What is persistent depressive disorder (PDD)?

Most people know what it’s like to feel sad, down, and “off” from time to time. But persistent depressive disorder (PDD) is different. PDD is a type of depression that is continuous and lasts for years, hence its name.

Around 2.5% of U.S. adults experience this condition in their lifetime. PDD doesn’t just affect adults, though; kids can experience it too. In fact, PDD can begin during childhood.  

Symptoms of persistent depressive disorder

Persistent depressive disorder is different from other types of depression like clinical depression, also known as major depressive disorder. PDD is characterized by mild to moderate chronic depression that affects adults most days for two years or more. It may be less severe than major depression, but it lasts longer. Many people with PDD say they’ve been depressed for as long as they can remember, or they feel they are going in and out of depression all the time.

With children and teens, a sad or depressed mood lasting for at least one year can be considered PDD. Clinical depression, on the other hand, occurs when someone experiences a low or depressed mood for at least two weeks. It’s not as long lasting as PDD. 

While you won’t necessarily experience PDD for the entirety of two years or more, episodes will come and go throughout this period. You might find that, during PDD episodes, you don’t feel joy from activities that you used to enjoy,  like catching up with your friends or playing basketball. You might not have the motivation to get work and other things done. PDD can also affect your sleep, eating habits, and self-esteem.  

Causes of persistent depressive disorder

When you have PDD, you might be desperate to understand why it’s happening. While scientists don’t have a complete grasp on what causes PDD, they think it could be related to low serotonin levels. Serotonin helps regulate moods, and when people don’t have a lot of this chemical messenger, they can feel depressed.

Traumatic life events — like a breakup, the death of a loved one, losing a job, or being the witness to or victim of a crime — might also cause PDD. Women are also more likely to experience PDD, along with depression generally. Though it’s likely that more men have this condition than is reported, given men are less likely to talk about their mental health.   

Family history can also play a role. If you have a close blood relative, like a parent or sibling, who has major depressive disorder or another type of depressive disorder, you might be more at risk of PDD. Other mental health conditions may also increase the likelihood of developing PDD. 

Does persistent depressive disorder ever go away?

Experiencing bouts of depression for years can impact everything from your relationships to work to social life. This can make everyday life feel difficult and sometimes even unbearable. Depressive symptoms may wax and wane but never fully resolve. Professional support can help reduce symptoms and show improved overall care. There are medications to help with depression too, but it’s important to work with your provider to determine if that’s the right option for you. 

Beyond depression, your general health may suffer because you have PDD. This is because people with depression are more vulnerable to develop chronic diseases like heart disease, diabetes, stroke, osteoporosis, and Alzheimer’s disease. It’s also important to keep in mind that suicidal thoughts and behavior* are more likely in people with PDD.  

*A note on safety: If you’re having thoughts of harming yourself, don’t hesitate to ask for help. Dial 988 from any phone to contact the National Suicide and Crisis Lifeline. Their counselors will provide confidential support and resources to help keep you safe.

Self-care strategies for managing persistent depressive disorder

The impacts of PDD can feel inescapable and like a defining feature of what would otherwise be joyful and productive years of your life. But there are some things you can do to lessen PDD’s grip on you. Because depression can lessen your self-worth and exhaust you, it can be helpful to integrate habits that fight back against these feelings. 

Some things worth considering include:

• Regular exercise
• Healthy diet
• Strong and supportive network of people that contribute to a positive sense of self 
• Attainable goal setting for yourself
• Environments that create a strong sense of belonging with your community
• Avoidance of substances like alcohol and drugs

Treatment options for persistent depressive disorder 

If you’ve tried coping strategies and have found they’re just not enough, it may be time to contact a qualified healthcare provider to look into treatment options. 

There are many medications to treat depression, but keep in mind that it usually takes around 4 to 6 weeks for antidepressants to work fully. While it’s certainly understandable that you’d want a quick fix with something as challenging as depression, continue to take the medication as prescribed during this period. Work with a psychiatric practitioner to determine if medication is the right option for you and your circumstances. 

Therapy is also another option. Cognitive behavioral therapy can help change unhelpful thoughts and thought patterns. In essence, this type of therapy helps you to rewire your brain so it can transform harmful thoughts. For example, you might think you’ll never get better or that you’re a failure because you’re not as productive as your colleagues. You may not realize that these thoughts are even there because they’re so normal to you.

Find care with Rula

If you have PDD, you might not have enough energy to seek out treatment options. But know that there is support available and life can get better, even with a diagnosis as challenging as PDD. 

At Rula, our diverse network of therapists and psychiatrists can help you take the first steps to feel better. You can book an appointment as soon as this week.

Find a therapist with Rula