Przewlekłe zaburzenie depresyjne

Przewlekłe zaburzenie depresyjne
Objawy

Przewlekłe zaburzenie depresyjne (PDD), wcześniej dystymia, to zaburzenie charakteryzujące się utrzymującym się obniżonym nastrojem przez co najmniej 2 lata u dorosłych i 1 rok u dzieci i młodzieży. Objawy obejmują m.in. poczucie beznadziejności, niską samoocenę, zaburzenia snu (bezsenność lub nadmierna senność), zmęczenie, problemy z koncentracją oraz drażliwość, szczególnie u młodszych pacjentów. W diagnostyce DSM-5 wymagane jest utrzymywanie się objawów przez większość dni, z obecnością co najmniej dwóch z siedmiu objawów takich jak zmieniony apetyt, niska energia, czy trudności decyzyjne, bez remisji trwającej dłużej niż 2 miesiące. PDD często współwystępuje z epizodami dużej depresji (tzw. podwójna depresja), co pogarsza rokowanie i zwiększa ryzyko samobójstwa (ryzyko 7,195-krotnie wyższe). Przewlekły charakter zaburzenia prowadzi do znacznego upośledzenia funkcjonowania społecznego i zawodowego, często większego niż w przypadku epizodów dużej depresji.

Ogólna charakterystyka Przewlekłego zaburzenia depresyjnego

Przewlekłe zaburzenie depresyjne (ang. Persistent Depressive Disorder, PDD), wcześniej znane jako dystymia, jest formą depresji charakteryzującą się długotrwałym, przewlekłym obniżeniem nastroju. W klasyfikacji DSM-5 stanowi połączenie wcześniejszych diagnoz dystymii i przewlekłej dużej depresji. Główną cechą tego zaburzenia jest obniżony nastrój utrzymujący się przez większość dnia, przez większość dni, przez co najmniej 2 lata u dorosłych lub 1 rok u dzieci i młodzieży¹².

W przeciwieństwie do epizodów dużej depresji, które mogą być intensywne, ale ograniczone w czasie, przewlekłe zaburzenie depresyjne charakteryzuje się dłuższym utrzymywaniem się objawów o zazwyczaj mniejszym nasileniu. Jednakże, mimo łagodniejszego przebiegu, przewlekła natura tego zaburzenia może prowadzić do znacznego upośledzenia funkcjonowania, porównywalnego lub nawet większego niż w przypadku dużej depresji³⁴.

Zaburzenie to często rozpoczyna się wcześnie w życiu – w dzieciństwie, okresie dojrzewania lub wczesnej dorosłości, a objawy mogą się nasilać i słabnąć, ale nigdy całkowicie nie ustępują⁵. Osoby z przewlekłym zaburzeniem depresyjnym często opisują swój nastrój jako smutny lub „przygnębiony”, a ponieważ objawy stają się częścią codziennego doświadczenia, mogą nie szukać pomocy, zakładając, że „zawsze były takie”⁶.

Objawy Przewlekłego zaburzenia depresyjnego

Objawy przewlekłego zaburzenia depresyjnego zwykle pojawiają się i ustępują przez okres lat. Intensywność objawów może się zmieniać w czasie, ale zazwyczaj nie znikają na więcej niż dwa miesiące naraz. Dodatkowo, epizody dużej depresji mogą wystąpić przed lub w trakcie przewlekłego zaburzenia depresyjnego⁷.

Główne objawy emocjonalne

Zasadniczym objawem przewlekłego zaburzenia depresyjnego jest utrzymujący się obniżony nastrój. U dorosłych przejawia się to jako smutek, poczucie pustki lub przygnębienia, podczas gdy u dzieci i nastolatków nastrój może być bardziej drażliwy niż depresyjny⁸⁹. Osoby cierpiące na PDD często doświadczają również:

Poczucia beznadziei¹⁰
Niskiej samooceny i nadmiernej samokrytyki¹¹
Poczucia winy i zamartwiania się przeszłością¹²
Utraty zainteresowania codziennymi czynnościami i aktywnościami, które wcześniej sprawiały przyjemność¹³

Objawy poznawcze

Przewlekłe zaburzenie depresyjne wpływa również na funkcje poznawcze. Osoby z tym zaburzeniem mogą doświadczać:

Problemów z koncentracją i podejmowaniem decyzji¹⁴
Trudności z wykonywaniem zadań na czas i z odpowiednią jakością¹⁵
Tendencji do negatywnego lub zniechęcającego postrzegania siebie, swojej przyszłości, innych ludzi i wydarzeń życiowych¹⁶

Objawy behawioralne

Na poziomie behawioralnym, osoby z przewlekłym zaburzeniem depresyjnym mogą wykazywać:

Zwiększoną drażliwość, niecierpliwość lub gniew¹⁷
Unikanie aktywności społecznych¹⁸
Zmniejszoną aktywność, efektywność i produktywność¹⁹

Objawy fizyczne

Fizyczne manifestacje przewlekłego zaburzenia depresyjnego mogą obejmować:

Zmęczenie i brak energii²⁰
Zaburzenia snu (zbyt mało lub zbyt dużo snu)²¹
Słaby apetyt lub przejadanie się²²

Objawy u dzieci i młodzieży

U dzieci i nastolatków, przewlekłe zaburzenie depresyjne może przejawiać się jako obniżony nastrój oraz drażliwość, co oznacza łatwe irytowanie się, niecierpliwość lub złość²³. Do diagnozy PDD u dzieci i młodzieży wymagane jest utrzymywanie się objawów przez co najmniej 1 rok²⁴.

Dodatkowe objawy u młodszych pacjentów mogą obejmować:

Problemy z relacjami rówieśniczymi²⁵
Trudności w szkole²⁶
Częste skargi fizyczne, takie jak bóle głowy, bóle brzucha czy ekstremalne zmęczenie²⁷
Uciekanie z domu lub groźby ucieczki²⁸
Nadwrażliwość na niepowodzenia lub odrzucenie²⁹

Kryteria diagnostyczne

Zgodnie z klasyfikacją DSM-5, do diagnozy przewlekłego zaburzenia depresyjnego wymagane są następujące kryteria³⁰³¹:

Obniżony nastrój przez większość dnia, przez większość dni, przez co najmniej 2 lata u dorosłych lub 1 rok u dzieci i młodzieży
Obecność co najmniej dwóch z następujących objawów podczas depresji:
- Słaby apetyt lub przejadanie się
- Bezsenność lub nadmierna senność
- Niska energia lub zmęczenie
- Niska samoocena
- Słaba koncentracja lub trudności z podejmowaniem decyzji
- Poczucie beznadziei
W okresie 2 lat (1 roku dla dzieci i młodzieży) zaburzenia, osoba nigdy nie była bez objawów z powyższych kryteriów przez więcej niż 2 miesiące naraz
Objawy powodują klinicznie znaczące cierpienie lub upośledzenie w ważnych obszarach funkcjonowania

Dodatkowo, w diagnozie należy określić czy przewlekłe zaburzenie depresyjne jest³²:

Czystym zespołem dystymicznym
Przewlekłym dużym zaburzeniem depresyjnym
Przerywanym dużym zaburzeniem depresyjnym

Rozpoznanie PDD może być trudne ze względu na subtelną naturę objawów, a pacjenci często potrafią ukrywać je w sytuacjach społecznych, co utrudnia ich wykrycie przez innych³³. Wiele osób z przewlekłym zaburzeniem depresyjnym uważa swoje objawy za część swojej osobowości, co może opóźniać poszukiwanie pomocy³⁴.

Progresja i przebieg choroby

Podwójona depresja

Przewlekłe zaburzenie depresyjne często współwystępuje z innymi zaburzeniami psychicznymi. Szczególnie istotne jest zjawisko „podwójnej depresji” (ang. double depression), które występuje, gdy osoba z PDD doświadcza również epizodów dużej depresji³⁵.

Szacuje się, że około 75% osób z dystymią spełnia kryteria co najmniej jednego epizodu dużej depresji³⁶. Po zakończeniu epizodu dużej depresji u osób z podwójną depresją, zazwyczaj następuje powrót do wcześniejszego, łagodniejszego stanu przewlekłej depresji, a nie całkowity brak objawów depresyjnych³⁷.

Pacjenci z podwójną depresją mają tendencję do dłuższych okresów depresji i spędzają mniej czasu w pełni zdrowi³⁸. Często zgłaszają również znacznie wyższy poziom beznadziejności niż jest to typowe³⁹.

Charakter przebiegu choroby

Przewlekłe zaburzenie depresyjne, zgodnie z nazwą, ma przewlekły przebieg. Objawy mogą się nasilać i słabnąć, ale rzadko całkowicie ustępują⁴⁰. W przeciwieństwie do dużej depresji, w której pacjenci zazwyczaj „cyklicznie” przechodzą przez okresy depresji, a następnie są wolni od objawów przez dłuższy czas, osoby z PDD doświadczają trwałych objawów przez lata⁴¹.

W 10-letnim badaniu followupowym, 75% osób z dystymią doświadczyło pewnego (co najmniej 2-miesięcznego) okresu remisji dużej depresji, przy czym średni czas do remisji wynosił 52 miesiące od rozpoczęcia badania. Jednakże większość (70%) tych, którzy osiągnęli remisję, doświadczyła nawrotu do kolejnego epizodu depresji, najczęściej w ciągu 3 lat po remisji⁴².

Przegląd systematyczny badań epidemiologicznych wykazał, że 46-71% osób z dystymią zgłosiło remisję w punktach obserwacji od 1 do 6 lat⁴³. Jednakże badanie przeprowadzone 10 lat później wykazało, że 60% osób z PDD nadal spełniało kryteria zaburzenia depresyjnego, w porównaniu do tylko 21% osób z nieprzewlekłymi zaburzeniami⁴⁴.

Czynniki wpływające na przebieg choroby

Kilka czynników może wpływać na przebieg przewlekłego zaburzenia depresyjnego⁴⁵⁴⁶:

Współistniejące zaburzenia, takie jak zaburzenia lękowe i zaburzenia osobowości, są związane z niższymi wskaźnikami remisji
Przewlekły stres jest związany z bardziej nasilonymi objawami i mniejszym prawdopodobieństwem remisji
Wcześniejszy początek (przed 21 rokiem życia) wiąże się z wyższym ryzykiem współwystępowania zaburzeń osobowości i uzależnień
Obecność wysokiego poziomu neurotyczności, bardziej nasilonych objawów, gorszego funkcjonowania ogólnego i współwystępujących zaburzeń lękowych lub zaburzeń zachowania prowadzi do gorszych długoterminowych wyników

Implikacje i powikłania

Wpływ na funkcjonowanie

Przewlekłe zaburzenie depresyjne negatywnie wpływa na funkcjonowanie społeczne i zawodowe na różne sposoby, które mogą być równie duże lub większe niż w przypadku dużej depresji⁴⁷. Osoby z PDD mogą doświadczać:

Trudności z wypełnianiem obowiązków w pracy, szkole lub domu⁴⁸
Problemów z socjalizacją i cieszeniem się hobby⁴⁹
Zwiększenia przytłaczających uczuć w stresujących sytuacjach⁵⁰
Bezrobocia, trudności w nawiązywaniu bliskich relacji, większego wykorzystania opieki zdrowotnej i świadczeń publicznych⁵¹

Ryzyko samobójstwa

Przewlekłe zaburzenie depresyjne wiąże się ze zwiększonym ryzykiem myśli i zachowań samobójczych⁵²⁵³. W jednym z badań wykazano, że osoby z PDD miały 7,195 razy wyższe ryzyko samobójstwa w porównaniu do osób bez PDD⁵⁴.

