Also known as dysthymia, persistent depressive disorder is characterized by chronic depression. For adults, the long-term symptoms are continuous for at least two years. With children and adolescents, the symptoms of depression occur for more than a year. According to medical author Roxanne Dryden-Edwards, MD, persistent depressive disorder affects anywhere from three to six percent of the population in the United States of America. Further, more women are afflicted compared to men as well as African-Americans opposed to Caucasians. Despite the statistics, biological, psychological and environmental factors may contribute to the condition equally opposed to one particular cause. It may even co-occur with other health ailments like substance abuse, personality disorders, or anxiety. If you or a loved one has symptoms of persistent depressive disorder, you should seek treatment to live a happier, more productive life.

Sadness, Hopelessness, or Feeling Guilty

If you have a feeling of sadness come over you mostly every single day for at least two years straight, then you may have persistent depressive disorder. For children and teens, feeling down may last for an entire year or longer. Not only do you feel sad more days than not, but you might also feel a sense of hopelessness. Worrying about the past or feeling guilty is another common emotion. Although these symptoms may range in severity, they will be ongoing for months. You might even experience major episodes of depression as other symptoms of persistent depressive disorder continue.



Loss of Interest in Daily or Social Activities

If you no longer care about sports, hobbies, or other daily activities that used to bring you joy, then you might have persistent depressive disorder. Do you find it difficult to be upbeat and positive even during the happiest occasions? Even though your mood may fluctuate in terms of mild, moderate, or severe depressions, you are not happy doing what you love. Maybe you used to have more fun, but now people think you are gloomy most of the time. Not only can persistent depressive disorder cause you to lose interest in daily activities, but you may find yourself avoiding social settings, too. It is okay to enjoy spending time alone; however, you should feel comfortable seeing people at public places and happy when you get to spend time with your loved ones.



Tiredness and Lack of Energy

After working all day long or running errands for hours, it might be time to kick back and relax with a nap. However, if you get enough rest at night, then you should have plenty of energy in the morning to tackle daily activities. If you always feel tired, your fatigue could be an underlying symptom of other serious illnesses. Besides feeling too tired to get out of bed, you might simply lack energy. Being a couch potato on a lazy Sunday afternoon is alright once in a while, but if you find yourself simply lying around day after day with no desire to complete any goals, then you might have persistent depressive disorder.



Self-Criticism and Low Self-Esteem

There is a fine line between being confident and cocky. Likewise, the old saying goes that we are our own worst critics. Although it might be difficult to find a balance when it comes to loving yourself, you should have a high amount of self-esteem to know you are uniquely beautiful both inside and out. Having a pity party for all the things wrong with yourself is not healthy. You can try to improve your flaws or bad habits, but in no way should you carry an overall feeling of inadequacy throughout your life. Feeling like you are never good enough is a symptom of persistent depressive disorder.



Irritable and Angry

Getting annoyed and irritable, especially over little things very quickly, is a common sign of persistent depressive disorder. Besides irritability, anger is another emotion associated with this health condition. For children or adolescents, these two feelings may be more prevalent along with a depressed mood. It’s important to note that everybody has a bad day once in a while, especially if outside factors are causing frustration or stress. However, waking up mad and going to bed annoyed for months at a time is a sign of persistent depressive disorder.



Trouble Concentrating or Decreased Productivity

Just as persistent depressive disorder can adversely affect your personal and social life, it can also have a negative impact on your school and work activities. Children and adults alike can have trouble concentrating. Having trouble making decisions is also a symptom, which may grow from the increasing pressure you put on yourself. A decrease in productivity and effectiveness at work might also become more noticeable as the disorder progresses. Depending on your career, you could fall behind on paperwork as your desk becomes unorganized. Persistent depressive disorder can interfere with work performance if you start showing up late or getting written up for behavior issues.



Poor Appetite or Overeating

Even small stresses can alter have people consume food. Sometimes high-demand events or tragic situations will cause you to either skip meals or indulge a little too much. Whether you use food as a comfort or a means of control in your life, it is a symptom of persistent depressive disorder. A poor appetite and overeating are both unhealthy. You need to find a balanced diet that will provide you with all of the nutrients your body needs. While cravings are also associated with menstruation and pregnancy, men and women with depression might have poor eating habits.



Sleep Problems

Like with other symptoms on this list, this sign of persistent depressive disorder can come from an isolated incident or another health condition. However, if you have restless nights for weeks on end along with other persistent depressive disorder symptoms, then you should seek treatment. You might be tossing and turning throughout the night. Only get a few solid hours of sleep, or simply stay up until the wee hours of the morning. Sleep problems like this can prevent you from completing daily activities and have other adverse effects on your relationships.



Treatment: Medication

Your doctor will consider several factors before offering treatment. For example, the severity of your symptoms, you’re your ability to handle medications, and your desire to address either emotional or situational issues will all make a difference. There are three main types of prescriptions for persistent depressive disorder. Often referred to as anti-depressants, selective serotonin reuptake inhibitors (SSRIs) are recommended because of the proven effectiveness and safety. Other options include tricyclic antidepressants (TCAs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Discuss the side effects of antidepressants with your doctor to determine your tolerability of each. Although you have lived with feelings of sadness or anger for such a long time, the symptoms of persistent depressive disorder can get better.



Treatment: Therapy

For children and teens, psychotherapy is the first treatment for persistent depressive disorder. However, it depends on the person as anti-depressants may also help. Also known as talk therapy or psychological counseling, psychotherapy involves seeing a therapist for several weeks or months. Talking to a mental health provider about your personal issues can help treat the symptoms of persistent depressive disorder. You can adjust to a new situation in your life as well as explore personal relationships and experiences that may have contributed to your current mood. After identifying the underlying cause of your depression, you can learn to cope with the problems and change your behaviors. Finally, you can set practical goals. Build confidence for healthy interaction, and regain a sense of control and happiness in your life.



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This site offers information designed for educational purposes only. You should not rely on any information on this site as a substitute for professional medical advice, diagnosis, treatment, or as a substitute for, professional counseling care, advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional.