Persistent Depressive Disorder: What you need to know

What is persistent depressive disorder?

Persistent depressive disorder (PDD) is part of a cluster called the depressive disorders. Depressive disorders are a group of conditions that include:

  • Major depressive disorder
  • Persistent depressive disorder (dysthymia)
  • Disruptive mood dysregulation disorder 

PDD is also called dysthymia. It is a form of chronic depression with symptoms that are longer lasting than other forms of depression. Those with PDD experience a low, sad, or irritable mood for at least 1 year. They might also have major depressive episodes at times.

Causes and Risk Factors of PDD

It could be caused by a combination of factors such as genetics, environmental, and psychological factors and biochemical disturbances.

  • Brain chemistry

Imbalances in certain neurotransmitters might play a role in how the brain works, which can affect moods and emotions and increase the likelihood of experiencing depression. Reduced dopamine, serotonin and norepinephrine levels can contribute to depression in some people. 

  • Environmental factors

Stressful, chaotic, or unstable family relationships and home environment can also make children more prone to experiencing depression. Bullying, abuse or neglect may also be a contributing factor.

  • Family history

Children with family members who have mood disorders are at a greater risk for being similarly affected or experiencing symptoms of depressive disorders.

  • Stress/trauma

Sudden changes in life or traumatic events might also contribute to feelings of depression. 

  • Other mental-illnesses

Having any other major disorder or a chronic medical condition can also make children more likely to develop depression.

What are the signs and symptoms of PDD?

A child must exhibit a depressed mood or irritability most of the day for at least one year for them to be diagnosed with PDD. PDD causes significant distress or interfere with their ability to function in daily life. Severity of symptoms might vary for each child. In order to be diagnosed with PDD a child must have two or more of the following symptoms for at least 1 year: 

  • Loss of interest or pleasure in all or almost all activities once enjoyed
  • Feeling hopeless or helpless
  • Marked weight loss or gain
  • Changes in appetite
  • Having low self-esteem
  • Feeling inadequacy
  • Decreased energy
  • Sleeping too much or too little
  • Restlessness
  • Lethargy or fatigue
  • Feelings of worthlessness  
  • Cloudy or indecisive thinking
  • Preoccupation with death
  • Suicidal ideation or an actual suicide attempt
  • Increased sensitivity to failure or rejection
  • Trouble with relationships
  • Being grouchy, hostile, or aggressive
  • Frequent physical complaints (headache or stomach ache)

How is PDD treated in a child?

The treatment for MDD might include psychotherapy (counselling), medication or a combination of the two depending on the severity of the symptoms and the age of the child. The treatment plan usually depends on your child’s symptoms, age, general health and the severity of the condition.

Mental-health Counselling 

Counselling might help children learn to think more positively and control negative behaviours. It gives children the tools to manage and cope with depression in healthier ways.


Many medications have proven effective in combating depression. The most common antidepressant medication for children increases the level of serotonin in the brain. Serotonin is a chemical that can help increase feelings of happiness and well-being.

It is recommended to be extra cautious when administering antidepressants to children. Some children might not show any improvement with the medications, or may even end up feeling more depressed. Medication should only be administered if prescribed by a qualified specialist. 

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