Znaleziono również istotne związki u pacjentów z PDD między doświadczaniem przemocy emocjonalnej w dzieciństwie a zachowaniami samobójczymi (w tym próbami samobójczymi)⁵⁵.

Zaburzenia współistniejące

Osoby z przewlekłym zaburzeniem depresyjnym są narażone na wyższe ryzyko wystąpienia zaburzeń osobowości i zaburzeń związanych z używaniem substancji⁵⁶. Są również bardziej narażeni na zaburzenia lękowe oraz zaburzenia zachowania⁵⁷.

U dzieci z przewlekłym zaburzeniem depresyjnym, które nie otrzymują leczenia, istnieje większe prawdopodobieństwo rozwoju zaburzeń osobowości i zaburzeń związanych z używaniem substancji w dorosłości⁵⁸.

Wpływ na sen i zdrowie fizyczne

Zaburzenia snu często towarzyszą PDD i mogą dodatkowo zwiększać ryzyko samobójstwa. W jednym badaniu wykazano, że osoby z zaburzeniami snu i PDD wykazywały 1,174 razy wyższe ryzyko samobójstwa w porównaniu do osób bez zaburzeń snu⁵⁹.

Przewlekłe zaburzenie depresyjne wiąże się również ze zwiększoną śmiertelnością i zachorowalnością z powodu niezwiązanych chorób fizycznych, a osoby z PDD często zgłaszają gorszy stan zdrowia⁶⁰.

Przewlekłe zaburzenie depresyjne a duża depresja

Choć objawy przewlekłego zaburzenia depresyjnego są podobne do tych występujących w dużej depresji, istnieją między nimi istotne różnice⁶¹:

Cecha	Przewlekłe zaburzenie depresyjne (PDD)	Duża depresja (MDD)
Czas trwania	Co najmniej 2 lata u dorosłych, 1 rok u dzieci i młodzieży	Co najmniej 2 tygodnie
Nasilenie objawów	Zazwyczaj łagodne do umiarkowanych	Umiarkowane do ciężkich
Przebieg	Chroniczny, z objawami utrzymującymi się przez długi czas	Epizodyczny, z okresami poprawy między epizodami
Liczba objawów	Mniej (2 z 7 objawów)	Więcej (5 z 9 objawów)
Początek	Często wcześniej w życiu (dzieciństwo, adolescencja, wczesna dorosłość)	Częściej po okresie dojrzewania, szczyt we wczesnej dorosłości
Wpływ na funkcjonowanie	Może być równie duży lub większy niż w MDD, ze względu na przewlekły charakter	Intensywny podczas epizodów, ale z okresami normalnego funkcjonowania

Główną różnicą jest czas trwania objawów – PDD trwa co najmniej 2 lata u dorosłych, podczas gdy osoby z MDD doświadczają epizodów depresyjnych, które są oddzielone od siebie co najmniej 2 miesiącami⁶².

Warto jednak zauważyć, że te dwa zaburzenia mogą współwystępować, prowadząc do stanu znanego jako „podwójna depresja”, gdy osoba z PDD doświadcza również epizodów dużej depresji⁶³.

Kluczowe wnioski i obserwacje

Przewlekłe zaburzenie depresyjne jest poważnym stanem, który może znacząco wpływać na jakość życia osoby dotkniętej tym zaburzeniem. Choć objawy mogą być łagodniejsze niż w przypadku dużej depresji, ich długotrwała natura może prowadzić do równie znaczącego lub nawet większego upośledzenia funkcjonowania⁶⁴.

Ze względu na przewlekły charakter, wiele osób z PDD może przyjmować swoje objawy jako część swojej osobowości, co może opóźniać poszukiwanie pomocy⁶⁵. Wczesna identyfikacja i leczenie są jednak kluczowe dla zminimalizowania długoterminowego wpływu na funkcjonowanie⁶⁶.

Osoby z przewlekłym zaburzeniem depresyjnym często wymagają dłuższego okresu leczenia, większej liczby sesji psychoterapii i/lub wyższych dawek leków przeciwdepresyjnych w porównaniu z pacjentami z ostrymi formami depresji⁶⁷. Jednak przy odpowiednim leczeniu, objawy mogą się zmniejszyć, a ich nasilenie może zostać ograniczone⁶⁸.

Badania wskazują, że kombinacja psychoterapii i farmakoterapii daje najlepsze wyniki w leczeniu przewlekłego zaburzenia depresyjnego⁶⁹. Leczenie podtrzymujące jest często konieczne, aby zapobiec nawrotowi objawów⁷⁰.

