Persistent Depressive Disorder: Symptoms, Causes, And Treatment
It is common to find, throughout life, that they tend to appear sad, negative or with a constant melancholic air.
However, when this persists over the years and begins to interfere with different aspects of the person’s life, we can speak of persistent depressive disorder.
Previously labeled as dysthymia or dysthymic disorder, the latest volume of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) renames it persistent depressive disorder.
Persistent depressive disorder is considered a chronic affective condition that is distinguished because the person permanently experiences a depressed mood and melancholic and very low self-esteem.
Despite these indications, it does not correspond to major depression since it does not meet all the diagnostic requirements for it.
Although its origin is not clearly established, it is believed that there is a genetic component, that is, hereditary, which, together with psychosocial elements such as detachment or lack of stimulation and rewards during childhood, predisposes the person to suffer from this persistent depressive disorder.
Symptoms
Within the symptomatology of persistent depressive disorder, The symptom that most characterizes it is the patient’s experience of a persistent state of demoralization, uneasiness or grief and disconsolation; which lasts for at least two years.
When this disorder appears in children or adolescents, the manifestations go from being a depressed mood to being irascible or angry; and must last at least one year.
Likewise, the person must have two or more of these symptoms most of the time:
It is common for people with persistent depressive disorder to suffer from a negative self-concept, as well as a pessimistic view of their future, of others and of practically everything around them; so it is difficult for them to resolve any type of problem or conflict.
Causes
As mentioned above, the specific causes that cause this persistent depressive disorder or chronic depression are still unknown. However, it is known that this is usually hereditary, that it affects more men than women and that it is suffered by approximately 5% of the population
Likewise, it has also been established that the appearance of persistent depressive disorder is related to other mental conditions or disorders such as anxiety or substance abuse disorders such as alcoholism or drug addiction.
Another point in common that patients with chronic depression have is that at least 50% of them will suffer an episode of major depression throughout their lives.
Diagnosis
To make an effective diagnosis of persistent depressive disorder, the relevant health professional must take a medical history in which both the mood and the rest of the symptoms associated with this condition are evaluated.
In addition, a series of laboratory tests must be performed to rule out any possible physical origin of the disease.
A correct diagnosis of this disorder must take into account the following classifying conditions established by the DSM-V:
1. Chronically depressed mood
The person must have a depressed mood for most of the day and on most days for at least 2 years. This can be reported directly by the patient or observed by the people around her.
2. Presence of two or more of these symptoms
3. Duration of 2 years
The symptoms of the two previous points must have remained in the person for at least two years, with interruptions of at most two months.
4. There are no major depressive episodes
The person has not suffered a major depressive episode during the first two years and the symptoms are not better explained by the presence of another type of depressive disorder.
5. There are no manic, hypomanic, etc. episodes.
The person has never experienced a manic episode, a mixed episode, or a hypomanic episode. Furthermore, the criteria for cyclothymic disorder are also not met.
6. It does not appear during a psychotic disorder
Symptoms do not appear exclusively in a chronic psychotic disorder such as schizophrenia or delusional disorder.
7. Symptoms are not caused by drugs or other diseases
The symptoms cannot be explained by the physiological effects of substance use or any medical illness.
8. Significant discomfort
The symptoms cause clinically significant discomfort in the person. This discomfort generates a deterioration in work, social or any other important areas of the patient.
Treatment and prognosis
Persistent depressive disorder is a chronic condition. However, The person may benefit from a treatment that consists of pharmacological therapy with antidepressants and intervention with psychotherapy
Although antidepressant medication works better in major depression than in persistent depressive disorder, there are a series of drugs that can improve the patient’s symptoms. These are:
Regarding the psychotherapy used in these cases, the most important thing is that the person is able to externalize their feelings and thoughts, as well as learn to manage them.
For this there are a series of very effective therapies:
Finally, the prognosis or evolution of this disorder differs greatly from one person to another. Its chronic nature means that the person suffers from it over the years and even throughout life, with very few people recovering completely
With the use of appropriate treatment, the person can improve very significantly and be able to continue their usual routine satisfactorily. However, in most cases, permanent psychological therapy is required.
