Understanding the difference between major depressive disorder and persistent depressive disorder

Both major and persistent depressive disorders are chronic conditions that create an environment of stress and worry. This stress is not your normal stress that withers away easily but one that degrades peace of mind and interferes with work and relationships. The main difference between major depressive disorder and persistent depressive disorder lies in its intensity, severity, and duration of occurrence. While major depressive disorder has an intense negative impact on the mind, it usually lasts for a short term like for a week or so. When it comes to persistent disorder, it is usually less empowering but long-lasting. 

For example, let’s consider a situation where a student gets a bad grade on an exam. For a few weeks, the student is depressed because of the sadness of the score. After some time, the sadness subsides and the student is happy again. This behavior can be labeled as major depressive disorder. However, with the persistent disorder, the sadness persists and the student is not happy or excited about anything even after recovering from the sad state. 

What is Major Depressive Disorder (MDD)?

Overlapping Symptoms of persistent and major depressive disorder 

 Symptoms of major and persistent depression can be identified through the following behavioral changes –

• Disinterest and lack of pleasure in everyday activities 
• Persistent feelings of sadness and hopelessness
• Irregular sleep schedules and trouble sleeping 
• Getting fatigued easily and being low on energy 
• Having difficulty maintaining focus or clarity 
• Experiencing self-criticizing thoughts and negative emotions
• Greater frequency of suicidal thoughts and attempts
• Increased restlessness or sluggishness 
• Onset of persistent and depressive mood nearly every day 
• Difficulty in thinking or making decisions 
• Significant impairment in social, occupational, and other areas of life 

What causes major and persistent depressive disorder? 

Various biological, psychological, and social factors are responsible for the development of persistent and major depressive disorder in an individual. Let’s understand each of these causes in detail.

Biological Causes 

• An imbalance in neurotransmitters such as serotonin, norepinephrine, and dopamine plays a major role in triggering depression in an individual, serotonin plays a more prominent role in the development of persistent depressive disorder.
• The genetic history of major depressive disorder is most likely to bring Major depressive symptoms in a person. While genetics also play a role in Persistent Depressive Disorder (PDD), the extent of genetic influence may be less pronounced compared to major depression.
• Certain chronic illness conditions such as diabetes, chronic pain, and thyroid disorders can be responsible for the occurrence of major depression. Medical conditions are less likely to establish persistent depression, but chronic issues can still add stress and reduce well-being.

Psychological Causes

• Negative thinking and self-criticizing thoughts trigger depressive symptoms.
• Traumatic life experiences like loss, abuse, or any other such incident can be responsible for depressive thoughts. However, in the case of persistent depression, it’s chronic low-grade stress, rather than major life changes, which is responsible for the symptoms.  
• Major depression is triggered by life events, while persistent depression is triggered by long-term stressors, unresolved interpersonal conflicts, and childhood adversity.

Social Factors

• Lack of social support during an emotional crisis.
• Chronic stress and challenges concerning a person’s economic condition.
• Childhood trauma and adverse life events, with early experiences and financial challenges, have a profound role in the development of persistent disorders.  

Treatment and Diagnosis Approaches 

Research says that for a doctor to diagnose major depressive disorder, a person must have experienced at least two of the depression episodes separated by at least 2 months

While for persistent depressive disorder, research suggests that, the symptoms cannot have been absent for more than 2 months at a time during 2 years, in adults, or 12 months, in younger people.

Treatment options 

For Major Depressive Disorder

According to the National Center for Biotechnology Information (NCBI), depression-centered psychotherapy is generally considered an initial treatment for mild to moderate major depression. Based on substantial clinical evidence, two distinct psychotherapeutic approaches are recommended for its treatment: cognitive-behavioral (CBT) therapy and interpersonal (IPT) therapy.

For Persistent Depressive Disorder

The various treatment techniques suggested under this aim to manage long-term symptoms and improve overall functioning. A report by NCBI shows persistent depressive disorder responds well to several acute interventions, such as combined psychological and pharmacological treatments

The treatment options suitable for each of these disorders depend on person to person, on their circumstances and medical condition. More severe cases might require a combination of medication and therapy, while milder cases might benefit more from initial therapy with medication. It’s better to seek professional help who understands the difference between major depressive disorder and persistent depressive disorder well.