Dla osób dotkniętych PDD, zrozumienie chronicznie niskiego nastroju jako zaburzenia, które można leczyć, a nie tylko jako cechy osobowości, może być pierwszym krokiem do poprawy jakości życia i znalezienia ulgi w objawach.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/
Persistent depressive disorder (PDD), as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), merges the previous diagnoses of dysthymic disorder and chronic major depressive disorder. This condition is marked by a depressed mood lasting most of the day, for more days than not, over at least 2 years in adults or 1 year in children and adolescents. PDD can begin early in life and often becomes chronic, with symptoms that persist or fluctuate but never completely resolve. Individuals with PDD face a heightened risk of suicidal thoughts and behaviors, with functional impairments that can be as severe as or more severe than those experienced in major depressive disorder. […] According to the DSM-5, persistent depressive disorder is characterized by a depressed mood that occurs for most of the day, for more days than not, for at least 2 years, or at least 1 year for children and adolescents. Major depression may precede PDD, and major depressive episodes may occur during PDD, which is known as double depression. PDD may begin early in life, and depressive symptoms may wax and wane but never fully resolve.
#2 Persistent depressive disorder – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/805?locale=it
Persistent depressive disorder includes common forms of depression, but lasting longer than acute major depressive disorder. […] Affected patients have a depressed mood most of the day, for more days than not, for at least 2 years. While depressed, patients have at least 2 of: poor appetite/over-eating, insomnia or hypersomnia, low energy/fatigue, low self-esteem, poor concentration or difficulty making decisions, or feelings of hopelessness. Symptoms do not remit for more than 2 months at a time. […] Associated with significant functional impairment (including unemployment, difficulty establishing intimate relationships, greater healthcare utilisation, greater utilisation of public entitlements). […] Patients require a longer treatment period, more psychotherapy sessions, and/or higher doses of antidepressant medication compared with patients with acute forms of depression. […] Key diagnostic factors include chronic mood disorder lasting greater than 2 years, depressive symptoms present for most of the day, most days, and no periods of euthymia in the past 2 years. […] Symptoms of major depression may be continuously present for 2 or more years.
#3 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/
The prognosis of PDD is similar, if not worse, than that of major depressive disorder. Outcomes of a 10-year study suggest that persistent depressive disorder is independently associated with greater severity of depression, anxiety, and somatic symptoms in individuals with major depressive disorder in comparison to individuals with major depressive disorder without PDD. […] Persistent depressive disorder (PDD) negatively affects social and occupational functioning in varying ways, which can be as great or greater than a major depressive disorder. PDD is associated with an increased risk of suicidal outcomes. The symptoms of PDD are much less likely to fully resolve in a given period. Individuals with PDD are at higher risk of personality disorders and substance use disorders. Significant associations were found in inpatients with PDD between childhood emotional abuse and suicidal behaviors (including suicide attempts).
#4 Psychiatry.org – What Is Depression?
https://www.psychiatry.org/patients-families/depression/what-is-depression
The symptoms cause significant distress or difficulty in work, social activities, or other important areas of functioning. While the impact of persistent depressive disorder on work, relationships and daily life can vary widely, its effects can be as great as or greater than those of major depressive disorder. […] A major depressive episode may precede the onset of persistent depressive disorder but may also arise during (and be superimposed on) a previous diagnosis of persistent depressive disorder.
#5 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/
Persistent depressive disorder (PDD), as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), merges the previous diagnoses of dysthymic disorder and chronic major depressive disorder. This condition is marked by a depressed mood lasting most of the day, for more days than not, over at least 2 years in adults or 1 year in children and adolescents. PDD can begin early in life and often becomes chronic, with symptoms that persist or fluctuate but never completely resolve. Individuals with PDD face a heightened risk of suicidal thoughts and behaviors, with functional impairments that can be as severe as or more severe than those experienced in major depressive disorder. […] According to the DSM-5, persistent depressive disorder is characterized by a depressed mood that occurs for most of the day, for more days than not, for at least 2 years, or at least 1 year for children and adolescents. Major depression may precede PDD, and major depressive episodes may occur during PDD, which is known as double depression. PDD may begin early in life, and depressive symptoms may wax and wane but never fully resolve.
#6 Psychiatry.org – What Is Depression?
https://www.psychiatry.org/patients-families/depression/what-is-depression
A person with persistent depressive disorder has a depressed mood for most of the day, for more days than not, for at least two years. In children and adolescents, the mood can be irritable or depressed, and must continue for at least one year. […] In addition to depressed mood, symptoms include: Poor appetite or overeating, Insomnia or hypersomnia, Low energy or fatigue, Low self-esteem, Poor concentration or difficulty making decisions, Feelings of hopelessness. […] Persistent depressive disorder often begins in childhood, adolescence, or early adulthood and affects an estimated 0.5% of adults in the United States every year. Individuals with persistent depressive disorder often describe their mood as sad or down in the dumps. Because these symptoms have become a part of the individuals day-to-day experience, they may not seek help, just assuming that I’ve always been this way.
#7 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder
Persistent depressive disorder symptoms usually come and go over a period of years. The intensity of symptoms can change over time. But symptoms usually don’t disappear for more than two months at a time. Also, major depression episodes may occur before or during persistent depressive disorder. […] Symptoms of persistent depressive disorder can cause major problems in your life and may include: Sadness, emptiness or feeling down. Loss of interest in daily activities. Tiredness and lack of energy. Low self-esteem, self-criticism or feeling you’re not capable. Trouble focusing clearly and trouble making decisions. Problems getting things done well and on time. Quickly becoming annoyed, impatient or angry. Avoidance of social activities. Feelings of guilt and worries over the past. Poor appetite or overeating. Sleep problems. Hopelessness. […] In children, symptoms of persistent depressive disorder may include depressed mood and being irritable, which means easily becoming annoyed, impatient or angry.
#8 Persistent depressive disorder: MedlinePlus Medical EncyclopediaLock
https://medlineplus.gov/ency/article/000918.htm
Persistent depressive disorder (PDD) is a chronic (ongoing) type of depression in which a person’s moods are regularly low. […] The main symptom of PDD is a low, dark, or sad mood on most days for at least 2 years. In children and teens, the mood can be irritable instead of depressed and lasts for at least 1 year. […] In addition, two or more of the following symptoms are present almost all of the time: Feelings of hopelessness, Too little or too much sleep, Low energy or fatigue, Low self-esteem, Poor appetite or overeating, Poor concentration. […] People with PDD will often take a negative or discouraging view of themselves, their future, other people, and life events. Problems often seem hard to solve. […] PDD is a chronic condition that can last for years. Many people recover fully while others continue to have some symptoms, even with treatment. […] PDD also increases your risk of suicide.
#9 Persistent depressive disorder – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/diagnosis-treatment/drc-20350935
If your health care provider thinks that you may have persistent depressive disorder, exams and tests may include: […] Symptoms caused by persistent depressive disorder can vary from person to person. When persistent depressive disorder starts before age 21, it’s called early onset. If it starts at age 21 or older, it’s called late onset. […] For an adult, depressed mood occurs most of the day for two or more years. […] For a child, depressed mood or irritability occurs most of the day for at least one year. […] Persistent depressive disorder makes it hard to engage in behavior and activities that can help you feel better. […] Don’t stop taking an antidepressant without talking to your health care provider. When it’s time, your provider can help you gradually and safely decrease your dose. […] When you have persistent depressive disorder, you may need to take antidepressants long term to keep symptoms under control.
#10 Persistent Depressive Disorder (PDD): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/9292-persistent-depressive-disorder-pdd
Persistent depressive disorder (PDD) is a mild to moderate chronic depression. It involves a sad or dark mood most of the day, on most days, for two years or more. The main symptom of persistent depressive disorder is a sad, low or dark mood. Other persistent depressive disorder symptoms may range from fatigue to trouble sleeping. Other persistent depressive disorder symptoms may include: Fatigue. Feelings of hopelessness and/or worthlessness. Lack of appetite or overeating. Lack of concentration. Limited energy. Low self-esteem. Difficulty performing at work or school. Trouble sleeping or sleeping too much. With medication, talk therapy and lifestyle changes, you can manage persistent depressive disorder and feel better. But if your symptoms come back or dont improve, talk to your healthcare provider. If youre feeling sad or down most of the day, for most days, over a long period of time, you may have persistent depressive disorder (PPD). It’s important to talk to a healthcare provider if you have depressive symptoms.
#11 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder
Persistent depressive disorder symptoms usually come and go over a period of years. The intensity of symptoms can change over time. But symptoms usually don’t disappear for more than two months at a time. Also, major depression episodes may occur before or during persistent depressive disorder. […] Symptoms of persistent depressive disorder can cause major problems in your life and may include: Sadness, emptiness or feeling down. Loss of interest in daily activities. Tiredness and lack of energy. Low self-esteem, self-criticism or feeling you’re not capable. Trouble focusing clearly and trouble making decisions. Problems getting things done well and on time. Quickly becoming annoyed, impatient or angry. Avoidance of social activities. Feelings of guilt and worries over the past. Poor appetite or overeating. Sleep problems. Hopelessness. […] In children, symptoms of persistent depressive disorder may include depressed mood and being irritable, which means easily becoming annoyed, impatient or angry.
#12 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder
Persistent depressive disorder symptoms usually come and go over a period of years. The intensity of symptoms can change over time. But symptoms usually don’t disappear for more than two months at a time. Also, major depression episodes may occur before or during persistent depressive disorder. […] Symptoms of persistent depressive disorder can cause major problems in your life and may include: Sadness, emptiness or feeling down. Loss of interest in daily activities. Tiredness and lack of energy. Low self-esteem, self-criticism or feeling you’re not capable. Trouble focusing clearly and trouble making decisions. Problems getting things done well and on time. Quickly becoming annoyed, impatient or angry. Avoidance of social activities. Feelings of guilt and worries over the past. Poor appetite or overeating. Sleep problems. Hopelessness. […] In children, symptoms of persistent depressive disorder may include depressed mood and being irritable, which means easily becoming annoyed, impatient or angry.
#13 Chronic Depression (Dysthymia): Symptoms, Treatments, and More
https://www.webmd.com/depression/chronic-depression-dysthymia
Persistent depressive disorder is a psychological condition in which you have mild or moderate symptoms, such as sadness and hopelessness, that last for a long time. It’s also called dysthymia. […] The symptoms of persistent depressive disorder are the same as those of clinical depression, but fewer in number and not as intense. They include the following: Sadness or depressed mood most of the day or almost every day, Loss of enjoyment in things that were once pleasurable, Major change in weight (gain or loss of more than 5% of weight within a month) or appetite, Insomnia or excessive sleep almost every day, Being physically restless or rundown in a way that is noticeable by others, Fatigue or loss of energy almost every day, Feelings of hopelessness or worthlessness or excessive guilt almost every day, Problems with concentration or making decisions almost every day, Recurring thoughts of death or suicide, suicide plan, or suicide attempt.
#14 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/
Depressed mood for most of the day, for more days than not, as indicated by subjective account or observation by others, for at least 2 years. […] Presence while depressed of two or more of the following: Poor appetite or overeating, Insomnia or hypersomnia, Low energy or fatigue, Low self-esteem, Poor concentration or difficulty making decisions, Feelings of hopelessness. […] During the 2 year period of the disturbance, the person has never been without symptoms from the above two criteria for more than 2 months at a time. […] The symptoms cause clinically significant distress or impairment in important areas of functioning.
#15 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder
Persistent depressive disorder symptoms usually come and go over a period of years. The intensity of symptoms can change over time. But symptoms usually don’t disappear for more than two months at a time. Also, major depression episodes may occur before or during persistent depressive disorder. […] Symptoms of persistent depressive disorder can cause major problems in your life and may include: Sadness, emptiness or feeling down. Loss of interest in daily activities. Tiredness and lack of energy. Low self-esteem, self-criticism or feeling you’re not capable. Trouble focusing clearly and trouble making decisions. Problems getting things done well and on time. Quickly becoming annoyed, impatient or angry. Avoidance of social activities. Feelings of guilt and worries over the past. Poor appetite or overeating. Sleep problems. Hopelessness. […] In children, symptoms of persistent depressive disorder may include depressed mood and being irritable, which means easily becoming annoyed, impatient or angry.
#16 Persistent depressive disorder: MedlinePlus Medical EncyclopediaLock
https://medlineplus.gov/ency/article/000918.htm
Persistent depressive disorder (PDD) is a chronic (ongoing) type of depression in which a person’s moods are regularly low. […] The main symptom of PDD is a low, dark, or sad mood on most days for at least 2 years. In children and teens, the mood can be irritable instead of depressed and lasts for at least 1 year. […] In addition, two or more of the following symptoms are present almost all of the time: Feelings of hopelessness, Too little or too much sleep, Low energy or fatigue, Low self-esteem, Poor appetite or overeating, Poor concentration. […] People with PDD will often take a negative or discouraging view of themselves, their future, other people, and life events. Problems often seem hard to solve. […] PDD is a chronic condition that can last for years. Many people recover fully while others continue to have some symptoms, even with treatment. […] PDD also increases your risk of suicide.
#17 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder
Persistent depressive disorder symptoms usually come and go over a period of years. The intensity of symptoms can change over time. But symptoms usually don’t disappear for more than two months at a time. Also, major depression episodes may occur before or during persistent depressive disorder. […] Symptoms of persistent depressive disorder can cause major problems in your life and may include: Sadness, emptiness or feeling down. Loss of interest in daily activities. Tiredness and lack of energy. Low self-esteem, self-criticism or feeling you’re not capable. Trouble focusing clearly and trouble making decisions. Problems getting things done well and on time. Quickly becoming annoyed, impatient or angry. Avoidance of social activities. Feelings of guilt and worries over the past. Poor appetite or overeating. Sleep problems. Hopelessness. […] In children, symptoms of persistent depressive disorder may include depressed mood and being irritable, which means easily becoming annoyed, impatient or angry.
