Depression is often spoken about as a single condition, but in reality, it encompasses a range of experiences and severities. Two of the most commonly diagnosed depressive disorders are Major Depressive Disorder (MDD) and Persistent Depressive Disorder (PDD). While they share similarities, they have distinct characteristics that impact diagnosis, treatment, and daily life. Understanding the differences between them is crucial for individuals seeking help, as well as for loved ones offering support.
Major Depressive Disorder (MDD): The Intense Episode
MDD, often referred to simply as “major depression,” is characterized by severe symptoms that interfere with daily functioning. These depressive episodes last at least two weeks and involve a combination of the following:
• Persistent sadness, hopelessness, or emptiness
• Loss of interest or pleasure in activities once enjoyed
• Significant weight loss or gain (without intentional dieting)
• Sleep disturbances (insomnia or excessive sleeping)
• Fatigue or low energy
• Difficulty concentrating or making decisions
• Feelings of worthlessness or excessive guilt
• Suicidal thoughts or behaviors
These episodes can be debilitating, making it difficult for individuals to maintain work, relationships, or even basic self-care. The intensity of symptoms often requires active treatment, such as therapy, medication, or both.
Persistent Depressive Disorder (PDD): The Chronic Low Mood
Previously known as Dysthymia, PDD is a chronic form of depression that lasts for at least two years (one year in children and adolescents). While the symptoms are often less severe than those of MDD, they are ongoing and can feel like a constant emotional weight. Symptoms include:
• A low or sad mood most of the day, more days than not
• Low self-esteem or feelings of inadequacy
• Fatigue and low energy
• Difficulty concentrating or making decisions
• Changes in appetite (overeating or poor appetite)
• Sleep disturbances
• Feelings of hopelessness
Because PDD is long-term, people with this disorder may come to believe that their persistent sadness is just a part of their personality or “who they are,” rather than recognizing it as a medically treatable condition.
In our next Blog Post, we will examine whether one can have both MDD, and PDD, as well as treatment options for both disorders.
Liza Linder, MSW, LCSW, is a therapist with 30 years of experience serving the LGBTQ+ and PLWHIV communities. Liza is in person only, in our Philadelphia offices. For more information about Liza, please click on the therapist’s bios.