Understanding and Managing Persistent Depressive Disorder
Persistent Depressive Disorder (PDD) causes chronic low mood and decreased enjoyment lasting two or more years, with symptoms milder than major depression but requiring specialized therapeutic intervention through evidence-based treatments like cognitive behavioral therapy to effectively manage ongoing symptoms and improve quality of life.
Ever feel like you're going through the motions of life but can't shake a persistent sense of heaviness? Persistent depressive disorder affects millions who maintain daily routines while privately struggling with long-term low mood – but you don't have to face this invisible battle alone.
In this Article
What Is Dysthymic Disorder, And How Do I Manage The Symptoms?
Depression is often portrayed in media as an inability to function daily—struggling to get out of bed or care for oneself. While these symptoms characterize major depressive disorder (MDD), some people experience a different type of depression that allows them to function but involves long-term, persistent low mood and difficulty finding enjoyment. This form of depression is known as persistent depressive disorder, previously called dysthymic disorder.
The Diagnostic and Statistical Manual of Mental Disorders describes various forms of depression, from major depression to psychotic depression and seasonal affective disorder. Dysthymic disorder is a subset depressive disorder with mild to moderate symptoms lasting two years or more. If you believe you might be living with persistent depressive disorder, understanding how to manage symptoms and find appropriate support can be beneficial.
What is dysthymic disorder?
According to the Diagnostic and Statistical Manual of Mental Disorders, persistent depressive disorder is characterized by a chronic form of mild to moderate depression that does not subside. People with dysthymic disorder may experience depressive symptoms like prolonged loss of interest in previously enjoyed activities, hopelessness, lack of energy, and low self-esteem. Dysthymic disorder, like other depressive disorders, can be associated with multiple comorbid conditions, including anxiety, substance use disorders, and others.
Recognizing persistent depressive disorder
Persistent depressive disorder (PDD) is a long-term mood disorder lasting approximately two years or longer with low-grade depressive symptoms. These depressive episodes may alternate with periods of average mood lasting no more than two months. Although symptoms of dysthymic disorder may not be as noticeable as those associated with major depressive disorder, they can still significantly impact an individual’s ability to lead a happy, healthy lifestyle.
PDD may be challenging to diagnose because the individual living with it may not immediately identify the symptoms as part of depression. However, persistent depressive disorder and major depressive disorder have several symptoms in common, including:
- A depressed mood experienced for most days in a week
- Changes in sleep patterns
- Changes in appetite or eating patterns
- Low energy and fatigue
- Difficulty concentrating
- Low self-esteem
- Feelings of hopelessness
- Physical aches and pains
- Substance use to cope
- Suicidal thoughts or urges
Some individuals living with persistent depressive disorder may also be diagnosed with other mental illnesses, including chronic major depressive disorder. However, unlike major depressive disorder, those who have dysthymic disorder may still feel pleasure and experience periods of respite from their symptoms.
How to manage persistent depressive disorder
As with other depressive disorders, the treatment of persistent depressive disorder may consist of talk therapy, medication, or a combination of the two. However, because persistent depressive disorder is known to have long-lasting symptoms, longer, more acute treatments may be required to help you better manage your symptoms.
Traditional treatment options are not the only way to help you cope with or prevent persistent depressive disorder symptoms. Below are a few lifestyle changes you can make throughout the course of your disorder to reduce symptom severity.
Diet and exercise
Exercising regularly and eating a more balanced diet may support your mental and physical health. Eating a balanced diet offers valuable nutrients that may balance mood, and exercise can release endorphins that increase your energy. Try to avoid substance use or processed foods, as they may negatively affect your body and brain’s chemical balance.
Research reports that exercise can relieve symptoms of depression and, in some cases, prevent it. Exercise produces brain chemicals that block the perception of pain and increase feelings of well-being.
Regular physical activity also provides additional benefits if done outside, as nature can improve mental health and allow you to receive vitamin D from the sun. If you are new to exercise or can’t exercise strenuously, a walk outside may decrease depressive symptoms.
Socializing and fun
Connect with those around you and engage in activities that make you happy. If you don’t feel up to socializing or partaking in previously enjoyed activities, try modifying them or breaking them down into steps. However, consider your limits. If you believe going out would make you feel worse, give yourself time. You might also talk to a licensed clinical social worker about these feelings to develop solutions for your unique circumstances.
Relieving lifestyle stress
The more stress you experience, the more you may experience adverse emotional and physical symptoms. Consider which areas of your lifestyle produce the most stress and how you can successfully reduce that stress.