#18 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder
Persistent depressive disorder symptoms usually come and go over a period of years. The intensity of symptoms can change over time. But symptoms usually don’t disappear for more than two months at a time. Also, major depression episodes may occur before or during persistent depressive disorder. […] Symptoms of persistent depressive disorder can cause major problems in your life and may include: Sadness, emptiness or feeling down. Loss of interest in daily activities. Tiredness and lack of energy. Low self-esteem, self-criticism or feeling you’re not capable. Trouble focusing clearly and trouble making decisions. Problems getting things done well and on time. Quickly becoming annoyed, impatient or angry. Avoidance of social activities. Feelings of guilt and worries over the past. Poor appetite or overeating. Sleep problems. Hopelessness. […] In children, symptoms of persistent depressive disorder may include depressed mood and being irritable, which means easily becoming annoyed, impatient or angry.
#19 Persistent Depressive Disorder – Depression and Bipolar Support Alliance
https://www.dbsalliance.org/education/depression/types-of-depression/persistent-depressive-disorder/
Persistent depressive disorder (formerly known as dysthymia) is a continuous long-term, chronic state of low-level depressed mood. The depressed state of persistent depressive disorder is not as severe as with major depression, but can be just as disabling. […] Symptoms of persistent depressive disorder include low self-esteem or self-confidence, or feelings of inadequacy; feelings of pessimism, despair or hopelessness; generalized loss of interest or pleasure; social withdrawal; chronic fatigue or tiredness; feelings of guilt or ruminating about the past; subjective feelings of irritability or excessive anger; decreased activity, effectiveness or productivity; and difficulty in thinking: poor memory, poor concentration or indecisiveness. […] Persistent depressive disorder is diagnosed when these symptoms last for more than two years in adults (or one year in children) and a person has not been symptom-free for more than two months at a time.
#20 Persistent Depressive Disorder (PDD): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/9292-persistent-depressive-disorder-pdd
Persistent depressive disorder (PDD) is a mild to moderate chronic depression. It involves a sad or dark mood most of the day, on most days, for two years or more. The main symptom of persistent depressive disorder is a sad, low or dark mood. Other persistent depressive disorder symptoms may range from fatigue to trouble sleeping. Other persistent depressive disorder symptoms may include: Fatigue. Feelings of hopelessness and/or worthlessness. Lack of appetite or overeating. Lack of concentration. Limited energy. Low self-esteem. Difficulty performing at work or school. Trouble sleeping or sleeping too much. With medication, talk therapy and lifestyle changes, you can manage persistent depressive disorder and feel better. But if your symptoms come back or dont improve, talk to your healthcare provider. If youre feeling sad or down most of the day, for most days, over a long period of time, you may have persistent depressive disorder (PPD). It’s important to talk to a healthcare provider if you have depressive symptoms.
#21 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/
Depressed mood for most of the day, for more days than not, as indicated by subjective account or observation by others, for at least 2 years. […] Presence while depressed of two or more of the following: Poor appetite or overeating, Insomnia or hypersomnia, Low energy or fatigue, Low self-esteem, Poor concentration or difficulty making decisions, Feelings of hopelessness. […] During the 2 year period of the disturbance, the person has never been without symptoms from the above two criteria for more than 2 months at a time. […] The symptoms cause clinically significant distress or impairment in important areas of functioning.
#22 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/
Depressed mood for most of the day, for more days than not, as indicated by subjective account or observation by others, for at least 2 years. […] Presence while depressed of two or more of the following: Poor appetite or overeating, Insomnia or hypersomnia, Low energy or fatigue, Low self-esteem, Poor concentration or difficulty making decisions, Feelings of hopelessness. […] During the 2 year period of the disturbance, the person has never been without symptoms from the above two criteria for more than 2 months at a time. […] The symptoms cause clinically significant distress or impairment in important areas of functioning.
#23 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder
Persistent depressive disorder symptoms usually come and go over a period of years. The intensity of symptoms can change over time. But symptoms usually don’t disappear for more than two months at a time. Also, major depression episodes may occur before or during persistent depressive disorder. […] Symptoms of persistent depressive disorder can cause major problems in your life and may include: Sadness, emptiness or feeling down. Loss of interest in daily activities. Tiredness and lack of energy. Low self-esteem, self-criticism or feeling you’re not capable. Trouble focusing clearly and trouble making decisions. Problems getting things done well and on time. Quickly becoming annoyed, impatient or angry. Avoidance of social activities. Feelings of guilt and worries over the past. Poor appetite or overeating. Sleep problems. Hopelessness. […] In children, symptoms of persistent depressive disorder may include depressed mood and being irritable, which means easily becoming annoyed, impatient or angry.
#24 Persistent Depressive Disorder in Children – Stanford Medicine Children’s Health
https://www.stanfordchildrens.org/en/topic/default?id=persistent-depressive-disorder-in-children-90-P01600
Persistent depressive disorder is a type of depression. With persistent depressive disorder, a child has a low, sad, or irritable mood for at least 1 year. […] Each child’s symptoms may vary. A child must have 2 or more of the following symptoms for at least 1 year to be diagnosed with persistent depressive disorder: Lasting feelings of sadness, Feelings of despair, helplessness, or guilt, Low self-esteem, Feelings of not being good enough, Feelings of wanting to die, Trouble with relationships, Sleep problems, such as insomnia, Changes in appetite or weight, A drop in energy, Problems focusing or making decisions, Being grouchy, hostile, or aggressive, Suicidal thoughts or attempts, Frequent physical complaints, such as headache, stomachache, or extreme tiredness (fatigue), Running away or threats of running away from home, Loss of interest in normal activities or activities once enjoyed, Sensitivity to failure or rejection.
#25 Persistent Depressive Disorder in Children – Stanford Medicine Children’s Health
https://www.stanfordchildrens.org/en/topic/default?id=persistent-depressive-disorder-in-children-90-P01600
Persistent depressive disorder is a type of depression. With persistent depressive disorder, a child has a low, sad, or irritable mood for at least 1 year. […] Each child’s symptoms may vary. A child must have 2 or more of the following symptoms for at least 1 year to be diagnosed with persistent depressive disorder: Lasting feelings of sadness, Feelings of despair, helplessness, or guilt, Low self-esteem, Feelings of not being good enough, Feelings of wanting to die, Trouble with relationships, Sleep problems, such as insomnia, Changes in appetite or weight, A drop in energy, Problems focusing or making decisions, Being grouchy, hostile, or aggressive, Suicidal thoughts or attempts, Frequent physical complaints, such as headache, stomachache, or extreme tiredness (fatigue), Running away or threats of running away from home, Loss of interest in normal activities or activities once enjoyed, Sensitivity to failure or rejection.
#26 Persistent Depressive Disorder in Children – Stanford Medicine Children’s Health
https://www.stanfordchildrens.org/en/topic/default?id=persistent-depressive-disorder-in-children-90-P01600
Persistent depressive disorder is a type of depression. With persistent depressive disorder, a child has a low, sad, or irritable mood for at least 1 year. […] Each child’s symptoms may vary. A child must have 2 or more of the following symptoms for at least 1 year to be diagnosed with persistent depressive disorder: Lasting feelings of sadness, Feelings of despair, helplessness, or guilt, Low self-esteem, Feelings of not being good enough, Feelings of wanting to die, Trouble with relationships, Sleep problems, such as insomnia, Changes in appetite or weight, A drop in energy, Problems focusing or making decisions, Being grouchy, hostile, or aggressive, Suicidal thoughts or attempts, Frequent physical complaints, such as headache, stomachache, or extreme tiredness (fatigue), Running away or threats of running away from home, Loss of interest in normal activities or activities once enjoyed, Sensitivity to failure or rejection.
#27 Persistent Depressive Disorder in Children | Phoenix Children’s Hospital
https://phoenixchildrens.org/specialties-conditions/persistent-depressive-disorder-children
Being grouchy, hostile, or aggressive […] Suicidal thoughts. Take any comments about suicide seriously. Get help right away. […] Suicide attempts. An attempt means someone harms themselves in a way that is meant to end their life, but they do not die because of their actions. This is an emergency. Get immediate help. […] Frequent physical complaints, such as headache, stomachache, or extreme tiredness or exhaustion (fatigue) […] Running away or threats of running away from home […] Loss of interest in normal activities or activities once enjoyed […] Sensitivity to failure or rejection. Persistent depressive disorder symptoms may look like other mental health problems. Persistent depressive disorder may put your child at an increased risk for major depression if they do not get the correct treatment. It also raises the risk for your child or teen to have other mental health disorders. A child with this disorder may have times of depression that last longer than 5 years. Correct, ongoing treatment can ease symptoms and stop them from returning.
#28 Persistent Depressive Disorder in Children | Phoenix Children’s Hospital
https://phoenixchildrens.org/specialties-conditions/persistent-depressive-disorder-children
Being grouchy, hostile, or aggressive […] Suicidal thoughts. Take any comments about suicide seriously. Get help right away. […] Suicide attempts. An attempt means someone harms themselves in a way that is meant to end their life, but they do not die because of their actions. This is an emergency. Get immediate help. […] Frequent physical complaints, such as headache, stomachache, or extreme tiredness or exhaustion (fatigue) […] Running away or threats of running away from home […] Loss of interest in normal activities or activities once enjoyed […] Sensitivity to failure or rejection. Persistent depressive disorder symptoms may look like other mental health problems. Persistent depressive disorder may put your child at an increased risk for major depression if they do not get the correct treatment. It also raises the risk for your child or teen to have other mental health disorders. A child with this disorder may have times of depression that last longer than 5 years. Correct, ongoing treatment can ease symptoms and stop them from returning.
#29 Persistent Depressive Disorder in Children | Phoenix Children’s Hospital
https://phoenixchildrens.org/specialties-conditions/persistent-depressive-disorder-children
Being grouchy, hostile, or aggressive […] Suicidal thoughts. Take any comments about suicide seriously. Get help right away. […] Suicide attempts. An attempt means someone harms themselves in a way that is meant to end their life, but they do not die because of their actions. This is an emergency. Get immediate help. […] Frequent physical complaints, such as headache, stomachache, or extreme tiredness or exhaustion (fatigue) […] Running away or threats of running away from home […] Loss of interest in normal activities or activities once enjoyed […] Sensitivity to failure or rejection. Persistent depressive disorder symptoms may look like other mental health problems. Persistent depressive disorder may put your child at an increased risk for major depression if they do not get the correct treatment. It also raises the risk for your child or teen to have other mental health disorders. A child with this disorder may have times of depression that last longer than 5 years. Correct, ongoing treatment can ease symptoms and stop them from returning.
#30 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/
Depressed mood for most of the day, for more days than not, as indicated by subjective account or observation by others, for at least 2 years. […] Presence while depressed of two or more of the following: Poor appetite or overeating, Insomnia or hypersomnia, Low energy or fatigue, Low self-esteem, Poor concentration or difficulty making decisions, Feelings of hopelessness. […] During the 2 year period of the disturbance, the person has never been without symptoms from the above two criteria for more than 2 months at a time. […] The symptoms cause clinically significant distress or impairment in important areas of functioning.
#31 Persistent Depressive Disorder (Dysthymia) Symptoms And Related DSMâ5 Diagnosis – Senior Care Psychological Consulting
https://seniorcarepsychological.com/persistent-depressive-disorder-dysthymia-symptoms-and-related-dsm-5-diagnosis/
Persistent Depressive Disorder (Dysthymia) diagnostic criteria 300.4 (F34.1): This disorder represents a consolidation of DSM-4-defined Chronic Major Depressive Disorder and Dysthymic Disorder. A. Depressed mood for most of the day, for more days than not, is indicated by either subjective account or observation by others, for at least two years. […] B. Presence, while depressed, of two (or more) of the following: 1. Poor appetite or overeating. 2. Insomnia or hypersomnia. 3. Low energy or fatigue. 4. Low self-esteem. 5. Poor concentration or difficulty making decisions. 6. Feelings of hopelessness. […] C. During the two-year period (1 year for children or adolescents) of the disturbance, individual has never been without the symptoms in criteria A and B for more than two months at a time. […] H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
#32 Reddit – The heart of the internet
https://www.reddit.com/r/dysthymia/comments/mu13ji/what_is_known_about_persistent_depressive/
Formally, the Diagnostic and Statistical Manual of Mental Disorders (DSM5) describes a person with PDD as having a depressed mood most of the day, more days than not for at least 2 years. […] The criteria further specify that 2 of the 6 symptoms be present for diagnoses: Changes in eating (abnormal appetite), Changes in sleep, Low energy, Low self-esteem (self-esteem is the opinion we have of ourselves), Poor concentration/decision-making skills, Hopelessness (no expectation of future improvement or success). […] The criteria also state that these symptoms do not cease for more than 2 months at a time in PDD. […] Psychiatrists are asked to also specify if the chronic depression is Pure dysthymic syndrome, Persistent major depressive disorder or Intermittent major depressive disorder.
#33 Dysthymia – Wikipedia
https://en.wikipedia.org/wiki/Dysthymia
Dysthymia is characterized by 2-year history of depressed mood, as well as at least two of the following symptoms: poor appetite or overeating, hypersomnia or insomnia, fatigue or low energy, low self-esteem, poor concentration or difficulty making decisions, and hopelessness. […] Individuals with PDD, defined in part by its chronicity, may experience symptoms for years before receiving a diagnosis, if one is received at all. […] Diagnosis of dysthymia can be difficult because of the subtle nature of the symptoms and patients can often hide them in social situations, making it challenging for others to detect symptoms. […] Dysthymia often co-occurs with other mental disorders. A „double depression” is the occurrence of episodes of major depression in addition to dysthymia. […] Patients with double depression tend to report significantly higher levels of hopelessness than is normal.
#34 Persistent Depressive Disorder – Depression and Bipolar Support Alliance
https://www.dbsalliance.org/education/depression/types-of-depression/persistent-depressive-disorder/
People with persistent depressive disorder may be unaware that they have a health condition. They might be able to go to work and manage their lives to some degree. However, they may be irritable, stressed, or sleepless much of the time. Many people with persistent depressive disorder believe their symptoms are just part of their personality. It may be more difficult for them to seek treatment. […] About 3-6% of the population has persistent depressive disorder. People with persistent depressive disorder often have their first symptoms earlier in life than those with major depressive disorder or bipolar disorder. […] Some people have persistent depressive disorder along with periodic episodes of major depression. Martin B. Keller, M.D coined the term double depression to describe this.
#35 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/
