
Persistent Depressive Disorder Diagnosis and Treatment
Learn about the causes, symptoms, and treatment methods for persistent depressive disorder.
Table of Contents
Understanding Persistent Depressive Disorder
Persistent depressive disorder, also known as dysthymia, is characterized by a long-term form of depression. In other words, it is a mild or moderate kind of depression that doesn’t go away. One of the distinct characteristics of dysthymia is that it lasts for at least two years in adults and over a year in children and teens. Symptoms can be absent for as long as two consecutive months in adults.
This disorder causes loss of interest in daily activities, decreased productivity, low self-esteem, and feelings of hopelessness. These feelings tend to last for several years and interfere with relationships and work output.1 As a result, affected individuals often find it difficult to be upbeat, even during happy occasions or after a significant achievement.
Those with this disorder are usually described as possessing a gloomy personality, constantly having a downbeat demeanor, and incapable of having fun. Although persistent depressive disorder is not considered as severe as major depressive disorder, it still causes significant obstacles against appreciating and enjoying life.
Is Persistent Depressive Disorder a Disability?
Depression is considered a disability under the Americans With Disabilities Act and the Blue Book—the Social Security Administration’s (SSA) comprehensive list that outlines medical conditions that make an affected individual qualify for disability benefits.
In the Blue Book, depressive disorders are recognized as a disability if it is characterized by at least five of the following features:2
- Depressed mood
- Diminished interest in activities
- Appetite disturbances
- Sleep disturbances
- Psychomotor agitation and retardation
- Decreased energy
- Difficulty concentrating or thinking
- Feelings of guilt
- Suicidal thoughts
Those with dysthymia usually exhibit most of these symptoms, and they last for a considerable amount of time, thereby qualifying the individual as a disabled person.
Prevalence of Persistent Depressive Disorder
Persistent Depressive Disorder Causes and Risk Factors
Persistent Depressive Disorder Causes
Genetics
Brain Chemistry
Medical and health professionals have linked persistent depressive disorder to a chemical imbalance in the brain. Neurotransmitters, such as dopamine, norepinephrine, and serotonin, play a role in an individual’s overall mood. As such, if the brain is not releasing enough neurotransmitters, feelings of well-being and happiness decrease.
Life Events
An aggregation of stressors and increased hassles over a considerable period has been linked to dysthymia, such as financial problems, traumatic events, the loss of a loved one, mental or physical abuse.
Risk Factors
Several risk factors have been found to increase the development of persistent depressive disorder. The various risk factors associated with dysthymia include:
- Stress and traumatic life events
- Child abuse
- Family history of depression
- Character traits, such as negativity and low self-esteem
- Brain injury
- Long-term illness
Signs and Symptoms of Persistent Depressive Disorder
Common Symptoms of Persistent Depressive Disorder
Some common symptoms of dysthymia include: 5
- Loss of interest in daily activities
- Sadness and emptiness
- Low self-esteem
- Poor concentration or difficulty making decisions
- Feelings of hopelessness
Persistent Depressive Disorder in Children
In children, persistent depressive disorder is diagnosed if they exhibit a consistent low, sad, or irritable mood for one year. It usually disturbs children’s sleep, eating, and thinking patterns and causes symptoms, such as increased sensitivity to rejection/failure, low self-esteem, headaches, and tiredness.
Environmental and genetic factors often predispose a child to dysthymia. Therefore, mental health experts often carry out dysthymia diagnoses with extensive interviews with the affected child and caregivers/close family members.

Diagnosis of Persistent Depressive Disorder
Physical Exam
Lab Tests
Lab tests are usually conducted to rule out the chance of other medical conditions that could cause depressive symptoms. For example, hyperthyroidism, a condition whose symptoms closely mirror depression, is usually tested for and ruled out.
Psychological Evaluation
An evaluation to pinpoint a specific diagnosis is usually conducted using a questionnaire to understand the patient’s thoughts and feelings. A psychological evaluation determines if patients have persistent depressive disorder or other closely related conditions, such as major depressive disorder, bipolar disorder, or seasonal affective disorder.
Diagnostic Criteria
- Poor appetite or overeating
- Insomnia or hypersomnia
- Low Energy or fatigue
- Low self-esteem
- Poor concentration or difficulty making decisions
- Feelings of hopelessness
Treatment for Persistent Depressive Disorder
The treatment process for dysthymia involves a combination of medications and talk therapy. Persistent depressive disorder treatment depends on personal preference, the severity of symptoms, tolerance for medications, and previous treatments. The following treatment options are all accredited and available to those with depression:7
Medications
Talk Therapy
Talk therapy involves psychological counseling. A mental health professional discusses the depressive condition with the patient and helps them formulate new coping strategies, identify behaviors that led to dysthymia, and regain a sense of control over their actions and lives. Usually, the preferred form of talk therapy is cognitive behavioral therapy (CBT).
Finding Help
Dysthymia Treatment Options at J. Flowers Health Institute
J. Flowers Health Institute provides programs that help address, evaluate, and treat mental health disorders, such as persistent depressive disorder. Our highly qualified staff prioritize the health and well-being of each patient. Begin the path to a better quality of life by calling J. Flowers Health Institute today.
Resources
- https://www.health.harvard.edu/newsletter_article/dysthymia
- https://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm#12_04
- https://www.nimh.nih.gov/health/statistics/persistent-depressive-disorder-dysthymic-disorder
- https://www.healthline.com/health/dysthymia#symptoms
- https://familydoctor.org/condition/persistent-depressive-disorder/
- https://www.nimh.nih.gov/health/topics/depression