This type of depression may cause you to feel sad and empty and to lose interest in life. You may feel like a failure. These feelings may last years.
Persistent depressive disorder is a continuous, long-term form of depression. You may feel sad and empty, lose interest in daily activities and have trouble getting things done. You may also have low self-esteem, feel like a failure and feel hopeless. These feelings last for years and may interfere with your relationships, school, work and daily activities.
If you have persistent depressive disorder, you may find it hard to be upbeat even on happy occasions. You may be described as having a gloomy personality, constantly complaining or not able to have fun. Persistent depressive disorder is not as severe as major depression, but your current depressed mood may be mild, moderate or severe.
Because persistent depressive disorder is long term, coping with depression symptoms can be challenging. A combination of talk therapy and medicine can be effective in treating this condition.
Persistent depressive disorder symptoms usually come and go over a period of years. The intensity of symptoms can change over time. But symptoms usually don't disappear for more than two months at a time. Also, major depression episodes may occur before or during persistent depressive disorder.
Symptoms of persistent depressive disorder can cause major problems in your life and may include:
In children, symptoms of persistent depressive disorder may include depressed mood and being irritable, which means easily becoming annoyed, impatient or angry.
If these feelings have been going on for a long time, you may think they'll always be part of your life. But if you have any symptoms of persistent depressive disorder, seek medical help.
Talk to your health care provider about your symptoms or seek help from a mental health professional. Or you can reach out to someone else who may be able to help guide you to treatment. This could be a friend or loved one, a teacher, a faith leader, or another person you trust.
If you think you may hurt yourself or attempt suicide, call 911 in the U.S. or your local emergency number immediately. Or contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential. The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 888-628-9454 (toll-free).
The exact cause of persistent depressive disorder is not known. As with major depression, it may involve more than one cause, such as:
Persistent depressive disorder often begins early — in childhood, the teen years or young adult life — and continues for a long time. Certain factors appear to increase the risk of developing persistent depressive disorder, including:
Conditions that may be linked with persistent depressive disorder include:
There's no sure way to prevent persistent depressive disorder. Because it often starts in childhood or during the teenage years, identifying children at risk of the condition may help them get early treatment.
Strategies that may help reduce or prevent symptoms include the following:
If your health care provider thinks that you may have persistent depressive disorder, exams and tests may include:
For a diagnosis of persistent depressive disorder, the main indication for an adult differs somewhat from that of a child:
Symptoms caused by persistent depressive disorder can vary from person to person. When persistent depressive disorder starts before age 21, it's called early onset. If it starts at age 21 or older, it's called late onset.
The two main treatments for persistent depressive disorder are medicines and talk therapy. What your health care provider recommends depends on factors such as:
Talk therapy may be the first option suggested for children and teenagers with persistent depressive disorder, but that depends on the individual. Sometimes antidepressants also are needed.
The types of antidepressants most commonly used to treat persistent depressive disorder include:
Talk with your health care provider or pharmacist about possible side effects.
You may need to try several medicines or a combination before you find one that works. This requires patience. Some medicines take several weeks or longer for full effect. It can also take this long for side effects to ease as your body adjusts.
Don't stop taking an antidepressant without talking to your health care provider. When it's time, your provider can help you gradually and safely decrease your dose. Stopping treatment suddenly or missing several doses may cause withdrawal-like symptoms. And quitting a medicine suddenly may cause depression to quickly get worse.
When you have persistent depressive disorder, you may need to take antidepressants long term to keep symptoms under control.
If you're pregnant or breastfeeding, some antidepressants may pose an increased health risk to your unborn baby or nursing child. Talk to your health care provider if you become pregnant or are planning on becoming pregnant.
Antidepressants are generally safe when taken as directed. But the U.S. Food and Drug Administration (FDA) requires all antidepressants to carry a warning: In some cases, children, teens and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants. This may be more of a risk in the first few weeks after starting or when the dose is changed. So watch closely for worsening depression or unusual behavior during these times.
If your teen or young adult has suicidal thoughts while taking an antidepressant, immediately contact a health care provider or mental health provider or get emergency help. Keep in mind that antidepressants are more likely to reduce suicide risk in the long term by improving mood.
Talk therapy, also called psychotherapy, is a general term for treating depression by talking with a mental health provider about your thoughts, feelings, behavior, relationships and related issues.
Different types of psychotherapy, such as cognitive behavioral therapy, can be effective for persistent depressive disorder. You and your therapist can discuss your goals for therapy and other issues, such as the length of treatment.
Talk therapy can help you:
Persistent depressive disorder generally is not a condition that you can treat on your own. But along with professional treatment, these self-care steps can help:
Make sure you understand the risks as well as the possible benefits if you decide to use alternative or complementary therapy. Avoid replacing conventional medical treatment or talk therapy with alternative medicine. When it comes to depression, alternative treatments are not a substitute for medical care.
For example, the herbal supplement called St. John's wort is not approved by the FDA to treat depression in the U.S., though it's available. It may help improve mild or moderate depression, but the overall evidence is not conclusive.
St. John's wort can interfere with a number of medicines, including blood-thinning drugs, birth control pills, chemotherapy, HIV/AIDS medicines and drugs to prevent organ rejection after a transplant. Also, avoid taking St. John's wort while taking antidepressants because the combination can cause serious side effects.
Unlike medicines, dietary supplements aren't approved and monitored by the FDA. You can't always be certain of what you're getting and whether it's safe. Some herbal and other dietary supplements can interfere with prescription medicines or cause dangerous interactions. Talk to your health care provider before taking any supplements.
Persistent depressive disorder makes it hard to engage in behavior and activities that can help you feel better. In addition to the treatments recommended by your doctor or therapist, consider these tips:
You may decide to schedule an appointment with your primary health care provider to talk about your concerns. Or you may decide to see a mental health provider, such as a psychiatrist or psychologist, for evaluation.
You may choose to take a family member or friend along to help you remember something that you missed or forgot.
Prepare for your appointment by making a list of:
Basic questions to ask may include:
Don't hesitate to ask other questions during your appointment.
Your provider may ask you several questions, such as:
Your health care provider or mental health provider will ask more questions based on your responses, symptoms and needs. Prepare and anticipate questions to make the most of your appointment time.