How Persistent Depressive Disorder (DSM-5) Can Affect Your Life
By: Sarah Fader
Updated May 29, 2020
Medically Reviewed By: Heather Cashell
Perhaps one of the most prevalent, and often misunderstood, psychiatric disorders is depression. Depression is a spectrum. People can be depressed due to external and internal reasons. You can feel depressed due to the situation you are in, or due to an imbalance in the brain.
In this post, we'll be talking about the persistent depressive disorder or PDD.
Persistent Depressive Disorder Or Dysthymia?
Before we talk about PDD, you may have heard of it be called dysthymia. Before 2013, when the DSM-5 was released, it was called dysthymia. Dysthymia comes from an Ancient Greek term that translates to "bad state of mind." The reason why it became known as PDD is because dysthymia was combined with chronic major depressive disorder. There didn't appear to be any big differences between the two conditions, and so the name stuck.
What Is Persistent Depressive Disorder?
As you probably guessed, it has to do with depression. Depression is more than just feeling sad; it's a tenacious feeling of sadness and apathy. You may be sad even though your life is going great. You may lose interest in activities even though they're fun. PDD deals with depression that happens throughout most of your day. There may be some days where you aren't as depressed, but you may feel depressed more days than you don't. This feeling has to occur for at least two years. For children and teenagers, it can be diagnosed in one year. Being free of any PDD symptoms won't last you more than two months.
So as you can see, the name is mostly self-explanatory.
With many of these mental disorders, there is no one cause. Instead, it can involve different causes and a combination of them, such as:
Biological difference: You may have had your brain change physically. The cause of this is unknown.
Brain chemistry: Depression is often called a chemical imbalance in the brain, and this is what they're talking about. When neurotransmitters change, it can cause depression.
Genetics: It's unknown what genes can cause depression, but there does seem to be a link between you having depression and one of your family members having one.
Trauma: Traumatic events can cause PDD. Untreated trauma or PTSD may result in the development of depression. If you have had a difficult or traumatic life experience happen to you recently, there may be a link between this experience and PDD symptoms.
PDD can begin early on, from childhood to young adult. If you have any of the above, including a traumatic event, a family member with it, and so on, you may be at risk for PDD.
Symptoms Of Persistent Depressive Disorder
If you have PDD, you'll be experiencing different symptoms, and may experience at least two of these symptoms below you.
-Insomnia/Hypersomnia: Insomnia, as you may know, is when a person can't fall asleep. Their body may feel tired, but their restless mind may keep them up. Insomnia can also equate to difficulty staying asleep, or when you wake up too early and can't fall back asleep. Occasional insomnia is common, but if you're experiencing it chronically, it may be a sign of a serious condition.
Hypersomnia is when you have trouble staying awake during the day, or sleep excessively. Even if you had a good night's sleep, you might feel so sleepy during the day that you can fall asleep in dangerous circumstances, like driving or while on the job.
Poor Appetite/Overeating: If you don't feel hungry, and you normally are a healthy eater, you may be experiencing a system of PDD. People with depression may overeat, as depression eating is common. Both of these can lead to weight loss or gain.
Low Self-Esteem: This comes naturally with feeling depressed. You may feel bad about your appearance, behavior, or just your life in general, even if the feeling is unwarranted.
Low energy/fatigue: Your body may feel tired and not able to perform tasks as well. You're not falling asleep as you would with hypersomnia, but you may feel sluggish.
Difficulty is deciding and concentrating: Because of the above, you may find it difficult to concentrate. If you're a student, you may find it harder to listen to one's lecture. If you're a team leader, you're not as sharp at making decisions as you should be.
Hopelessness: You may feel like there's no hope for yourself, your future, or anyone else around you.
Irritability: You may feel easily irritated. Naturally, this can lead to poor relationships with your peers or family members. This is especially prevalent in children and teenagers, and to be diagnosed, the feeling of irritability needs to last at least one year.
Many people with PDD may remain undiagnosed; as the symptoms happen so often, the individual thinks that they've always been like this. Usually, the person has to be prompted to be diagnosed.
To be diagnosed, the person has to meet all the criteria above, and also not have a manic, mixed, or hypomanic episode. This can be a sign of another disorder, such as bipolar. People with PDD won't have days where they have hyper self-esteem. You must also not meet the criteria for the cyclothymic disorder, which is another disorder where you may have different emotional lows and highs.
Also, the depression must not be caused by any other factors, like substance abuse or because of another condition like a stroke. The symptoms need to cause significant hindrance to the person's daily lives, such as preventing them from functioning in work, school, etc.
Like other forms of depression, PDD is treatable, and you can take different routes to treat it, including:
Psychotherapy can be a powerful weapon in defeating PDD. Not only can traditional therapy work, but self-help and support groups are effective as well. Perhaps the best therapy is cognitive behavior therapy, where the person can develop their coping strategies to deal with their depression.
So there are a few routes to take with therapy. While you should consult a professional, you can get group help as well. This is great if you're on a budget or as a way to supplement your professional therapy.
Depression is most notably treated with medications. SSRIs are perhaps the first medicine doctors go to when treating PDD. You may be prescribed SSRIs like sertraline, paroxetine, citalopram, etc. If those names sound confusing, you can talk to your doctor. They can tell you which medication you need.
Sadly, medicine can be a trial and error situation. There isn't one medication that works for everyone, and you may find yourself having to try different types before you find the medicine that best treats your PDD. Keep talking to your doctor until you get it right. Also, it may take 6-8 weeks before you start to feel the effects of the medicine, so don't change the medication if it's not working immediately. It takes a bit for it to get into your body.
There are fewer side effects in SSRIs when compared to any medication, but if you're experiencing any ill side effects, always talk to your doctor.
Perhaps the most effective way to treat PDD is a combination of both medication and therapy. When it comes to treating medical disorders, it's not like you're taking two separate routes that lead to the same destination. Instead, you'll take many routes, and they'll tend to intertwine. Antidepressants can help to reduce or eliminate the symptoms of PDD, while psychotherapy can help you to take out the causes of PDD. When you do a combination, you may have a 75% chance of improvement. If you just do one, you'll have a 48% chance. That's a big increase in odds, so don't be afraid to do both.
How It Affects Your Life
Through the symptoms, you probably have a good idea as to how PDD can change your life, but if you're still not certain, here is a rundown.
-PDD can cause you to lose friends or family members. You may feel like you're not good enough for them, or they may feel like they're depressing you. Clear communication is important in these situations.
-PDD can affect your work life. You might not be able to succeed at your job as well as you could if you weren't depressed.
-PDD can make your grades suffer.
-PDD can make you excessively self-critical and damage your self-esteem. In a worst-case scenario, it can make you feel suicidal.
If you're experiencing any of these symptoms, don't be afraid to talk to a professional about diagnoses and a possible route to treatment. You can even talk to an online counselor through the comfort of your own home. Depression shouldn't be the determining factor in your life. Talk to a professional and conquer that depression. You'll be glad you did, and you'll be on your way to a happier life.
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