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Persistent Depressive Disorder in Children

What is persistent depressive disorder?

Persistent depressive disorder is a type of mood disorder. It often seems like a less severe, but more long-lasting (chronic) form of major (clinical) depression. But children with persistent depressive disorder may also have major depressive episodes at times.

Depression is a mood disorder that involves a child's body, mood, and thoughts. It can affect and disrupt eating, sleeping, or thinking patterns. It is not the same as being unhappy or in a blue mood. It is also not a sign of personal weakness. It is not a condition that can be willed or wished away. Children with a depressive illness can’t just pull themselves together and get better. Treatment is often needed. In many cases treatment is vital to recovery.

There are 3 main types of depression:

  • Major depression (clinical depression)

  • Bipolar disorder (manic depression)

  • Persistent depressive disorder (dysthymia)

Who is affected by persistent depressive disorder?

Persistent depressive disorder occurs in about 11% of children ages 13 to 18.

What are the symptoms of persistent depressive disorder?

Each teen’s symptoms may vary. Some of the most common symptoms of persistent depressive disorder include:

  • Constant feelings of sadness

  • Feeling hopeless or helpless

  • Having low self-esteem

  • Feeling inadequate

  • Excessive guilt

  • Feelings of wanting to die

  • Trouble with relationships

  • Sleep problems (such as insomnia or hypersomnia)

  • Changes in appetite or weight

  • Decreased energy

  • Trouble concentrating

  • Irritability, hostility, aggression

  • A decrease in the ability to make decisions

  • Suicidal thoughts or attempts

  • Frequent physical complaints (like headache, stomachache, or fatigue)

  • Running away or threats of running away from home

  • Loss of interest in usual activities or activities once enjoyed

  • Overly sensitive to failure or rejection

For a diagnosis of persistent depressive disorder to be made, a depressed or irritable mood must last for at least 1 year. It must occur with at least 2 other major depressive symptoms. The symptoms of persistent depressive disorder may seem like other health problems or psychiatric conditions. Always talk with your teen’s healthcare provider for a diagnosis.

How is persistent depressive disorder diagnosed?

Depression often occurs with other psychiatric disorders, such as substance abuse or anxiety disorders. Early diagnosis and treatment is vital to your teen’s recovery.

A child psychiatrist or other mental health professional usually makes a diagnosis after a full psychiatric evaluation. To make a diagnosis, it may also be helpful to evaluate the teen’s family and to get information from teachers and care providers.

Treatment for persistent depressive disorder  

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Mood disorders, including persistent depressive disorder, can often be effectively treated. Treatment should always be based on a full evaluation of the teen and family. Children and teens with depression may need to try different therapists and types of therapies before they find a combination that works. Treatment may include 1or more of the following:

  • Antidepressant medicines. These have been shown to be work very well in treating depression in children and teens. They are also very effective when used together with psychotherapy.

  • Psychotherapy (most often cognitive-behavioral or interpersonal therapy) for the teen. This should focus on changing the child’s distorted self-views and also the child’s environment. It should also help the teen work through difficult relationships. Another goal should be identifying stressors in the environment and learning how to avoid them.

  • Family therapy

  • Consultation with the teen’s school

Parents play a key supportive role in any treatment process.

Persistent depressive disorder is linked to an increased risk for major depression if a child or teen does not get proper treatment. This disorder also increases the risk for a child or teen to develop other mental health disorders. Proper treatment helps to make symptoms less severe. It also reduces the risk of having another depressive episode (called a relapse).

Periods of persistent depressive disorder may last longer than 5 years. So long-term, ongoing treatment may help to prevent the depressive symptoms from returning.

Online Medical Reviewer: Ballas, Paul, DO
Online Medical Reviewer: Fraser, Marianne, MSN, RN
Date Last Reviewed: 6/1/2017
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