Persistent depressive disorder (PDD), as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), merges the previous diagnoses of dysthymic disorder and chronic major depressive disorder. This condition is marked by a depressed mood lasting most of the day, for more days than not, over at least 2 years in adults or 1 year in children and adolescents. PDD can begin early in life and often becomes chronic, with symptoms that persist or fluctuate but never completely resolve. Individuals with PDD face a heightened risk of suicidal thoughts and behaviors, with functional impairments that can be as severe as or more severe than those experienced in major depressive disorder. […] According to the DSM-5, persistent depressive disorder is characterized by a depressed mood that occurs for most of the day, for more days than not, for at least 2 years, or at least 1 year for children and adolescents. Major depression may precede PDD, and major depressive episodes may occur during PDD, which is known as double depression. PDD may begin early in life, and depressive symptoms may wax and wane but never fully resolve.
#36 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview
An estimated 75% of people with dysthymia meet criteria for at least 1 major depressive episode, referred to as double depression. Those with dysthymia who have depressive episodes tend to have longer periods of depression and spend less time fully recovered. […] In a 10-year follow-up study of people with dysthymia, 75% experienced some (at least 2 mo) period of recovery from major depression; the mean time to recovery was 52 months from study entry. In this study, most (70%) of those who recovered experienced a relapse into another episode of depression, most commonly in the 3 years following recovery. […] Persistent depressive disorder (formerly known as dysthymia) is by definition chronic. Periods of depression or euthymia may occur during the course of the illness. A systematic review of epidemiologic studies found that 4671% of persons with dysthymia reported remission at follow-up points ranging from 16 years.
#37 Persistent Depressive Disorder (Dysthymia): Symptoms, Causes, Diagnosis, Treatment, Coping
https://www.verywellmind.com/what-is-dysthymia-dysthymic-disorder-1066954
The symptoms of PDD are chronic, meaning that people experience a depressed mood for most days for a period of at least two years. The timeframe has been reduced to one year for children and teens. In that two-year time frame for adults, they cannot be without symptoms for more than two months at a time. […] A person meeting the diagnostic criteria for persistent depressive disorder can also experience major depressive episodes. When the major depressive episode has ended, however, there is a return to the previous milder state of chronic depression rather than an absence of depressive symptoms. This co-occurrence of PDD and MDD is sometimes referred to as double depression. […] Another distinction is that PDD may have an earlier onset than MDD, with symptoms first appearing during the childhood, teen, or young adult years. MDD is more likely to occur after puberty, peaking in early adulthood, but can occur at any time throughout adulthood.
#38 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview
An estimated 75% of people with dysthymia meet criteria for at least 1 major depressive episode, referred to as double depression. Those with dysthymia who have depressive episodes tend to have longer periods of depression and spend less time fully recovered. […] In a 10-year follow-up study of people with dysthymia, 75% experienced some (at least 2 mo) period of recovery from major depression; the mean time to recovery was 52 months from study entry. In this study, most (70%) of those who recovered experienced a relapse into another episode of depression, most commonly in the 3 years following recovery. […] Persistent depressive disorder (formerly known as dysthymia) is by definition chronic. Periods of depression or euthymia may occur during the course of the illness. A systematic review of epidemiologic studies found that 4671% of persons with dysthymia reported remission at follow-up points ranging from 16 years.
#39 Dysthymia – Wikipedia
https://en.wikipedia.org/wiki/Dysthymia
Dysthymia is characterized by 2-year history of depressed mood, as well as at least two of the following symptoms: poor appetite or overeating, hypersomnia or insomnia, fatigue or low energy, low self-esteem, poor concentration or difficulty making decisions, and hopelessness. […] Individuals with PDD, defined in part by its chronicity, may experience symptoms for years before receiving a diagnosis, if one is received at all. […] Diagnosis of dysthymia can be difficult because of the subtle nature of the symptoms and patients can often hide them in social situations, making it challenging for others to detect symptoms. […] Dysthymia often co-occurs with other mental disorders. A „double depression” is the occurrence of episodes of major depression in addition to dysthymia. […] Patients with double depression tend to report significantly higher levels of hopelessness than is normal.
#40 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview
An estimated 75% of people with dysthymia meet criteria for at least 1 major depressive episode, referred to as double depression. Those with dysthymia who have depressive episodes tend to have longer periods of depression and spend less time fully recovered. […] In a 10-year follow-up study of people with dysthymia, 75% experienced some (at least 2 mo) period of recovery from major depression; the mean time to recovery was 52 months from study entry. In this study, most (70%) of those who recovered experienced a relapse into another episode of depression, most commonly in the 3 years following recovery. […] Persistent depressive disorder (formerly known as dysthymia) is by definition chronic. Periods of depression or euthymia may occur during the course of the illness. A systematic review of epidemiologic studies found that 4671% of persons with dysthymia reported remission at follow-up points ranging from 16 years.
#41 Persistent Depression Disorder – Discovery Mood & Anxiety Program
https://discoverymood.com/blog/persistent-depression-disorder/
Symptoms of persistent depressive disorder can cause significant impairment in daily functioning and may include: Loss of interest in daily activities, Sadness, emptiness or feeling down, Hopelessness, Tiredness and lack of energy, Low self-esteem, self-criticism or feeling incapable, Trouble concentrating and trouble to make decisions, Irritability or excessive anger, Decreased activity, effectiveness, and productivity, Avoidance of social activities, Feelings of guilt and worries over the past, Poor appetite or overeating, Sleep problems. […] While individuals with major depressive disorder will typically âcycleâ through episodes of feeling severely depressed and then be symptom-free for periods, dysthymia presents with persistent symptoms for years. This disorder can be difficult to diagnose because its less severe and lingering nature can make the condition feel ânormalâ for that individual.
#42 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview
An estimated 75% of people with dysthymia meet criteria for at least 1 major depressive episode, referred to as double depression. Those with dysthymia who have depressive episodes tend to have longer periods of depression and spend less time fully recovered. […] In a 10-year follow-up study of people with dysthymia, 75% experienced some (at least 2 mo) period of recovery from major depression; the mean time to recovery was 52 months from study entry. In this study, most (70%) of those who recovered experienced a relapse into another episode of depression, most commonly in the 3 years following recovery. […] Persistent depressive disorder (formerly known as dysthymia) is by definition chronic. Periods of depression or euthymia may occur during the course of the illness. A systematic review of epidemiologic studies found that 4671% of persons with dysthymia reported remission at follow-up points ranging from 16 years.
#43 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview
An estimated 75% of people with dysthymia meet criteria for at least 1 major depressive episode, referred to as double depression. Those with dysthymia who have depressive episodes tend to have longer periods of depression and spend less time fully recovered. […] In a 10-year follow-up study of people with dysthymia, 75% experienced some (at least 2 mo) period of recovery from major depression; the mean time to recovery was 52 months from study entry. In this study, most (70%) of those who recovered experienced a relapse into another episode of depression, most commonly in the 3 years following recovery. […] Persistent depressive disorder (formerly known as dysthymia) is by definition chronic. Periods of depression or euthymia may occur during the course of the illness. A systematic review of epidemiologic studies found that 4671% of persons with dysthymia reported remission at follow-up points ranging from 16 years.
#44 Persistent Depressive Disorder (Dysthmyia): Symptoms, Causes, And Treatments | BetterHelp
https://www.betterhelp.com/mental-health/disorders-conditions/persistent-depressive-disorder-dysthymia/
Some recent research shows that people with dysthymia or PDD may improve slower than people who are non-chronically depressed. Results from a recent study found that, at a 10-year follow-up, 60% of people with PDD still met the criteria for depressive disorder, compared to only 21% of those with non-chronic disorders.
#45 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview
Comorbidities, such as anxiety disorders and depressive personality disorder, are associated with lower recovery rates. Chronic stress is associated with more severe symptoms and a lower likelihood of recovery. […] Patients should be closely monitored for the emergence of major depression or bipolar disorder. Review of longitudinal studies showed that 76% of dysthymic children developed major depression and that 13% developed bipolar disorder over follow-up periods of 312 years. […] Additional concerns in dysthymia include the following: Increased mortality and morbidity from unrelated physical illnesses – dysthymia is associated with poorer self-rated health status. Suicide, attempted or completed – dysthymia significantly increases risk of suicide. […] If possible, family members and other significant individuals should be helped to understand depression, to view the patient’s complaints as symptoms of an illness, and to be sensitive to signs of major depression, with its risk of suicide. For example, an increase in irritability often heralds the progression from dysthymia to depression and may be apparent to people close to the patient before the patient is aware of the change.
#46 Persistent Depressive Disorder (Dysthymia) – PsychDB
https://www.psychdb.com/mood/persistent-depressive-disorder-dysthymia
Persistent Depressive Disorder (PDD) is a mood disorder characterized by a depressed mood that occurs for most of the day, for more days than not, for at least two years (one year for children and adolescents). […] PDD often has an early and insidious onset in childhood, adolescence, or early adulthood. […] The disorder, by definition, has a chronic course, and are less likely to resolve, compared to a major depressive disorder episode. […] The presence of high neuroticism, more severe symptoms, worse global functioning, and comorbid anxiety disorders or conduct disorder leads to worse long-term outcomes. […] Since these symptoms have been part of the individual’s day-to-day experience for many years (especially in the case of early onset), patients may not report depressive episodes unless directly prompted (e.g. – I’ve always been this way.)
#47 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/
The prognosis of PDD is similar, if not worse, than that of major depressive disorder. Outcomes of a 10-year study suggest that persistent depressive disorder is independently associated with greater severity of depression, anxiety, and somatic symptoms in individuals with major depressive disorder in comparison to individuals with major depressive disorder without PDD. […] Persistent depressive disorder (PDD) negatively affects social and occupational functioning in varying ways, which can be as great or greater than a major depressive disorder. PDD is associated with an increased risk of suicidal outcomes. The symptoms of PDD are much less likely to fully resolve in a given period. Individuals with PDD are at higher risk of personality disorders and substance use disorders. Significant associations were found in inpatients with PDD between childhood emotional abuse and suicidal behaviors (including suicide attempts).
#48 Major vs. persistent depressive disorder: Understanding dysthymia
https://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder
Persistent depressive disorder (PDD) and major depressive disorder (MDD) are two forms of depression. Some symptoms may overlap, and doctors may use similar approaches for the diagnosis, but the causes of PDD and MDD can differ. […] A key difference involves the duration of symptoms. For a doctor to diagnose PDD in an adult, symptoms must have lasted for at least 2 years. […] PDD symptoms include: feeling depressed or irritable, having a poor appetite or overeating, having insomnia or sleeping too much, experiencing fatigue or low energy, having low self-esteem, having trouble concentrating or making decisions, having feelings of hopelessness. […] Those with PDD may experience difficulties in fulfilling work, school, or home responsibilities. The condition can also make socializing and enjoying hobbies difficult. It may also cause an increase in overwhelming feelings during stressful situations.
#49 Major vs. persistent depressive disorder: Understanding dysthymia
https://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder
Persistent depressive disorder (PDD) and major depressive disorder (MDD) are two forms of depression. Some symptoms may overlap, and doctors may use similar approaches for the diagnosis, but the causes of PDD and MDD can differ. […] A key difference involves the duration of symptoms. For a doctor to diagnose PDD in an adult, symptoms must have lasted for at least 2 years. […] PDD symptoms include: feeling depressed or irritable, having a poor appetite or overeating, having insomnia or sleeping too much, experiencing fatigue or low energy, having low self-esteem, having trouble concentrating or making decisions, having feelings of hopelessness. […] Those with PDD may experience difficulties in fulfilling work, school, or home responsibilities. The condition can also make socializing and enjoying hobbies difficult. It may also cause an increase in overwhelming feelings during stressful situations.
#50 Major vs. persistent depressive disorder: Understanding dysthymia
https://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder
Persistent depressive disorder (PDD) and major depressive disorder (MDD) are two forms of depression. Some symptoms may overlap, and doctors may use similar approaches for the diagnosis, but the causes of PDD and MDD can differ. […] A key difference involves the duration of symptoms. For a doctor to diagnose PDD in an adult, symptoms must have lasted for at least 2 years. […] PDD symptoms include: feeling depressed or irritable, having a poor appetite or overeating, having insomnia or sleeping too much, experiencing fatigue or low energy, having low self-esteem, having trouble concentrating or making decisions, having feelings of hopelessness. […] Those with PDD may experience difficulties in fulfilling work, school, or home responsibilities. The condition can also make socializing and enjoying hobbies difficult. It may also cause an increase in overwhelming feelings during stressful situations.
#51 Persistent depressive disorder – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/805?locale=it
Persistent depressive disorder includes common forms of depression, but lasting longer than acute major depressive disorder. […] Affected patients have a depressed mood most of the day, for more days than not, for at least 2 years. While depressed, patients have at least 2 of: poor appetite/over-eating, insomnia or hypersomnia, low energy/fatigue, low self-esteem, poor concentration or difficulty making decisions, or feelings of hopelessness. Symptoms do not remit for more than 2 months at a time. […] Associated with significant functional impairment (including unemployment, difficulty establishing intimate relationships, greater healthcare utilisation, greater utilisation of public entitlements). […] Patients require a longer treatment period, more psychotherapy sessions, and/or higher doses of antidepressant medication compared with patients with acute forms of depression. […] Key diagnostic factors include chronic mood disorder lasting greater than 2 years, depressive symptoms present for most of the day, most days, and no periods of euthymia in the past 2 years. […] Symptoms of major depression may be continuously present for 2 or more years.
#52 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/
The prognosis of PDD is similar, if not worse, than that of major depressive disorder. Outcomes of a 10-year study suggest that persistent depressive disorder is independently associated with greater severity of depression, anxiety, and somatic symptoms in individuals with major depressive disorder in comparison to individuals with major depressive disorder without PDD. […] Persistent depressive disorder (PDD) negatively affects social and occupational functioning in varying ways, which can be as great or greater than a major depressive disorder. PDD is associated with an increased risk of suicidal outcomes. The symptoms of PDD are much less likely to fully resolve in a given period. Individuals with PDD are at higher risk of personality disorders and substance use disorders. Significant associations were found in inpatients with PDD between childhood emotional abuse and suicidal behaviors (including suicide attempts).
