Many people experience symptoms of depression but wonder whether they meet the criteria to be diagnosed with major depressive disorder. Depression is defined by the Mayo Clinic as a mood disorder that causes feelings of sadness, a loss of interest and low energy levels. Although a person may have days where these symptoms ring true, they may feel their experiences are milder than cases of depression they often hear about.

One of the main reservations people have before seeking professional mental health treatment is whether they feel their experiences would warrant a diagnosis of depression. Sadly, it’s not well-known that there are numerous diagnoses of depressive disorders, and some are more applicable to those who feel they have high-functioning depression.

In this article we’ll look at what “high-functioning depression” really means, and why persistent depressive disorder DSM V criteria may be more applicable.

High-functioning depression

While not a clinical term or diagnosis, high-functioning depression is sometimes used to describe people who experience a low mood or lack of energy but are able to continue with their normal lives. An individual with high-functioning depression symptoms will still appear to manage normal life with few interruptions in school, work, relationships or daily tasks.

These individuals have a life that seems balanced. They may have stable families, satisfying careers and participate in church or club organizations. They are able to socialize normally and maintain friendships, and even those close to the individual with high-functioning depression may not recognize symptoms of something deeper.

In most of these cases, a person is struggling with depression symptoms, but in much milder forms. These symptoms tend to persist over long periods of time and those affected may refrain from seeking treatment because they feel their features of depression do not cause significant interference in daily living. This is called a persistent depressive disorder.

Persistent depressive disorder

Persistent depressive disorder (PDD) is less widely known than major depressive disorder (MDD). Persistent depressive disorder is characterized by feelings of sadness, low self-esteem, hopelessness and low motivation or interest. It is a long-term form of depression and must be present for two years before a diagnosis can be made.

Persistent depressive disorder is sometimes referred to as dysthymia and is more chronic than major depressive disorder.

Symptoms of PDD

Because PDD is long-term, symptoms come and go over time and change in intensity. Individuals may have low periods followed by more moderate symptoms. At times, these high-functioning depression symptoms may escalate to episodes of major depression. Symptoms may cause interference at times, then seemingly disappear. 

Symptoms of persistent depressive disorder according to the DSM V include the following:

• Sadness
• Emptiness
• Hopelessness
• Low mood
• Lack of energy
• Loss of interest in activities that were previously enjoyable
• Low self-worth
• Changes in appetite or weight
• Changes in sleep
• Trouble making decisions
• Issues concentrating
• Trouble getting tasks done (especially completing work or school tasks, or daily chores like grocery shopping)
• Irritability
• Becoming annoyed or angry easily
• Avoiding friends and family
• Excessive worry, fear or guilt

Someone with persistent depressive disorder will feel as if she is going through life without enjoyment, and simply “going through the motions.” If you or someone you know has exhibited mild forms of depressive behavior and feelings over a long period of time, it’s worth getting a second opinion regarding a potential PDD diagnosis.

PDD can be recognized by loved ones who notice the following behaviors:

• Increasing use of drugs and alcohol
• Appearing unmotivated to do simple tasks
• Expressing disinterest or seemingly feeling numb
• Increasingly avoiding social gatherings or missing commitments
• Becoming defensive of behavior

PDD can be hard to recognize in someone you know, especially because symptoms can be difficult to distinguish from personality over time.

Because persistent depressive disorder can escalate, suicidal ideation may occur. If suicidal thoughts occur or increase in frequency, the time for treatment is now.

Treating persistent depressive disorder

Signs of PDD aren’t always apparent to either the person affected or to his or her loved ones. A person who has lived with PDD for several years may have adapted the behavior to easily hide symptoms and when they are visible they may be dismissed as “having an off day.”

Moreover, the origin of depression symptoms may relate to the type of depression present. Persistent depressive disorder may be caused by trauma, biological causes, chronic pain or chemical imbalances. This type of depression may be influenced by a person’s circumstances, such as having a family member going through years of cancer treatment or prolonged and unsuccessful fertility treatments.

Regardless of the causes of PDD or the manifestations of this mood disorder, each case is worthy of treatment. Anyone affected by long-term feelings of sadness, loss of interest and low energy can benefit from professional and personalized intervention.

Treatment for PDD

The best treatment for persistent depressive disorder according to the DSM V is therapy. Talk therapy, or psychotherapy, that occurs in group or one-on-one settings is the first line of defense in treatment. In addition, to talk therapy, many people find medications to be helpful in managing symptoms of depression.

Common medications for PDD include selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors and tricyclic antidepressants. Because symptoms tend to ebb and flow, medication management and regular check-ins with healthcare providers are essential.

Breaking out of the rut

Individuals who face persistent depressive disorder often hide symptoms and are reluctant to seek treatment because their experiences are more moderate than major depressive disorders. Finding care for PDD requires you to break out of the rut and decide that you’ve struggled long enough.

Aim for the life you deserve and contact Silvermist Recovery today. Whole-person healing is within reach with evidence-based mood disorder treatment.