• A continuous long-term (chronic) form of depression
  • Causes continuous feelings of deep sadness and hopelessness
  • Symptoms are not as severe as with major depression
  • Also known as Dysthymia


  • Persistent feelings of sadness and hopelessness
  • Sleep problems
  • Low energy
  • Poor appetite or overeating
  • Difficulty concentrating
  • Indecisiveness
  • Lack of interest in daily activities
  • Decreased productivity
  • Poor self-esteem
  • A negative attitude
  • Avoidance of social activities
  • Irritability or excessive anger
  • Feelings of guilt and worries over the past


  • Chemical imbalance in the brain
  • Family history of the condition
  • History of other mental health conditions
  • Stressful or traumatic life events
  • Chronic physical illness, such as heart disease or diabetes
  • Physical brain trauma, such as a concussion

Risk Factors

  • Having a first-degree relative with major depressive disorder
  • Personality traits that include negativity
  • History of other mental health disorders, such as a personality disorder

Diagnostic Tests

  • Physical examination
  • Lab tests
  • Psychological Evaluation
  • Diagnosis based on DSM-5 list
  • The PDD Symptoms listed in the DSM-5 include:
  • A depressed mood almost every day for most of the day
  • Having a poor appetite or overeating
  • Difficulty falling asleep or staying asleep
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness


  • Psychotherapy


  • Selective serotonin reuptake inhibitors (SSRIs)
  • Tricyclic antidepressants (TCAs)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Lifestyle Changes:

  • Exercise at least three times per week
  • Eat a diet that largely consists of fresh fruits and vegetables
  • Avoid drugs and alcohol
  • See an acupuncturist
  • Take certain supplements, including St. John’s wort and fish oil
  • Practice yoga, tai chi, or meditation
  • Maintain a journal


  • Fluoxetine(Prozac)
  • Sertraline (Zoloft)
  • Amitriptyline (Elavil)
  • Amoxapine (Asendin)
  • Duloxetine (Cymbalta)
  • Desvenlafaxine (Pristiq)


  • No sure way to prevent PDD
  • Take steps to control stress
  • Reach out to family and friends
  • Get treatment at the earliest sign of a problem
  • Consider getting long-term maintenance treatment

Lifestyle Management

  • Stick to the treatment plan
  • Learn about persistent depressive disorder
  • Pay attention to warning signs
  • Eat healthy
  • Be physically active
  • Get plenty of sleep
  • Avoid alcohol and recreational drugs