#53 Persistent depressive disorder: MedlinePlus Medical EncyclopediaLock
https://medlineplus.gov/ency/article/000918.htm
Persistent depressive disorder (PDD) is a chronic (ongoing) type of depression in which a person’s moods are regularly low. […] The main symptom of PDD is a low, dark, or sad mood on most days for at least 2 years. In children and teens, the mood can be irritable instead of depressed and lasts for at least 1 year. […] In addition, two or more of the following symptoms are present almost all of the time: Feelings of hopelessness, Too little or too much sleep, Low energy or fatigue, Low self-esteem, Poor appetite or overeating, Poor concentration. […] People with PDD will often take a negative or discouraging view of themselves, their future, other people, and life events. Problems often seem hard to solve. […] PDD is a chronic condition that can last for years. Many people recover fully while others continue to have some symptoms, even with treatment. […] PDD also increases your risk of suicide.
#54 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/
In one study, results showed that the suicide risk in those with sleep disorders was 1.429 times higher than in those with no sleep disorders, and people with PDD exhibited a 7.195 times higher risk of suicide compared with those without PDD. Those with sleep disorders and PDD exhibited a 1.174 times higher risk of suicide compared to those with no sleep disorders.
#55 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/
The prognosis of PDD is similar, if not worse, than that of major depressive disorder. Outcomes of a 10-year study suggest that persistent depressive disorder is independently associated with greater severity of depression, anxiety, and somatic symptoms in individuals with major depressive disorder in comparison to individuals with major depressive disorder without PDD. […] Persistent depressive disorder (PDD) negatively affects social and occupational functioning in varying ways, which can be as great or greater than a major depressive disorder. PDD is associated with an increased risk of suicidal outcomes. The symptoms of PDD are much less likely to fully resolve in a given period. Individuals with PDD are at higher risk of personality disorders and substance use disorders. Significant associations were found in inpatients with PDD between childhood emotional abuse and suicidal behaviors (including suicide attempts).
#56 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/
The prognosis of PDD is similar, if not worse, than that of major depressive disorder. Outcomes of a 10-year study suggest that persistent depressive disorder is independently associated with greater severity of depression, anxiety, and somatic symptoms in individuals with major depressive disorder in comparison to individuals with major depressive disorder without PDD. […] Persistent depressive disorder (PDD) negatively affects social and occupational functioning in varying ways, which can be as great or greater than a major depressive disorder. PDD is associated with an increased risk of suicidal outcomes. The symptoms of PDD are much less likely to fully resolve in a given period. Individuals with PDD are at higher risk of personality disorders and substance use disorders. Significant associations were found in inpatients with PDD between childhood emotional abuse and suicidal behaviors (including suicide attempts).
#57 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview
Comorbidities, such as anxiety disorders and depressive personality disorder, are associated with lower recovery rates. Chronic stress is associated with more severe symptoms and a lower likelihood of recovery. […] Patients should be closely monitored for the emergence of major depression or bipolar disorder. Review of longitudinal studies showed that 76% of dysthymic children developed major depression and that 13% developed bipolar disorder over follow-up periods of 312 years. […] Additional concerns in dysthymia include the following: Increased mortality and morbidity from unrelated physical illnesses – dysthymia is associated with poorer self-rated health status. Suicide, attempted or completed – dysthymia significantly increases risk of suicide. […] If possible, family members and other significant individuals should be helped to understand depression, to view the patient’s complaints as symptoms of an illness, and to be sensitive to signs of major depression, with its risk of suicide. For example, an increase in irritability often heralds the progression from dysthymia to depression and may be apparent to people close to the patient before the patient is aware of the change.
#58 Dysthymia (Persistent Depressive Disorder) | Boston Children’s Hospital
https://www.childrenshospital.org/conditions/dysthymia
Persistent depressive disorder, also called dysthymia, is a form of chronic depression. It includes symptoms similar to major depression, but they are more severe and longer lasting. Persistent depressive disorder represents a new diagnosis, combining both dysthymia and chronic major depressive disorder. If a child presents with depressed or irritable mood on most days for more than a year, he or she may have persistent depressive disorder. […] A child or adolescent with persistent depressive disorder will experience a depressed or irritable mood on most days for at least a year. In addition, the child will exhibit appetite changes, sleep disturbances, fatigue, low self-esteem, poor concentration, difficulty making decisions, or feelings of hopelessness. […] Those with persistent depressive disorder are at high risk of going on to develop a major depressive episode. People that develop persistent depressive disorder earlier in life (21 years of age) tend to have a poorer prognosis than those that develop the disorder later in life. Children with persistent depressive disorder who do not receive treatment are more likely to develop personality disorders and substance use disorders in adulthood. Early identification and treatment of the disorder is important to minimize the long-term impact on the child or adolescent.
#59 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/
In one study, results showed that the suicide risk in those with sleep disorders was 1.429 times higher than in those with no sleep disorders, and people with PDD exhibited a 7.195 times higher risk of suicide compared with those without PDD. Those with sleep disorders and PDD exhibited a 1.174 times higher risk of suicide compared to those with no sleep disorders.
#60 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview
Comorbidities, such as anxiety disorders and depressive personality disorder, are associated with lower recovery rates. Chronic stress is associated with more severe symptoms and a lower likelihood of recovery. […] Patients should be closely monitored for the emergence of major depression or bipolar disorder. Review of longitudinal studies showed that 76% of dysthymic children developed major depression and that 13% developed bipolar disorder over follow-up periods of 312 years. […] Additional concerns in dysthymia include the following: Increased mortality and morbidity from unrelated physical illnesses – dysthymia is associated with poorer self-rated health status. Suicide, attempted or completed – dysthymia significantly increases risk of suicide. […] If possible, family members and other significant individuals should be helped to understand depression, to view the patient’s complaints as symptoms of an illness, and to be sensitive to signs of major depression, with its risk of suicide. For example, an increase in irritability often heralds the progression from dysthymia to depression and may be apparent to people close to the patient before the patient is aware of the change.
#61 Persistent Depressive Disorder (Dysthymia): Symptoms, Causes, Diagnosis, Treatment, Coping
https://www.verywellmind.com/what-is-dysthymia-dysthymic-disorder-1066954
Persistent depressive disorder (PDD), formerly known as dysthymia, is a mood disorder that is characterized by a milder but more chronic form of depression. […] The symptoms of persistent depressive disorder (PDD) are very similar to major depressive disorder. However, there is a wider range of symptoms available on the criteria list for major depression. You need to have three of the seven symptoms for PDD as opposed to five out of nine symptoms for MDD. […] The main symptom of PDD is a sad or depressed mood nearly every day. In children, the mood may manifest as irritability. […] In addition to depressed/irritable mood, at least two of the following symptoms are present: Changes in appetite (poor appetite or overeating), Sleep difficulties (too little or too much sleep), Lack of energy or fatigue, Poor self-esteem, Hopelessness or feeling stuck in a rut, Trouble concentrating or difficulty making decisions.
#62 Major vs. persistent depressive disorder: Understanding dysthymia
https://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder
To receive the diagnosis, a person must have at least two PDD symptoms, as well as depression or irritability that has lasted for at least 2 years, in adults, or at least 1 year, in children and teens. […] For a person to receive a diagnosis of PDD, the symptoms cannot have been absent for more than 2 months at a time during a 2-year period, in adults, or a 12-month period, in younger people. […] PDD and MDD are two forms of depression that have similar symptoms and treatment methods. […] The main difference concerns the duration of symptoms. PDD symptoms last for at least 2 years, in adults, while people with MDD experience depressive episodes that are separated by at least 2 months.
#63 Chronic Depression (Dysthymia): Symptoms, Treatments, and More
https://www.webmd.com/depression/chronic-depression-dysthymia
Its not uncommon for a person with persistent depressive disorder to also experience an episode of clinical depression at the same time. This is called double depression. […] Dysthymia is a type of depression with mild to moderate symptoms that go on for at least 2 years. It can be hard to recognize and diagnose it, but it can be treated with psychotherapy and medication.
#64 What is dysthymia or persistent depressive disorder? | Here to Help
https://www.heretohelp.bc.ca/q-and-a/what-is-dysthymia-or-persistent-depressive-disorder
There is a myth that PDD is not as severe an illness as major depressive disorder, but research shows that the disability of the illness, like the ability to work productively and enjoy hobbies, may be as severe in PDD as it is in major depressive disorder. As PDD involves a smaller number of symptoms that last for a very long time, many people begin to assume PDD is just part of their personality rather than an illness that can be effectively treated. So you should most certainly talk to a doctor or mental health professional if you think you might have PDD.
#65 Persistent Depressive Disorder: What to Know About Symptoms and Treatments – The New York Times
https://www.nytimes.com/2023/12/04/well/mind/depression-persistent-treatment-dysthymia.html
Because P.D.D. can be long lasting â and does not always disrupt a patientâs day-to-day life â those with the disorder may assume that their milder depressive symptoms are simply character traits. […] She urged those who feel consistently unmotivated, apathetic or lacking interest in things that they once enjoyed to seek help.
#66 Dysthymia (Persistent Depressive Disorder) | Boston Children’s Hospital
https://www.childrenshospital.org/conditions/dysthymia
Persistent depressive disorder, also called dysthymia, is a form of chronic depression. It includes symptoms similar to major depression, but they are more severe and longer lasting. Persistent depressive disorder represents a new diagnosis, combining both dysthymia and chronic major depressive disorder. If a child presents with depressed or irritable mood on most days for more than a year, he or she may have persistent depressive disorder. […] A child or adolescent with persistent depressive disorder will experience a depressed or irritable mood on most days for at least a year. In addition, the child will exhibit appetite changes, sleep disturbances, fatigue, low self-esteem, poor concentration, difficulty making decisions, or feelings of hopelessness. […] Those with persistent depressive disorder are at high risk of going on to develop a major depressive episode. People that develop persistent depressive disorder earlier in life (21 years of age) tend to have a poorer prognosis than those that develop the disorder later in life. Children with persistent depressive disorder who do not receive treatment are more likely to develop personality disorders and substance use disorders in adulthood. Early identification and treatment of the disorder is important to minimize the long-term impact on the child or adolescent.
#67 Persistent depressive disorder – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/805?locale=it
Persistent depressive disorder includes common forms of depression, but lasting longer than acute major depressive disorder. […] Affected patients have a depressed mood most of the day, for more days than not, for at least 2 years. While depressed, patients have at least 2 of: poor appetite/over-eating, insomnia or hypersomnia, low energy/fatigue, low self-esteem, poor concentration or difficulty making decisions, or feelings of hopelessness. Symptoms do not remit for more than 2 months at a time. […] Associated with significant functional impairment (including unemployment, difficulty establishing intimate relationships, greater healthcare utilisation, greater utilisation of public entitlements). […] Patients require a longer treatment period, more psychotherapy sessions, and/or higher doses of antidepressant medication compared with patients with acute forms of depression. […] Key diagnostic factors include chronic mood disorder lasting greater than 2 years, depressive symptoms present for most of the day, most days, and no periods of euthymia in the past 2 years. […] Symptoms of major depression may be continuously present for 2 or more years.
#68 Persistent Depressive Disorder (Dysthymia) – Harvard Health
https://www.health.harvard.edu/a_to_z/dysthymia-a-to-z
Symptoms can grow into a full-blown episode of major depression. People with persistent depressive disorder have a greater-than-average chance of developing major depression. […] The main symptom of persistent depressive disorder is a long-lasting low or sad mood. Children and adolescents with persistent depressive disorder may be irritable. Other symptoms include: increased or decreased appetite or weight, lack of sleep or sleeping too much, fatigue or low energy, low self-esteem, difficulty concentrating, indecisiveness, hopelessness or pessimism. […] Persistent depressive disorder can start early in life, even in childhood. There can be ups and downs in mood, but lower moods dominate and are persistent. Treatment can reduce how long it lasts and the intensity of the symptoms. […] Treatment may improve the duration and intensity of symptoms. In many people, the symptoms go away completely. Without treatment, the illness is more likely to persist, the person is likely to have a reduced quality of life and has an increased risk of developing major depression. […] Even when treatment is successful, maintenance treatment often is required to prevent symptoms from returning.
#69 Dysthymia – Wikipedia
https://en.wikipedia.org/wiki/Dysthymia
It has been suggested that the best way to prevent double depression is by treating the dysthymia. […] Persistent depressive disorder can be treated with psychotherapy and pharmacotherapy. […] The overall rate and degree of treatment success is somewhat lower than for non-chronic depression, and a combination of psychotherapy and pharmacotherapy shows best results. […] Because of dysthymia’s chronic nature, treatment resistance is somewhat common.
#70 Persistent Depressive Disorder (Dysthymia) – Harvard Health
https://www.health.harvard.edu/a_to_z/dysthymia-a-to-z
Symptoms can grow into a full-blown episode of major depression. People with persistent depressive disorder have a greater-than-average chance of developing major depression. […] The main symptom of persistent depressive disorder is a long-lasting low or sad mood. Children and adolescents with persistent depressive disorder may be irritable. Other symptoms include: increased or decreased appetite or weight, lack of sleep or sleeping too much, fatigue or low energy, low self-esteem, difficulty concentrating, indecisiveness, hopelessness or pessimism. […] Persistent depressive disorder can start early in life, even in childhood. There can be ups and downs in mood, but lower moods dominate and are persistent. Treatment can reduce how long it lasts and the intensity of the symptoms. […] Treatment may improve the duration and intensity of symptoms. In many people, the symptoms go away completely. Without treatment, the illness is more likely to persist, the person is likely to have a reduced quality of life and has an increased risk of developing major depression. […] Even when treatment is successful, maintenance treatment often is required to prevent symptoms from returning.

