If your doctor suspects you have persistent depressive disorder, exams and tests may include
- Physical exam. The doctor may do a physical exam and ask in-depth questions about your health to determine what may be causing your depression. In some cases, it may be linked to an underlying physical health problem.
- Lab tests. Your doctor may order lab tests to rule out other medical conditions that may cause depressive symptoms. For example, your doctor may order a blood test to find out if your thyroid is underactive (hypothyroidism).
- Psychological evaluation. This includes discussing your thoughts, feelings and behavior and it may include a questionnaire to help pinpoint a diagnosis. This evaluation can help determine if you have persistent depressive disorder or another condition that can affect mood, such as major depression, bipolar disorder or seasonal affective disorder.
To diagnose persistent depressive disorder, many doctors use the symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.
For a diagnosis of persistent depressive disorder, the main indication for an adult differs somewhat from that of a child:
- For an adult, depressed mood occurs most of the day for two or more years
- For a child, depressed mood or irritability occurs most of the day for at least one year
Symptoms caused by persistent depressive disorder can vary from person to person. When persistent depressive disorder starts before age 21, it's called early onset; if it starts at age 21 or older, it's called late onset.
Dec. 19, 2015
- Persistent depressive disorder (dysthymia). In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Oct. 12, 2015.
- Kriston L, et al. Efficacy and acceptability of acute treatments for persistent depressive disorder: A network meta-analysis. Depression and Anxiety. 2014;31:621.
- AskMayoExpert. Persistent depressive disorder. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
- Hales RE, et al. Depressive disorders. In: The American Psychiatric Publishing Textbook of Psychiatry. 6th ed. Washington, D.C.: American Psychiatric Publishing; 2014. http://www.psychiatryonline.org. Accessed Oct. 12, 2015.
- Depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed Oct. 12, 2015.
- Depression. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Depression/Overview. Accessed Oct. 12, 2015.
- Cristancho MA, et al. Persistent depressive disorders: Dysthymia and chronic major depressive disorder. In: Encyclopedia of Clinical Psychology. 1st ed. John Wiley and Sons; 2015. http://onlinelibrary.wiley.com/book/10.1002/9781118625392. Accessed Oct. 13, 2015.
- Stewart D. et al. Risks of antidepressants during pregnancy: Selective serotonin reuptake inhibitors (SSRIs). http://www.uptodate.com/home. Accessed Oct. 12, 2015.
- Coryell W. Unipolar depression in adults: Course of illness. http://www.uptodate.com/home. Accessed Oct. 12, 2015.
- Ciechanowski P. Unipolar major depression in adults: Choosing initial treatment. http://www.uptodate.com/home. Accessed Oct. 12, 2015.
- Ravindran AV, et al. Complementary and alternative therapies as add-on to pharmacotherapy for mood and anxiety disorders: A systematic review. Journal of Affective Disorders. 2013;150:707.
- Natural medicines in the clinical management of depression. Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/ce/CECourse.aspx?cs=MAYO&pm=5&s=nd&pc=09-30&searchid=53681138#keywordanchor. Accessed Oct. 12, 2015.
- Hoban CL, et al. A comparison of patterns of spontaneous adverse drug reaction reporting with St. John's wort and fluoxetine during the period 2000-2013. Clinical and Experimental Pharmacology and Physiology. 2015;42:747.
- Marchand WR. Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression, anxiety, pain, and psychological distress. Journal of Psychiatric Practice. 2012;18:233.
- Rohren CH (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 22, 2105.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 27, 2015.
Persistent depressive disorder (dysthymia)