There are several types of depressive disorders that can have a negative impact on mental health, strain relationships, and interfere with daily function. Two common conditions are
persistent depressive disorder (PDD) and major depressive disorder (MDD). Understanding the differences between major depression vs. persistent depressive disorder can help you get the correct diagnosis and the treatment you need.
Defining Persistent Depressive Disorder (PDD)
Persistent depressive disorder, sometimes called dysthymia, is a chronic mood disorder that typically lasts for the majority of the day, most days of the week over the span of 2 years. A diagnosis requires the following symptoms over that time frame:
- A negative view of self, others, and life
- Chronic low energy
- Low self-esteem
- Feelings of hopelessness
- Overeating or undereating
- Sleep problems, either hypersomnia or insomnia
- Poor concentration
Symptoms can go away or change in intensity over time but they typically don’t disappear for longer than 2 months at a time if they do and then they come back contributing to that two-year time span.
Defining Major Depressive Disorder (MDD)
A diagnosis of major depressive disorder requires at least five of the following symptoms occurring concurrently during the same two-week time frame:
- Prolonged sadness, emptiness, and hopelessness severe enough to be observed by others
- Diminished interest in all activities that someone once liked
- Significant weight loss or weight gain when a person is not trying to diet, generally 5% of their body weight or more in a given month
- Hypersomnia or insomnia nearly every day
- Psychomotor agitation or retardation nearly every day
- Fatigue or a complete loss of energy nearly every day
- Loss of interest in activities
- A diminished ability to think or concentrate or indecisiveness nearly every day
- Suicidal thoughts
Those who have major depressive disorder vs. persistent depressive disorder will experience the combination of these symptoms to such a degree that they interfere with daily function, socialization, and even work.
Key Differences Between Persistent Depressive Disorder and Major Depressive Disorder
The key differences between PDD and MDD have to do with the duration and severity of symptoms.
Duration and Symptom Consistency
One difference between major depressive disorder and persistent depressive disorder is the duration and symptom consistency.
Major depressive disorder requires, as mentioned, five of the symptoms listed above to occur at the same time for at least 2 weeks, whereas persistent depressive disorder requires symptoms that last over 2 years without significant breaks.
Symptom Severity
Another difference between major depressive disorder vs. persistent depressive disorder is the severity of symptoms. The symptoms of major depressive disorder are often much more severe and significantly more intense, with severe risks of things like hopelessness, significant changes to body weight, and even suicidal thoughts.
Despite the fact that a key difference between major depressive disorder and persistent depressive disorder is the severity of symptoms, the persistence, duration, and symptom consistency for persistent depressive disorder vs. major depressive disorder means that it can have a more substantial impact on daily function.
Functional Impact
Both conditions can have a functional impact on social activities, work, relationships, and daily function because of the pervasive hopelessness, low self-esteem, and difficulty with concentration.
When it comes to work, those who have persistent depressive disorder vs. major depressive disorder will have difficulty fulfilling their responsibilities because of the long-term, chronic nature of the symptoms related to PDD. By comparison, someone with major depressive disorder might have noticeable functional impairment such as absenteeism, but it is more short-lived.
Another difference when comparing major depressive disorder vs. persistent depressive disorder is the effect on relationships. Someone with major depressive disorder will experience negative impacts on their interpersonal relationships, but these negative impacts might be short-lived compared to the complete withdrawal from friends and family that often manifests in those who have persistent depressive disorder.
Onset and Diagnosis
Major depressive disorder vs. persistent depressive disorder is different in terms of the onset and diagnosis.
Major depressive disorder can happen at any age, but it typically doesn’t start until adulthood, whereas persistent depressive disorder will manifest much sooner.
A diagnosis for either requires working with a mental health professional or therapist who can review symptoms and the time span of those symptoms, then subsequently rule out any other explanations in accordance with the DSM.
Diagnosis and Treatment Approaches
The treatment process for persistent depressive disorder vs. major depressive disorder looks very similar despite their differences.
Diagnostic Process
The diagnostic process is very similar, where an individual seeks professional help, meets with a qualified professional to answer questions and discuss mental and physical health history, and receives a diagnosis.
Both conditions have a high risk of comorbidities, which means they likely exist with other conditions like anxiety disorders, so assessments will often be made to confirm whether there are co-occurring conditions or to rule out other possible explanations.
Treatment for Persistent Depressive Disorder vs. Major Depressive Disorder
When it comes time for treatment, both conditions can be managed with therapy and medications.
Therapy can include in-person or online psychotherapy sessions for things like interpersonal therapy to improve relationship skills or cognitive behavioral therapy to help change distorted views of self. Other forms of psychotherapy can extend to managing stress sources, reducing anxiety, and changing your relationship to the symptoms, especially for persistent depressive disorder, when symptoms are much more long-lasting.
Antidepressant medications can be prescribed as well, and they are most efficacious when combined with therapy. It’s important to note that most medications take several weeks before results are seen, so it’s imperative that you stick with the regimen you are prescribed even if you don’t get relief right away.
Other holistic treatment options for major depression vs. persistent depressive disorder can include transcranial magnetic stimulation or TMS. Transcranial magnetic stimulation has been shown to help with major depressive disorder, particularly treatment-resistant depression, by stimulating deeper areas of the brain responsible for many mood-related symptoms. This is a simple process that is non-invasive with next to no side effects. Moreover, it can be combined with any other type of treatment.
As part of the therapy sessions, individuals who struggle with either condition might be advised on holistic care management techniques, including stress reduction techniques, yoga, meditation, and mindfulness.
When to Seek Professional Help
There are several signs and symptoms indicating the need for professional help. Severe symptoms that make it next to impossible to get out of bed or complete a task might require an outpatient treatment program or a temporary hospital stay after which other forms of treatment can be prescribed.
If there is an emergency relating to self-harm or harm to others, it is imperative to call 911 immediately.
If you notice symptoms that are interfering with your daily function, making it difficult to maintain relationships, find motivation to do anything, or improve your mood at all, consult mental health professionals to get an accurate diagnosis and start your treatment plan today.
Summing Up
Overall, the key differences between persistent depressive disorder vs. major depressive disorder have to do with the onset, the duration of symptoms, and their severity. No matter which set of symptoms you are experiencing, seek treatment options today for improved mental health.
