What Causes Persistent Depressive Disorder?

December 4, 2020

Persistent depressive disorder can be a very frustrating form of depression for patients and their families. It is often milder, but much longer-lasting than other forms of depression. This can make it harder to diagnose in many cases. 

Here’s what you need to know about persistent depressive disorder.

What is Persistent Depressive Disorder?

Persistent depressive disorder is ongoing depression. Symptoms are sometimes less severe than other types of depression, but they are very long-lasting, which can be exhausting for the person experiencing it. Previously, persistent depressive disorder was known as two separate illnesses: chronic major depressive episode and dysthymic disorder. You will still hear it called both of those terms occasionally, both within and outside of the medical community.

Who Does Persistent Depressive Disorder Affect?

Persistent depressive disorder can begin at any age, from childhood into adulthood. When symptoms appear before 21 years of age, it is considered early-onset persistent depressive disorder. Symptoms that start after 21 are considered late-onset. It tends to be more common in women than in men.

What Causes Persistent Depressive Disorder?

There are a number of factors that contribute to persistent depressive disorder. The exact cause is not known. However, here are a few of the factors that might tend to result in persistent depressive disorder:

  • A parent with the disorder. Either parent can pass this depressive disorder to their children. People who have a parent with the disorder may be more likely to get it.
  • Exposure to chronic stress. Long lasting or severe stress can alter the chemical balance in the brain, making mood disorders like persistent depressive disorder more  likely.
  • Trauma. Loss, hardship, or trauma can trigger depressive symptoms like persistent depressive disorder in anyone who might have been predisposed to it.

Symptoms of Persistent Depressive Disorder

Diagnosing different types of depression can be challenging because the differences can be quite subtle. The primary symptom of persistent depressive disorder is, not surprisingly, a persistent depressed mood. 

The depressed mood must occur on most days, for at least two years for adults, and one year for adolescents and children. During this period, individuals will not be free of depression symptoms for more than 2 months at a time. Persistent depressive disorder isn’t as severe as major depression. It is defined as having at least two of the following symptoms:

  • Irritability and a low feeling mood
  • Listlessness and lack of energy
  • Inability to take pleasure in things you once enjoyed
  • Lack of motivation and disengagement from life activities
  • Over or under-eating and corresponding weight fluctuations
  • A negative self-image, general pessimism, and indecisiveness 

How is Persistent Depressive Disorder Different from Other Depressive Mood Disorders?

All forms of depression can look very similar, with similar symptoms. However, individual disorders are distinguished because of the timing and duration of the disorder. 

The primary distinction for persistent depressive disorder from other disorders is the ongoing nature of the condition. Relatively mild symptoms are often associated with it, but this is not the defining feature of the condition.

Can You Have Persistent Depressive Disorder and Not Know It? 

When persistent depressive disorder begins in adulthood, most people realize that something about their mood and quality of life has changed. However, if it corresponds with a loss or traumatic event, individuals may simply believe that this is their new mental state as a result of their experience.

Children who begin experiencing symptoms very early in life may believe that their depressive state is just an aspect of their personality. Furthermore, since persistent depressive disorder tends to run in families, children may believe that a negative outlook on life and relatively little interest in activities is normal. 

Why is Persistent Depressive Disorder So Challenging to Diagnose? 

Unfortunately, the impactful effects of persistent depressive disorder often go on for years without being diagnosed. It is believed that it may occur in men as much as in women but because men are less likely to talk to their doctors about their mood, it is less likely to be diagnosed in men.

Furthermore, the nature of this persistent disorder can make it challenging for people to realize that something is wrong. 

Because the symptoms are much more mild than a major depressive episode and because it often follows a traumatic event, changes can easily be perceived as normal adaptations rather than a disorder. This is unfortunate since the symptoms appear to be unlikely to alleviate on their own. In fact, it is more likely that symptoms will escalate into a major depressive episode. 

To make it even more difficult, persistent depressive disorder can easily go unnoticed when a patient experiencing it has a major depressive episode. As many as 75% of people who experience persistent depressive disorder will also have a major depressive episode.

