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Amy Perez  at Sunday, July 3, 2022 9:38:57 PM
Persistent Depressive Disorder Educational Blog
Persistent depressive disorder, or dysthymia, is a mood disorder described by feelings of sadness and other symptoms that are present for most of the day, on most days, for at least one year in children and adolescents. These feelings may appear less severe, yet more chronic, than major depression. If there are any periods that are symptom-free within the year, these do not last for more than two months at a time (American Psychiatric Association, 2015). In fact, children and adolescents with dysthymia may have only some good days, but these do not last more than several days at a time before signs and symptoms of dysthymia re-emerge (Emslie & Mayes, 2001). Two or more of the following symptoms being experienced as described above may indicate persistent depressive disorder (dysthymia) in children or adolescents:
Poor appetite/ overeating
Sleeping too much/ not sleeping enough
Low energy levels /complaints of feeling overly tired
Low self-esteem /feelings of inadequacy
Poor concentration /difficulty in making decisions
Feeling hopeless or negative thinking and speaking
Irritability or easily frustrated/ feeling angry
Constant physical complaints (i.e, headache, stomachache, etc.)
Excessive fear of rejection or failure at attempts
Poor self-image
Thoughts or attempts at self-harm
Getting Help
Getting properly diagnosed is extremely important to get the right help and treatment for yourself (or a child/adolescent displaying signs and symptoms of persistent depressive disorder/dysthymia.) Therefore, evaluation by a healthcare provider is necessary and should be without delay, as they can create an individualized plan of care that may incorporate various approaches, which when used together, depending on individual client needs, can help to significantly improve the signs and symptoms of dysthymia. Treatment approaches include:
Medications such as fluoxetine and paroxetine (SSRIs, or selective serotonin reuptake inhibitors, is the classification of these medications) which help balance brain chemicals to help lessen feelings of sadness and other signs and symptoms of dysthymia. Many medication trials have shown these medications to be helpful in managing these symptoms in these age groups (Emslie & Mayes, 2001). Fluoxetine is also FDA approved for use in children ages 8 -17 years.
Non-pharmacological treatments such as Cognitive Behavioral Therapy (CBT) can involve individual, group and/or family therapy, where children and adolescents can discuss their emotions and behavior patterns and learn practical ways to modify them.
Some studies have shown benefits for SSRIs in combination with CBT when compared to CBT or SSRIs alone (Effective Health Care Program et al., 2020).
Resources and Referrals
Various resources and referrals exist to further guide you and your loved ones to healthcare providers and programs within your community. If you suspect that you or a child/ adolescent you know may be suffering from dysthymia, visit one of the links below for further guidance regarding resources in your area.
In an emergency call 911
If you suspect that someone is in danger of suicide CALL: THE SUICIDE PREVENTION HOTLINE: 1-800-273-TALK (8255)
Resources for Youth (aacap.org)
Children, Youth and Families at Risk (CYFAR) | National Institute of Food and Agriculture (usda.gov)
For a video on better understanding of this condition, you may watch this video

References
American Psychiatric Association. (2015). DSM-5: Diagnostic and statistical manual of mental disorders, 5th edition. Generic.
Effective Health Care Program, Viswanathan, Kennedy, McKeeman, Christian, Coker-Schwimmer, Cook-Middleton, Bann, Lux, Randolph, & Forman-Hoffman. (2020, April 10). Treatment of depression in children and adolescents. effectivehealthcare.ahrq.gov. https://doi.org/10.23970/AHRQEPCCER224
Emslie, G. J., & Mayes, T. L. (2001). Mood disorders in children and adolescents: Psychopharmacological treatment. Biological Psychiatry, 49(12), 1082–1090. https://doi.org/10.1016/s0006-3223(01)01149-0
Medical Centric. (2021, July 16). Persistent depressive disorder (PDD), causes, signs and symptoms, diagnosis and treatment. [Video]. Youtube.com. https://www.youtube.com/watch?v=D0WNARDzjvI
Nobile, M., Cataldo, G. M., Marino, C., & Molteni, M. (2003). Diagnosis and treatment of dysthymia in children and adolescents. CNS Drugs, 17(13), 927–946. https://doi.org/10.2165/00023210-200317130-00001

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