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Persistent Depressive Disorder (Dysthymia)

A 42-year-old man reports a 3-year history of low mood, hopelessness, low self-esteem, and fatigue, never symptom-free for more than 2 months. Outline diagnosis and management steps.

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Encourage exercise, sleep hygiene, social support

Monitor for emergence of MDD episodes

Combination of psychotherapy and antidepressants

DSM-5 criteria require ≥2 years depressed mood + ≥2 symptoms

Specialist care if suicidality or treatment-resistant

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