Przewlekłe zaburzenie depresyjne Objawy

Ogólna charakterystyka Przewlekłego zaburzenia depresyjnego

Objawy Przewlekłego zaburzenia depresyjnego

Główne objawy emocjonalne

Objawy poznawcze

Objawy behawioralne

Objawy fizyczne

Objawy u dzieci i młodzieży

Kryteria diagnostyczne

Progresja i przebieg choroby

Podwójona depresja

Charakter przebiegu choroby

Czynniki wpływające na przebieg choroby

Implikacje i powikłania

Wpływ na funkcjonowanie

Ryzyko samobójstwa

Zaburzenia współistniejące

Wpływ na sen i zdrowie fizyczne

Przewlekłe zaburzenie depresyjne a duża depresja

Kluczowe wnioski i obserwacje

Kolejne rozdziały

Materiały źródłowe

#1 Persistent Depressive Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK541052/

#2 Persistent depressive disorder – Symptoms, diagnosis and treatment | BMJ Best Practicehttps://bestpractice.bmj.com/topics/en-gb/805?locale=it

#3 Persistent Depressive Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK541052/

#4 Psychiatry.org – What Is Depression?https://www.psychiatry.org/patients-families/depression/what-is-depression

#5 Persistent Depressive Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK541052/

#6 Psychiatry.org – What Is Depression?https://www.psychiatry.org/patients-families/depression/what-is-depression

#7 Persistent depressive disorder | UM Health-Sparrowhttps://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#8 Persistent depressive disorder: MedlinePlus Medical EncyclopediaLockhttps://medlineplus.gov/ency/article/000918.htm

#9 Persistent depressive disorder – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/diagnosis-treatment/drc-20350935

#10 Persistent Depressive Disorder (PDD): Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/9292-persistent-depressive-disorder-pdd

#11 Persistent depressive disorder | UM Health-Sparrowhttps://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#12 Persistent depressive disorder | UM Health-Sparrowhttps://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#13 Chronic Depression (Dysthymia): Symptoms, Treatments, and Morehttps://www.webmd.com/depression/chronic-depression-dysthymia

#14 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/

#15 Persistent depressive disorder | UM Health-Sparrowhttps://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#16 Persistent depressive disorder: MedlinePlus Medical EncyclopediaLockhttps://medlineplus.gov/ency/article/000918.htm

#17 Persistent depressive disorder | UM Health-Sparrowhttps://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#18 Persistent depressive disorder | UM Health-Sparrowhttps://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#19 Persistent Depressive Disorder – Depression and Bipolar Support Alliancehttps://www.dbsalliance.org/education/depression/types-of-depression/persistent-depressive-disorder/

