Depression Types Do You Have Mild, Low-Grade Depression? By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. Learn about our editorial process Nancy Schimelpfening Medically reviewed by Medically reviewed by Carly Snyder, MD on January 25, 2020 facebook twitter linkedin Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments. Learn about our Review Board Carly Snyder, MD Updated on March 23, 2020 Print Li Kim Goh / E+ / Getty Images Table of Contents View All Symptoms Causes Diagnosis Treatment Coping People with mild, low-grade depression may not even realize they are depressed. In fact, the chronic feelings of sadness and low mood they experience may have been around for so long that they feel normal. However, it is not normal to go through life feeling unhappy all of the time. Everyone experiences occasional bouts of low mood in response to sad or stressful life events, but constantly feeling depressed does not have to be the story of your life. Symptoms Chronic low-grade depression is a symptom of persistent depressive disorder (PDD), formerly known as dysthymia or dysthymic disorder. Dysthymia was previously listed separately from chronic major depression in the Diagnostic and Statistical Manual of Mental Disorders, but the disorders have since been combined as of the fifth edition, as no scientifically meaningful difference was found between them. The signs and symptoms of PDD are very similar to major depressive disorder, except that they tend to be milder and are chronic in nature. Symptoms of PDD include: Appetite or weight changesFatigueFeelings of hopelessness, worthlessness, or guiltLack of enjoyment or pleasure in thingsLow energy and reduced motivationRestlessnessSadness, tearfulness, frequent cryingSleep problemsThoughts of death or suicideTrouble concentrating, focusing, and making decisions If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see our National Helpline Database. Overview of Persistent Depressive Disorder (Dysthymia) Causes As with major depressive disorder, persistent depressive disorder is also believed to be a multifactorial condition—meaning they are likely caused by a combination of genetic susceptibility, biochemical imbalance, life stress, and environmental circumstances. In about three-quarters of patients with dysthymia, the primary cause of the disorder is not clear. But people with PDD tend to have other complicating factors, such as chronic illness, another psychiatric disorder, or substance use issues. In these cases, it becomes very difficult to say whether the depression would exist independently of the other condition. In addition, these comorbid conditions often create a vicious cycle wherein each illness makes the other more difficult to treat. Diagnosis Like other forms of depression, there isn't really a blood test or brain scan that can be used to make a diagnosis of dysthymic disorder. Instead, doctors must go by the signs that they can observe, as well as any symptoms patients report to them. Doctors and mental health professionals can check to see if a patient's symptoms fit into a pattern laid out by the DSM-5, a guidebook for diagnosing mental disorders such as depression. With dysthymic disorder, doctors will need to determine if the patient's symptoms have been present for an extended period of time (a minimum of two years for adults and one year for children). In addition, they will consider whether the severity of the symptoms is less than what a patient might experience with a major depressive disorder. Doctors will also use blood and urine tests to try to rule out possible medical conditions, such as hypothyroidism, that could cause symptoms like chronic mild depression. Other factors a doctor will consider when making a diagnosis include a patient's medical history, as well as whether there is a history of depression in their family. Treatment Persistent depressive disorder responds to many of the same treatments that are used to treat major depression. Antidepressant medications are generally prescribed, with selective serotonin reuptake inhibitors (SSRIs) being a popular choice. In addition, psychotherapy, also known as talk therapy, can often be quite helpful for people with chronic low-grade depression. You'll have to work with your mental health care provider to develop a treatment plan that's most appropriate for you. Depression Discussion Guide Get our printable guide to help you ask the right questions at your next doctor's appointment. Download PDF Coping There are also several self-care treatments that can help treat chronic mild depression. Here are a few suggestions to keep in mind: Aim for 30 minutes of moderately-intense exercise most days of the week, and add vigorous exercise if you are able to do so.Avoid alcohol and illegal drugs.Be sure that you are taking your medications correctly. Tell your doctor about any supplements or herbal remedies you take.Eat a varied and nutritious diet.Find things to do that you enjoy.Get enough sleep and ensure you have a restful sleeping environment.Seek out people for friends who are positive, supportive, and show that they care about you. If you have been diagnosed with dysthymia, but your depression symptoms are getting worse, make sure you talk to your doctor. They will reevaluate your symptoms and adjust your treatment if necessary. The Best Online Resources for Depression Was this page helpful? Thanks for your feedback! Everything feels more challenging when you're dealing with depression. Get our free guide when you sign up for our newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Persistent Depressive Disorder. U.S. National Library of Medicine. Reviewed July 8, 2018. Depression. National Institute of Mental Health. Revised February 2018. Melrose S. Persistent depressive disorder or dysthymia: An overview of assessment and treatment approaches. Open Journal of Depression. 2017;06(01):1-13. doi:10.4236/ojd.2017.61001 Patel RK, Rose GM. Persistent depressive disorder (dysthymia). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013;168-171.