Persistent depressive disorder (persistent depressive disorder) is a mental health condition that causes symptoms of low-level depression or irritability for at least one year. It may also be called long-term (chronic) depression or dysthymia. persistent depressive disorder may include episodes of more severe depression that last for about 2 weeks (major depressive disorder or MDD).

persistent depressive disorder can affect the way your child thinks, feels, and sleeps. This condition can affect your child’s relationships at home and school. Your child may also be more likely to get sick if he or she has persistent depressive disorder.

The exact cause of this condition is not known. persistent depressive disorder is most likely caused by a combination of things, which may include:

  • Genetic factors. These are traits that are passed along from parent to child.
  • Individual factors. Your child’s personality, your child’s behaviour, and how your child handles his or her thoughts and feelings may contribute to persistent depressive disorder. This includes personality traits and behaviours learned from others.
  • Physical factors, such as:
    • Differences in brain structures that control emotion.
    • Chronic medical or psychiatric illnesses.
  • Social factors. Traumatic experiences or major life changes may play a role in the development of persistent depressive disorder.

The following factors may make your child more likely to develop persistent depressive disorder:

  • A family history of depression.
  • Being a girl.
  • Abnormally low levels of certain brain chemicals.
  • Traumatic events in childhood, especially abuse or the loss of a parent.
  • Being under a lot of stress, or long-term (chronic) stress, such as:
    • Experiencing social exclusion or discrimination on a regular basis.
    • Living in poverty.
    • Having regular exposure to violence.
  • A history of:
    • Chronic physical illness.
    • Other mental health disorders.
    • Substance abuse.

Symptoms of this condition occur for most of the day for several months at a time, and may include:

  • Fatigue or low energy.
  • Eating or sleeping too much or too little.
  • Restlessness or agitation.
  • Feelings of sadness or hopelessness.
  • Feeling worthless or guilty.
  • Poor concentration or difficulty making decisions. This may result in poor performance at school.
  • Low self-esteem.
  • Negative outlook.
  • Inability to have fun or experience pleasure.
  • Difficulty interacting with others in social situations.
  • Unexplained physical complaints.
  • Irritability.
  • Mood swings.

This condition may be diagnosed based on:

  • Your child’s symptoms.
  • Your child’s medical history, including your child’s mental health history. This may involve tests to evaluate your child’s mental health. You may be asked how long your child has had symptoms of persistent depressive disorder.
  • A physical exam.
  • Blood tests to rule out other conditions.

Your child may be diagnosed with persistent depressive disorder if he or she has had a depressed mood or irritability for 1 year or longer as well other symptoms of depression.

This condition is usually treated by mental health professionals, such as psychologists, psychiatrists, and clinical social workers. Your child may need more than one type of treatment. Treatment may include:

  • This is also called talk therapy or counselling. Types of psychotherapy include:
    • Cognitive behavioural therapy (CBT). This type of therapy teaches your child to recognize unhealthy feelings, thoughts, and behaviours, then replace them with positive thoughts and actions.
    • Interpersonal therapy (IPT). This helps your child to improve the way he or she relates to and communicate with others.
    • Family therapy. This treatment includes family members.
  • Medicine to treat anxiety and depression, or to help your child control certain emotions and behaviours.
  • Lifestyle changes, such as making sure your child:
    • Exercises regularly.
    • Gets plenty of sleep.
    • Eats a healthy diet.
    • Finds healthy ways to cope with stress.


  • Let your child return to his or her normal activities as told by your child’s health care provider.
  • Have your child exercise regularly as told by your child’s health care provider.

General instructions

  • Give over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Make sure your child eats a healthy diet and gets plenty of sleep.
  • Encourage your child to find activities that he or she enjoys.
  • Help your child find healthy ways to cope with stress, such as:
    • Meditation or deep breathing.
    • Physical activities, like organized sports, recreational games, or play groups.
    • Spending time in nature.
    • Journaling.
  • Consider having your child join a support group. Your child’s health care provider may be able to recommend a support group.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.
  • Your child’s symptoms get worse.
  • Your child develops new symptoms.
  • Your child has trouble sleeping or doing his or her daily activities.
  • Your child harms himself or herself.
  • Your child has serious thoughts about hurting himself or herself or others.
  • Your child sees, hears, tastes, smells, or feels things that are not present (hallucinates).
  • Persistent depressive disorder involves symptoms of low-level depression or irritability for at least one year.
  • This condition is usually treated by mental health professionals and may involve psychotherapy, medicines, and lifestyle changes.

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