#20 Persistent Depressive Disorder (PDD): Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/9292-persistent-depressive-disorder-pdd

#21 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/

#22 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/

#23 Persistent depressive disorder | UM Health-Sparrowhttps://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#24 Persistent Depressive Disorder in Children – Stanford Medicine Children’s Healthhttps://www.stanfordchildrens.org/en/topic/default?id=persistent-depressive-disorder-in-children-90-P01600

#25 Persistent Depressive Disorder in Children – Stanford Medicine Children’s Healthhttps://www.stanfordchildrens.org/en/topic/default?id=persistent-depressive-disorder-in-children-90-P01600

#26 Persistent Depressive Disorder in Children – Stanford Medicine Children’s Healthhttps://www.stanfordchildrens.org/en/topic/default?id=persistent-depressive-disorder-in-children-90-P01600

#27 Persistent Depressive Disorder in Children | Phoenix Children’s Hospitalhttps://phoenixchildrens.org/specialties-conditions/persistent-depressive-disorder-children

#28 Persistent Depressive Disorder in Children | Phoenix Children’s Hospitalhttps://phoenixchildrens.org/specialties-conditions/persistent-depressive-disorder-children

#29 Persistent Depressive Disorder in Children | Phoenix Children’s Hospitalhttps://phoenixchildrens.org/specialties-conditions/persistent-depressive-disorder-children

#30 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/

#31 Persistent Depressive Disorder (Dysthymia) Symptoms And Related DSMâ5 Diagnosis – Senior Care Psychological Consultinghttps://seniorcarepsychological.com/persistent-depressive-disorder-dysthymia-symptoms-and-related-dsm-5-diagnosis/

#32 Reddit – The heart of the internethttps://www.reddit.com/r/dysthymia/comments/mu13ji/what_is_known_about_persistent_depressive/

#33 Dysthymia – Wikipediahttps://en.wikipedia.org/wiki/Dysthymia

#34 Persistent Depressive Disorder – Depression and Bipolar Support Alliancehttps://www.dbsalliance.org/education/depression/types-of-depression/persistent-depressive-disorder/

#35 Persistent Depressive Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK541052/

#36 Dysthymic Disorder: Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/290686-overview

#37 Persistent Depressive Disorder (Dysthymia): Symptoms, Causes, Diagnosis, Treatment, Copinghttps://www.verywellmind.com/what-is-dysthymia-dysthymic-disorder-1066954

#38 Dysthymic Disorder: Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/290686-overview

#39 Dysthymia – Wikipediahttps://en.wikipedia.org/wiki/Dysthymia

#40 Dysthymic Disorder: Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/290686-overview

#41 Persistent Depression Disorder – Discovery Mood & Anxiety Programhttps://discoverymood.com/blog/persistent-depression-disorder/

#42 Dysthymic Disorder: Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/290686-overview

#43 Dysthymic Disorder: Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/290686-overview

#44 Persistent Depressive Disorder (Dysthmyia): Symptoms, Causes, And Treatments | BetterHelphttps://www.betterhelp.com/mental-health/disorders-conditions/persistent-depressive-disorder-dysthymia/

#45 Dysthymic Disorder: Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/290686-overview

#46 Persistent Depressive Disorder (Dysthymia) – PsychDBhttps://www.psychdb.com/mood/persistent-depressive-disorder-dysthymia

#47 Persistent Depressive Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK541052/

#48 Major vs. persistent depressive disorder: Understanding dysthymiahttps://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder

#49 Major vs. persistent depressive disorder: Understanding dysthymiahttps://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder

#50 Major vs. persistent depressive disorder: Understanding dysthymiahttps://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder

#51 Persistent depressive disorder – Symptoms, diagnosis and treatment | BMJ Best Practicehttps://bestpractice.bmj.com/topics/en-gb/805?locale=it

#52 Persistent Depressive Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK541052/

#53 Persistent depressive disorder: MedlinePlus Medical EncyclopediaLockhttps://medlineplus.gov/ency/article/000918.htm

#54 Persistent Depressive Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK541052/

#55 Persistent Depressive Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK541052/

#56 Persistent Depressive Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK541052/

#57 Dysthymic Disorder: Background, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/290686-overview

#58 Dysthymia (Persistent Depressive Disorder) | Boston Children’s Hospitalhttps://www.childrenshospital.org/conditions/dysthymia

Przewlekłe zaburzenie depresyjne
Objawy

#1 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/

#2 Persistent depressive disorder – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/805?locale=it

#3 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/

#4 Psychiatry.org – What Is Depression?
https://www.psychiatry.org/patients-families/depression/what-is-depression

#5 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/

#6 Psychiatry.org – What Is Depression?
https://www.psychiatry.org/patients-families/depression/what-is-depression

#7 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#8 Persistent depressive disorder: MedlinePlus Medical EncyclopediaLock
https://medlineplus.gov/ency/article/000918.htm

#9 Persistent depressive disorder – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/diagnosis-treatment/drc-20350935

#10 Persistent Depressive Disorder (PDD): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/9292-persistent-depressive-disorder-pdd

#11 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#12 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#13 Chronic Depression (Dysthymia): Symptoms, Treatments, and More
https://www.webmd.com/depression/chronic-depression-dysthymia

#14 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/

#15 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#16 Persistent depressive disorder: MedlinePlus Medical EncyclopediaLock
https://medlineplus.gov/ency/article/000918.htm

#17 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#18 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#19 Persistent Depressive Disorder – Depression and Bipolar Support Alliance
https://www.dbsalliance.org/education/depression/types-of-depression/persistent-depressive-disorder/

#20 Persistent Depressive Disorder (PDD): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/9292-persistent-depressive-disorder-pdd

#21 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/

#22 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/

#23 Persistent depressive disorder | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/persistent-depressive-disorder

#24 Persistent Depressive Disorder in Children – Stanford Medicine Children’s Health
https://www.stanfordchildrens.org/en/topic/default?id=persistent-depressive-disorder-in-children-90-P01600

#25 Persistent Depressive Disorder in Children – Stanford Medicine Children’s Health
https://www.stanfordchildrens.org/en/topic/default?id=persistent-depressive-disorder-in-children-90-P01600

#26 Persistent Depressive Disorder in Children – Stanford Medicine Children’s Health
https://www.stanfordchildrens.org/en/topic/default?id=persistent-depressive-disorder-in-children-90-P01600

#27 Persistent Depressive Disorder in Children | Phoenix Children’s Hospital
https://phoenixchildrens.org/specialties-conditions/persistent-depressive-disorder-children

#28 Persistent Depressive Disorder in Children | Phoenix Children’s Hospital
https://phoenixchildrens.org/specialties-conditions/persistent-depressive-disorder-children

#29 Persistent Depressive Disorder in Children | Phoenix Children’s Hospital
https://phoenixchildrens.org/specialties-conditions/persistent-depressive-disorder-children

#30 Table 10, DSM-IV to DSM-5 Dysthymic Disorder/Persistent Depressive Disorder Comparison – DSM-5 Changes – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t6/

#31 Persistent Depressive Disorder (Dysthymia) Symptoms And Related DSMâ5 Diagnosis – Senior Care Psychological Consulting
https://seniorcarepsychological.com/persistent-depressive-disorder-dysthymia-symptoms-and-related-dsm-5-diagnosis/

#32 Reddit – The heart of the internet
https://www.reddit.com/r/dysthymia/comments/mu13ji/what_is_known_about_persistent_depressive/

#33 Dysthymia – Wikipedia
https://en.wikipedia.org/wiki/Dysthymia

#34 Persistent Depressive Disorder – Depression and Bipolar Support Alliance
https://www.dbsalliance.org/education/depression/types-of-depression/persistent-depressive-disorder/

#35 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/

#36 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview

#37 Persistent Depressive Disorder (Dysthymia): Symptoms, Causes, Diagnosis, Treatment, Coping
https://www.verywellmind.com/what-is-dysthymia-dysthymic-disorder-1066954

#38 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview

#39 Dysthymia – Wikipedia
https://en.wikipedia.org/wiki/Dysthymia

#40 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview

#41 Persistent Depression Disorder – Discovery Mood & Anxiety Program
https://discoverymood.com/blog/persistent-depression-disorder/

#42 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview

#43 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview

#44 Persistent Depressive Disorder (Dysthmyia): Symptoms, Causes, And Treatments | BetterHelp
https://www.betterhelp.com/mental-health/disorders-conditions/persistent-depressive-disorder-dysthymia/

#45 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview

#46 Persistent Depressive Disorder (Dysthymia) – PsychDB
https://www.psychdb.com/mood/persistent-depressive-disorder-dysthymia

#47 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/

#48 Major vs. persistent depressive disorder: Understanding dysthymia
https://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder

#49 Major vs. persistent depressive disorder: Understanding dysthymia
https://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder

#50 Major vs. persistent depressive disorder: Understanding dysthymia
https://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder

#51 Persistent depressive disorder – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/805?locale=it

#52 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/

#53 Persistent depressive disorder: MedlinePlus Medical EncyclopediaLock
https://medlineplus.gov/ency/article/000918.htm

#54 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/

#55 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/

#56 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/

#57 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview

#58 Dysthymia (Persistent Depressive Disorder) | Boston Children’s Hospital
https://www.childrenshospital.org/conditions/dysthymia

#59 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK541052/

#60 Dysthymic Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/290686-overview

#61 Persistent Depressive Disorder (Dysthymia): Symptoms, Causes, Diagnosis, Treatment, Coping
https://www.verywellmind.com/what-is-dysthymia-dysthymic-disorder-1066954

#62 Major vs. persistent depressive disorder: Understanding dysthymia
https://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder

#63 Chronic Depression (Dysthymia): Symptoms, Treatments, and More
https://www.webmd.com/depression/chronic-depression-dysthymia

#64 What is dysthymia or persistent depressive disorder? | Here to Help
https://www.heretohelp.bc.ca/q-and-a/what-is-dysthymia-or-persistent-depressive-disorder

#65 Persistent Depressive Disorder: What to Know About Symptoms and Treatments – The New York Times
https://www.nytimes.com/2023/12/04/well/mind/depression-persistent-treatment-dysthymia.html

#66 Dysthymia (Persistent Depressive Disorder) | Boston Children’s Hospital
https://www.childrenshospital.org/conditions/dysthymia

#67 Persistent depressive disorder – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/805?locale=it

#68 Persistent Depressive Disorder (Dysthymia) – Harvard Health
https://www.health.harvard.edu/a_to_z/dysthymia-a-to-z

#69 Dysthymia – Wikipedia
https://en.wikipedia.org/wiki/Dysthymia

#70 Persistent Depressive Disorder (Dysthymia) – Harvard Health
https://www.health.harvard.edu/a_to_z/dysthymia-a-to-z