For example, you might try cutting down on non-essential, stress-producing activities. Setting realistic goals you can reach without overexerting yourself can be worthwhile. Also, putting off major decisions that don’t need to be made immediately can be helpful, especially when you’re having difficulty making decisions. Although some stress can be healthy, excessive stress is not beneficial for your mental health.
Finding positives
For people with PDD, finding positives in daily life can be challenging. However, with support and practice, optimism and gratitude may increase. Try pointing out the positive aspects of life daily, reducing judgment of what those aspects are. For example, you might be thankful for how your hair smells or the growth of new flowers outside your apartment.
Building a support system
Being surrounded by trustworthy, supportive individuals who can act as your safety net when struggling with your mental health may be crucial to reducing depression. A support system can also involve pets, spiritual leaders, teachers, mentors, doctors, or therapists. For many, a licensed clinical social worker is one of the most effective ways to receive support during a depressive episode.
Beginning medication
According to the Diagnostic and Statistical Manual of Mental Disorders, there are various forms of depression, from major depressive disorder to chronic depression and persistent depressive disorder. Certain antidepressants like selective serotonin reuptake inhibitors are widely used in the treatment of depression. Selective serotonin reuptake inhibitors work by “inhibiting” serotonin reuptake in the brain. This means there is more serotonin available, which leads to improved mood. Selective serotonin reuptake inhibitors can relieve various symptoms such as a depressed mood, lack of motivation, and low self-esteem.
Important Note: ReachLink therapists are licensed clinical social workers who do NOT prescribe medications. If medication appears beneficial for your condition, your therapist will provide appropriate referrals to qualified medical professionals who can evaluate and prescribe medications as needed.
Talking to a therapist
Some people experience barriers to reaching out for therapeutic support, such as financial constraints, lack of transportation, or challenges with social interaction. Due to a demand for remote care, many online resources exist to help clients see a therapist from home. Through telehealth platforms like ReachLink, individuals can access video sessions with licensed clinical social workers and receive cost-effective treatment options. ReachLink’s subscription-based model provides ongoing support rather than one-off sessions, which is particularly valuable for chronic conditions like persistent depressive disorder.
Research published in the Journal of Affective Disorder examines the efficacy of iCBT (internet-based cognitive-behavioral therapy) used by over 6,000 Australians in managing symptoms of depression and anxiety during the pandemic. Participants reported a significant reduction in the severity of their anxiety and depression symptoms and decreased psychological stress.
Takeaway
Dysthymic disorder has been renamed persistent depressive disorder since the release of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders – 5). This statistical manual is referred to by healthcare professionals to assess and diagnose patients. However, no matter what term you use, this condition can be as difficult to cope with as other forms of depression. It can also be treated. Lifestyle changes, therapy, medication, or a combination approach can all be effective ways to experience symptom reduction.
If you’re looking for personalized support from a licensed clinical social worker who specializes in depression management, consider contacting ReachLink to get started with telehealth therapy services. Our evidence-based therapeutic approaches can help you develop strategies to manage persistent depressive disorder while providing the ongoing support needed for this chronic condition.
FAQ
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How is Persistent Depressive Disorder different from Major Depression?
Persistent Depressive Disorder (PDD) is characterized by a long-term, chronic pattern of low mood lasting two years or more, while major depression typically involves more severe but shorter episodes. With PDD, people can usually maintain daily functions but experience consistent difficulty finding joy or enthusiasm. Understanding this distinction helps in determining the most effective therapeutic approach.
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What types of therapy are most effective for treating Persistent Depressive Disorder?
Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) have shown significant effectiveness in treating Persistent Depressive Disorder. CBT helps identify and change negative thought patterns and behaviors, while IPT focuses on improving relationships and social support systems. Dialectical Behavior Therapy (DBT) may also be beneficial for developing emotional regulation skills and mindfulness practices.
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When should someone seek professional help for chronic low mood?
Consider seeking professional help if you've experienced persistent feelings of sadness, low self-worth, or decreased interest in activities for more than two months. Early intervention through therapy can prevent symptoms from becoming more severe and provide you with effective coping strategies. It's especially important to reach out if these feelings are affecting your relationships, work, or daily activities.
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What can I expect in therapy sessions for Persistent Depressive Disorder?
In therapy sessions, you'll work with a licensed therapist to explore the patterns of your depression, identify triggers, and develop practical coping strategies. Sessions typically involve setting achievable goals, learning mood-monitoring techniques, and developing skills for managing negative thoughts. Your therapist will create a personalized treatment plan that adapts to your progress and specific needs.
