. If you have PDD, there are things you can do to help yourself feel better. Talk to your healthcare provider about how you’re feeling. Get treatment for your PDD. It may help to find activities that make you feel good or help you feel a sense of accomplishment.

  • Go to a movie.
  • Take a drive on a pleasant day.
  • Go to a ball game.
  • Work in the garden.
  • Do something nice for someone else.
  • Complications

People with PDD sometimes experience episodes of major depression. This can make them think about suicide. If you have thoughts about hurting yourself or others, tell someone right away.

This handout provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, contact your family healthcare provider.

Copyright (c) by the American Academy of Family Physicians

Permission is granted to print and photocopy this material for non-profit educational uses.

Written permission is required for all other uses, including electronic uses.

Nova Scotia Telecare, Reviewed by Clinical Services Working Group, February 2025

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