Patients often do not realize or to tell their doctor that they were depressed to a lesser degree before the major episode. 

When they recover from the major episode, they may be more likely to perceive their depressed state as normal since it is less severe than the major depressive episode. The tendency of people to believe that their persistent depressive disorder is their normal personality state makes it extremely challenging to diagnose this disorder.

How Common is Persistent Depressive Disorder?

Worldwide, the prevalence of all depression, including persistent depressive disorder, is about 12%. The prevalence is slightly higher in the United States. The prevalence of major depressive disorder is about 17%, and persistent depressive disorder is around 3%

However, as discussed previously, we may not be very good at estimating these numbers when it comes to persistent depressive disorder. It may be unreported in general, and especially underreported in men.  

Furthermore, it may be less diagnosed in the elderly since it is compounded by other disorders associated with aging. The reported occurrence of persistent depressive disorder, at this time, is two times higher in women than in men, both in the U.S. and worldwide.

Treatment for Persistent Depressive Disorder

If you suspect that you or a loved one is suffering from persistent depressive disorder, it is essential that you seek out diagnosis and treatment. There are a number of things that you can do in your own life, combined with things a medical provider can do, to alleviate your symptoms and improve your quality of life. 

Medication can be a very effective tool in helping you deal with your persistent depressive disorder. Here are a few other things that can make a difference in the life of someone struggling with persistent depressive disorder:

Get Plenty of Sleep and Eat a Healthy Diet

It can be hard to convince yourself to take care of your body when you’re experiencing a mood disorder. However, caring for yourself is essential in helping you overcome mood-related problems. 

Eat foods that have natural mind fueling and mood-boosting properties, like fruits, vegetables, nuts, and legumes. 

Avoid drinking alcohol in excess or falling into unhealthy eating patterns. Not only does unhealthy eating directly impact your mental health, but the guilt and frustration that often goes along with it can intensify the negative thinking that tends to promote persistent depressive disorder.

Always Take Medications as Instructed

When you feel better or experience side effects, it can be very tempting to stop the medication abruptly or play with dosages yourself. However, for medications related to mood disorders to work properly, they need to be carefully managed and should never be altered without your physician’s instruction. Abruptly stopping can cause withdrawal symptoms and worsen your depression.

Pay Attention to Your Symptoms and Take Action 

Take care of yourself, even when you don’t feel like it. It can be very helpful to think about yourself as a loved one having a bad day. 

Think about what you know has made you happy in the past and actively work to improve your happiness and participate in things that give you joy. This is especially important when your symptoms are at their worst.

Seek out Help

You are not alone in your battle with persistent depressive disorder. Your mental health practitioner and the family and friends around you are there to help you get through the most difficult parts of dealing with persistent depressive disorder. 

Don’t hesitate to speak with your doctor when you feel that you need additional help. 

Get Help for Persistent Depressive Disorder 

There are things that you can do to improve your persistent depressive disorder yourself at home, but to overcome it for good, you will want to seek help from a mental health professional. You may need medication to help you overcome the disorder or you may find that another option like talk therapy can make a huge difference in your life. 

If you are hesitant to step into your local mental health clinic, consider trying an online mental health clinic like YANA. Not only is YANA more affordable than traditional mental health solutions, but it’s also easily accessible, discreet, and overall better suited to provide you the help you need when you need it. 

Regardless of what works for you, a mental health professional who understands what you are going through is an important part of your recovery. Get started with YANA today and see how easy it can be to take a step toward better mental health. 

Sources:

https://www.health.harvard.edu/a_to_z/dysthymia-a-to-z

https://my.clevelandclinic.org/health/diseases/9292-persistent-depressive-disorder

https://www.ncbi.nlm.nih.gov/books/NBK541052/

https://emedicine.medscape.com/article/290686-overview

https://www.nami.org/Blogs/NAMI-Blog/January-2018/Understanding-Dysthymia

https://www.mountsinai.org/health-library/diseases-conditions/persistent-depressive-disorder