Psychiatry Associates Blog

Persistent Depressive Disorder: When Depression Hides in Plain Sight

persistent depressive disorderPicture someone who is depressed.  What do you see?  You may envision someone who looks tired and unkempt.  Perhaps they are crying and struggling to get out of bed.  This is the image of depression that has been projected for decades.  Depression is supposed to be a major disruption of someone’s life, a drastic shift from who they normally are, right?  In the case of major depressive disorder or a depressive phase of bipolar disorder, these images may be somewhat accurate.  However, depression is a chameleon, and it can look and feel different in nearly every individual.  In some cases, this means that spotting the signs of depression is far more difficult than we would like to believe.

Defining Persistent Depressive Disorder (PDD)

Persistent depressive disorder, or dysthymia, is a long-lasting form of depression that is believed to affect at least 1.5 percent of the population.  Unfortunately, the accuracy of those numbers is questionable given how difficult it can be to identify PDD.  The condition is typically less severe than major depressive disorder (MDD), but it is also less relenting.  Whereas MDD tends to cause noticeable symptoms of depression most days, for nearly the entire day, for a period of weeks or months, PDD results in less noticeable, albeit still disruptive, symptoms that last for years at a time.  Due to this milder and more extensive nature, persistent depressive disorder can be easily overlooked and chalked up to simply being part of an individual’s personality.  

Spotting the Signs of Persistent Depressive Disorder

While it can be easy to overlook milder symptoms of depression that do not prevent one from completing their day-to-day tasks, these signs indicate a much larger problem, and attempting to “power through” them could result in serious, negative consequences.  Just like others suffering from depression, patients with PDD may experience long-term complications such as troubles with relationships, school, or work, physical pain, and even suicidal thoughts or actions.  And, on a daily basis, they may experience:

  • Feelings of sadness or hopelessness
  • Fatigue
  • Low self-esteem or hyper self-criticism
  • Anger and irritability
  • Avoidance of social settings
  • Persistent feelings of guilt

Treating Persistent Depressive Disorder

The criteria for diagnosing PDD requires ongoing symptoms for a period of at least two years (one year in children), but anyone experiencing symptoms of depression should not wait this long to seek treatment.  In order to mitigate the impact that condition can have on one’s life, patients should receive medical attention from a board-certified psychiatrist when signs, even mild ones, have been observed for a period of several weeks.

Treatment protocol for patients believed to be suffering from PDD typically includes prescription medication from one or more of the following groups:

  • Antidepressants, or select serotonin reuptake inhibitors, such as Prozac or Zoloft
  • Dual-action antidepressants, or serotonin and norepinephrine reuptake inhibitors, such as Effexor
  • Tricyclic antidepressants such as Tofranil

In addition, a psychiatrist may recommend a form of psychotherapy such as cognitive behavioral therapy (CBT) in order to maximize results.

Persistent depressive disorder is the form of depression rarely discussed, in large part due to the fact that sufferers may not recognize it as depression.  When you feel “off” for an extended period of time, even if it isn’t preventing you from completing your normal tasks, it is always best to seek care.  The longer such issues are left unchecked, the more impactful they can become. 

If you have been experiencing the symptoms of PDD, contact Psychiatry Associates of Baton Rouge, and request an appointment with one of our board-certified physicians.  Not only can they help you identify and treat the underlying problem, our team also includes other providers such as therapists to bring you the most comprehensive, well-rounded treatment possible.


Topics: Depression