HomeBlogConditionsTipsMajor Depressive Disorder vs Persistent Depressive Disorder Explained

Major Depressive Disorder vs Persistent Depressive Disorder Explained

This article will review the differences and similarities between Major Depressive Disorder vs Persistent Depressive Disorder, providing clear, expert-informed insights to enhance understanding and support effective treatment and management strategies.


Everybody feels sad now and again, maybe experiencing acute loneliness or hopelessness after moving to a new city, ending a relationship, or losing a loved one. Depression can have a serious impact on mental health and daily function, and depressive disorders can have an even more profound impact because their symptoms are long-lasting, not the result of single and temporary issues.

It is important to distinguish between Major Depressive Disorder (MDD) and Persistent Depressive Disorder (PDD) so that you can understand the role of treatment for each. This article will briefly review the common causes and risk factors between the two, the symptoms and diagnostic criteria, and the importance of getting an accurate diagnosis.

major depressive disorder vs persistent depressive disorder

Key symptoms of major depressive disorder vs persistent depressive disorder

Many of the key symptoms of major depressive disorder vs. persistent depressive disorder might look similar at first glance, but there are some key differences. 

Persistent depressive disorder has the same symptoms as major depressive disorder, with the exception being that the symptoms last at least two years. Those who have the symptoms of a major depressive disorder, whose symptoms have lasted for at least two years, are typically diagnosed with both PDD and MDD. 


Major depressive disorder is when an individual struggles with a major depressive episode that lasts at least two weeks with significant changes to mood, activities, and a complete loss of pleasure nearly every day of that span.

During a major depressive episode, individuals will experience things like:

  • Changes in weight or appetite
  • Changes in sleep patterns
  • Changes to psychomotor activity
  • Decreased energy
  • Feelings of worthlessness or guilt
  • Problems concentrating
  • Problems making decisions
  • Difficulty focusing
  • Thoughts of death or suicide
  • Suicide attempts 

The mood changes can be described as hopeless or discouraged. Some individuals complain that they feel anxious or don’t have any feelings at all, and this can be accompanied by somatic issues like unexplained aches or pains in the body, increased irritability with frustration over minor issues, and angry outbursts.

It’s not uncommon for someone with a major depressive disorder to have a complete disinterest in their usual activities, not caring anymore, pulling away from activities they once enjoyed, withdrawing socially, and even having significant reductions in their sexual interest. 

Appetite changes can go one way or the other, with significant increases in cravings for things like simple carbohydrates or sugars or a complete lack of appetite. The same happens with sleep in that someone might struggle with severe insomnia or hypersomnia. Decreased energy levels and fatigue are common, as are psychomotor changes that include things like an inability to sit still, constant pacing, long pauses before answering questions, and slowed speech.


With persistent depressive disorder, individuals struggle with depressed moods that occur for the entire day, almost every day, for at least two years. Individuals with persistent depressive disorder struggle with feeling sad or down in the dumps with long periods of depressed mood that last for so long that they start to think that that’s just how they’ve always been and that’s who they are.

Causes of persistent depressive disorder vs major depressive disorder

The exact cause of major depressive disorder is unknown. In some cases, depression can result from medical conditions or medication, but in most situations, it is the result of biological causes like exposure to stress or trauma. 

The exact cause of persistent depressive disorder is also unknown, but there are biological differences, risk factors like changes to brain chemistry, and trauma. 

Risk factors for MDD vs PDD

With MDD vs. PDD, there are several risk factors:

  1. Environmental 
  2. Genetic
  3. Physiological 

Environmental risk factors like exposure to dramatic experiences in childhood can increase the risk of developing major depressive disorder.

There are social factors like perpetual low income, racism, limited formal education, and discrimination that increase the risk of major depressive disorder.

Genetically, those with a first-degree family member who also has major depressive disorder are between 2 and 4 to develop MDD themselves. 

With PDD, changes to brain chemistry can cause persistent depressive disorder, which can happen because of life events, medication, substance abuse, or other conditions.

For both PDD and MDD, it is believed that a family history increases your chance of developing the condition and that traumatic events like high levels of stress, financial strain, or the loss of a loved one can also cause the condition. 

Impact on daily life: PDD and MDD

PDD and MDD share a similar impact on daily life. For example, both conditions might cause things like the following:

  • Limited sexual interest or sex drive, which can impact intimacy and sexual relationships with partners and spouses
  • An inability to find joy or pleasure in activities that may have once been pleasurable which can cause individuals to pull away from hobbies or social engagements with others that they once found enjoyable
  • Increased irritability and sadness which can cause people to cry at even the slightest prompting
  • Low energy or fatigue which can make it difficult for individuals to complete tasks find the motivation to go to work, take care of themselves, or engage in social relationships

Functionally speaking, one difference between major depressive disorder and persistent depressive disorder is the consequence or impact on daily life. The effects of persistent depressive disorder are as great or greater than the effects of major depressive disorder on social and occupational function.

Treatment difference between major depressive disorder and persistent depressive disorder

Finding the right treatment can be difficult because there are many complexities involved in diagnosing persistent depressive disorder vs. major depressive disorder. Though you might not see more than one difference between major and persistent depressive disorder at first glance, it’s still important to get an accurate diagnosis by way of a healthcare professional so that you can find effective treatment.

Treatment often involves a combination of medication, therapy, and self-help coping skills.


For major depressive disorder vs. persistent depressive disorder, you might be prescribed medication like selective serotonin reuptake inhibitors, which help to control the level of serotonin in your body. You might also be prescribed serotonin and norepinephrine reuptake inhibitors that control the norepinephrine and serotonin in your body. Tricyclic antidepressants are also prescribed to help modulate mood. 

major depressive disorder vs persistent depressive disorder


The most common form of therapy for MDD vs. PDD is psychotherapy, like cognitive behavioral therapy. Cognitive behavioral therapy can help you better recognize your thoughts and feelings and separate those that are realistic from those that are unrealistic, harmful, and unfounded. Doing so can help you recognize the impact that your thoughts have had on your emotions and your behaviors and practice better ways of managing those automatic negative thoughts.


Coping skills are an essential part of your ability to change your relationship to your condition. Since there is no single known cause for either condition, you will need to learn how to change your relationship to the condition by accepting it for what it is and changing aspects that are within your control.

These are skills that therapy can help you with, but you’ll need to find yourself a care routine to help manage symptoms, which could include things like:

  • Sleep hygiene
  • Healthy diet
  • Yoga or tai chi
  • Meditation
  • Finding rewarding activities
  • Exercising regularly 

Summing Up

What is the difference between major depressive disorder and persistent depressive disorder? The severity. PDD and MDD share the same symptoms, and it is not uncommon for people to be diagnosed with both. However, one difference between MDD and PDD is that persistent depressive disorder lasts for at least two years, so long that individuals can start to believe that this is normal.

Learning more about the differences between the two and getting a correct diagnosis can help you find effective treatment. What matters most is that you find therapy, social support, and lifestyle changes that are proactive in supporting your long-term health and happiness.

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