Persistent Depressive Disorder (PDD)

Last Updated August 2023 | This article was created by editorial staff and reviewed by Deepak S. Patel, MD, FAAFP, FACSM

What is dysthymic disorder or persistent depressive disorder (PDD)?

Persistent depressive disorder (PDD) is chronic depression that lasts a long time. A person’s moods are generally affected for at least 2 years (1 year for children and adolescents). Their depression is usually mild or moderate, rather than severe. Most people who have PDD can’t recall when they first became depressed.

PDD is a common type of depression. It can begin in childhood or in adulthood. No one knows why. It appears to be more common in women. It used to be called dysthymic disorder or dysthymia.

Symptoms of dysthymic disorder or PDD

The main symptom of PDD is a sad, low, or dark mood on most days. This lasts for at least 2 years. Children and teens with PDD can feel irritable instead of depressed. Their symptoms last for at least 1 year.

Other symptoms that happen much of the time include:

  • Poor appetite or overeating
  • Difficulty sleeping or sleeping too much
  • Low self-esteem
  • Poor concentration
  • Low energy
  • Fatigue
  • Feelings of hopelessness

Most people who have PDD may have an episode of major depression at least once in their lives. Older people who have PDD find it difficult to care for themselves. They feel isolated and have medical illnesses

People who have PDD may have periods of normal moods that can last up to 2 months. Family members and friends may not even know that their loved one is depressed. This type of depression is mild. It may be difficult for a person to function at home, school, or work.

What causes dysthymic disorder or PDD?

No one knows what causes PDD. It may be related to some changes in the brain that involve a chemical called serotonin. Serotonin helps your brain handle emotions and make judgments. Other medical problems and ongoing life stress may also play a role.

You may be at higher risk of developing PDD if you are a woman. It also tends to run in families. If a family member has it or another type of depression, you could be more likely to get it.

How is PDD diagnosed?

If you think you have PDD, discuss your concerns with your doctor. Your doctor will ask you questions to find out if you have depression and what type you have. Your doctor may ask you questions about your health and your symptoms. This may include how well you’re sleeping, if you feel tired a lot, and if you have trouble concentrating. Your doctor will also consider medical reasons that may cause you to feel depressed. These could be problems with your thyroid or a certain medicine you may be taking. Your doctor might order blood or urine tests to check for these or other causes.

Can PDD be prevented or avoided?

In general, PDD and other forms of depression are conditions that cannot be prevented. There are lifestyle changes you can make that can boost your mood and minimize symptoms, including:

  • Get enough sleep.
  • Follow a healthy diet.
  • Reduce or avoid your alcohol consumption.
  • Do not take illegal drugs.
  • Take medicines as prescribed by your doctor.
  • Watch for changes in your PDD. Talk to your doctor about changes.
  • Engage in activities that bring you enjoyment.
  • Talk to someone you trust about how you feel.
  • Be around people who are positive and uplifting.

PDD treatment

PDD can be treated with an antidepressant medicine. This type of medicine helps relieve depression. Antidepressants don’t cause people to feel “high,” and they are not habit-forming.

It may take weeks or months before you and your doctor know whether an antidepressant is helping you. It is important for you to take the medicine exactly as your doctor tells you. If the antidepressant helps you feel better, you may need to take this medicine for several years. You should continue to take the medicine, even if you begin to feel better. Never stop the medicine without first discussing it with your doctor.

Sometimes there are side effects from stopping antidepressant medicine suddenly. If you want to stop taking your medicine, talk to your doctor first.

Should I see a counselor too?

Some patients find that counseling can help them deal with specific problems. It’s a safe place where you can talk about your thoughts and feelings. Many doctors believe that combining talk therapy with medicine is the most effective way to treat PDD and other types of depression.

Living with PDD

PDD is a chronic condition. It can last for many years. If you have PDD, there are things you can do to help yourself feel better. Talk to your doctor about how you’re feeling. Get treatment for your PDD. It may help to find activities that make you feel good or help you feel a sense of accomplishment.

  • Go to a movie.
  • Take a drive on a pleasant day.
  • Go to a ball game.
  • Work in the garden.
  • Do something nice for someone else.


People with PDD sometimes experience episodes of major depression. This can make them think about suicide. If you have thoughts about hurting yourself or others, tell someone right away. You can tell your doctor, your family, or a friend. You can also call a suicide hotline. There may be a local number you can call. Or call the National Suicide Prevention Lifeline at 1-800-273-8255.

Get help right away. PDD and other forms of depression can be treated successfully. There is always someone who can help you.

Questions to ask your doctor

  • I’ve felt down for a long time. Could I have PDD?
  • Do I need treatment? What are my treatment options?
  • Should I see a counselor or someone else for talk therapy?
  • Will I need medicine to treat my symptoms? How long will I need to take it?
  • How is the treatment for PDD different than for major depression?
  • What should I do if I find myself in a very dark place or start having thoughts of suicide?
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