Persistent Depressive Disorder

The Chronic Version of Depression

Understanding, Pinpointing, and Treating Persistent Depressive Disorder

Understanding Persistent Depressive Disorder

Persistent Depression is a more constant form of depression. It’s often accompanied by the total loss of interest in daily activities, productivity, low self-esteem, and hopelessness. 

Persistent Depressive Disorder (also referred to as “dysthymia” or “PDD”) is a long-term (chronic) form of depression. Those who suffer from PDD easily lose interest in normal daily activities, lack productivity, have low self-esteem, feel hopeless, and carry an overall feeling of inadequacy. These feelings vary in severity, but last for years and often interfere significantly with work, relationships, education, and daily activities.

Because of the chronic nature of Persistent Depressive Disorder, you might be characterized as having a gloomy personality, complaining constantly or incapable of having fun. Coping with these depression symptoms can be extremely challenging, but there’s hope. A combination of psychotherapy and medication can be effective in treating this long-term disorder and Valley is here to help.

Facts & Figures

Persistent Depressive Disorder Averages & Statistics


What Are the Symptoms of Persistent Depressive Disorder?

The symptoms of Persistent Depressive Disorder usually come and go over a period of years, and their intensity over time can fluctuate. Typically, symptoms don’t disappear for more than two months at a time. In addition, major depression episodes may occur before or during Persistent Depressive Disorder —this is sometimes referred to as “double depression”.

Symptoms of PDD can cause significant impairment 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 making 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
  • Depressed mood and irritability in children

Valley Services

How is Valley Treating Persistent Depressive Disorder?

Paying regular attention to your mental well-being is good and should be a normal part of healthy living. At Valley, we know there is no one-size-fits-all approach to mental health, which is why we take the time to care for each client individually and consider their broader story. Every client who walks through our doors is assessed holistically and cared for comprehensively within a solution-focused approach.

We offer a wide variety of counseling and counseling environments for a wide variety of clients:

Our individual counseling focuses in on each client and their unique story in order to discover the solutions that are right for them. After pairing our clients with the ideal therapist, we take the time to press into the cognitive, behavioral, and motivational aspects of our client’s recovery while also considering dual-diagnosis.

At Valley, we offer FDA approved psychiatric medication as part of our comprehensive treatment plan. Each medication program is prescribed by a trained medical professional (e.g., psychiatrist, nurse practitioner) within a broad scope of long-term care.

Research shows that counseling within a group setting is just as effective, sometimes even moreso, as individual care. At Valley, we are proud to provide robust and interactive interactive care groups led by trained clinicians. These empowering spaces have proven to be an invaluable resource for learning coping skills, feeling acceptance, and avoiding social isolation.

While every client needs to be individually motivated to seek treatment, one of the largest factors in successful treatment is a solid support system. Our family and couples counseling partners with immediate family, primary caregivers, adopted families, and support systems to get everyone on the same page in caring for their loved ones.

Complementary & Alternative Treatments

Integrating Alternative Medicine and Activity

Incorporating complementary or alternative medicine is often referred to as an integrated approach and works best when used alongside professional treatment. Don’t replace conventional medical treatment or psychotherapy with alternative medicine.

With that said, here are some things proven to be helpful when dealing with Persistent Depressive Disorder:

Dietary Supplements
  • Fish oil: Fish oil and fish are common sources of two of the three main types of omega-3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These fatty acids may affect the chemicals in your brain associated with mood disorders.
  • Rhodiola rosea: Rhodiola rosea (arctic root or golden root) may help treat mild to moderate depression. Rosea is a mild stimulant and may cause insomnia. Other side effects include vivid dreaming and nausea.
  • S-adenosylmethionine: Studies indicate that the supplement form of a substance that naturally occurs in the body, S-adenosylmethionine, may also be beneficial for depression. 
  • N-acetylcysteine: This antioxidant helps reduce oxidative stress. In one randomized controlled trial of people with bipolar disorder, adding 2 grams of N-acetylcysteine per day to traditional bipolar medication treatment led to significant improvement in depression, mania, and quality of life.

Exercise is generally categorized as aerobic (running or walking), resistance (weight training), or mindfulness-based (yoga or tai chi). Exercise is known to improve cognitive mechanisms due to a diversion from negative thinking, social contact, and feelings of control over your health. Consider walking, jogging, swimming, gardening or another activity that you enjoy.  


Getting a healthy amount of sleep is important for both your physical and mental well-being. If you’re having trouble sleeping, talk to your doctor about what they can do to help.

Calming Techniques

Stress complicates depression. Calming techniques can’t cure Persistent Depressive Disorder, but they may help you manage your symptoms and be a valuable part of your treatment plan. Several alternative treatments aim to reduce anxiety and stress. These treatments include:

  • massage therapy
  • yoga
  • acupuncture
  • meditation

Videos & Podcasts

Knowledgeable Insights from Around the Web


What is Dysthymia? (Persistent Depressive Disorder)

06:47 Min


Anxiety Slayer


Anxiety Slayer

The Mental Illness Happy Hour


The Mental Illness Happy Hour

Jen Gotch is OK...Sometimes


Jen Gotch is OK...Sometimes

Mentally Yours


Mentally Yours

The Hilarious World of Depression


The Hilarious World of Depression

The Struggle Bus


The Struggle Bus: Self-Care, Mental Health, and Other Hilarious Stuff

Page Turners

Great Resources on Persistent Depressive Disorder

The Happiness Trap: How to Stop Struggling and Start Living: A Guide to ACT

By Russ Harris

Speaking of Sadness: Depression, Disconnection, and the Meanings of Illness

By David A. Karp

The Noonday Demon: An Atlas of Depression

By Andrew Solomon

Darkness Visible: A Memoir of Madness

By William Styron

Research and Resources

Great Articles & Resources on Persistent Depressive Disorder

Diet, Exercise, Sleep
Blurt It Out

For those of us who look after children in some capacity, we’ve probably read a fair few articles and books over our time in the hope of raising them to be healthy, well-rounded individuals. The concept of ‘self-care‘ can be a tricky one to explain to little ones – it’s a broad topic, interchangeable as …

Lifting weights might lift your mood

Aerobic exercise has been linked with reducing symptoms of depression, but resistance training, such as weight lifting and bodyweight exercises like push-ups, can have the same effect. A meta-analysis published in the June 2018 JAMA Psychiatry examined the effects of resistance training on depression symptoms in 33 clinical trials involving 1,877 people. The researchers found that people who …

Exercise, Sleep, Therapy
Yoga for anxiety and depression

Research suggests that this practice modulates the stress response. Since the 1970s, meditation and other stress-reduction techniques have been studied as possible treatments for depression and anxiety. One such practice, yoga, has received less attention in the medical literature, though it has become increasingly popular in recent decades. One national survey estimated, for example, that …