Sample Healthcare Paper on Persistent Depressive Disorder

Persistent depressive disorder, which is also known as dysthymia, is a continuous long term form of depression which is less severe. Most people with this disease describe it as they always feel depressed as long as they can remember or having a feeling of drifting in out of depression. It usually starts in childhood and tends to run in the family. It is commonly found in women, but in men, it might go undiagnosed since men don’t like talking about their mood. Sadly, their no known single cause of dysthymia. Persistent depressive disorder is a disorder that should not be ignored, and one is required to seek a psychotherapist.


Persistent depressive disorder is usually diagnosed by the duration the patient has had since it can go on for years. Its symptoms include a person losing interest in normal daily activities, feeling hopeless, lack of productivity, having low self-esteem and an overall feeling of being inadequate. It can also include symptoms such as overeating, oversleeping and diminished capacity to feel pleasurable things. It usually or sometimes erupts into a major depression as a result of loss or as a response to a certain stressor. (Patel & Rose, 2020) This leads to a double depression where a major depression wraps itself around dysthymia. In children, the symptoms may vary a little in that the child may lose appetite, and children may experience insomnia. Grouchy and hostile behavior, as well as frequent complaints on issues such as headaches, stomachaches, or fatigue, are symptoms of persistent depressive disorder in children.

Theories of Etiology

Modernization and advancement of medicine have resulted in the continued evolution of etiology on depression. Generally, dysthymia is caused by biological, social and psychological factors. Biological factors such as genetics, neurology, hormones, immunological factors play a significant role in dysthymia. This is because they are based on the reaction to stressors and processing information, which is emotional. The occurrence of dysthymia at earlier ages is often associated with chronicity and impairment. The occurrence of depression at different ages can shed light on different causal factors. Some risk factors associated with dysthymia include genetics, history of mental illness, sense of self-worth, trauma and social determinants of health.

Ethiologiacal models are usually diathesis-stress models that make experiences that are stressful to trigger depression. Some of the environmental stressors which can cause dysthymia include stress, which is chronic, childhood exposure to adversity and certain life events. The biological events which were stated earlier, and personal vulnerabilities such as interpersonal and personality factors usually add to cause dysthymia and can also be affected by depressive states. (Larson et al.)However, for some individuals, the persistence of these symptoms is not always typical, and it has become a significant challenge for the people who do research why some people experience different symptoms as compared to others.


The treatment of persistent depressive disorder is usually the use of psychotherapy and medication. The type of psychotherapy to be used usually depends on a number of factors, which may include the nature of stressful events, whether the family is available or not, social support, and what the person prefers( McCullough et al.). The therapy usually includes emotional support and giving out education about depression and how it can be overcome. Correction of self-critical and faulty life thought patterns is examined through cognitive behavior therapy. Reccomendation of antidepressants such as serotonin reuptake inhibitors (SSRIs such as fluoxetine), serotonin-norepinephrine reuptake inhibitors (SNRIs) as venlafaxine), mirtazapine, and bupropion are also advised. In children, the disorder can be treated by the use of family therapy, whereby the parents talk to their children, thereby knowing some of the contributing factors. The school which the child goes to should also be involved for the child to have specialized treatment or care.

The therapist initially focusing on behavioral changes on Bonnie, such as exercise, in my opinion, was right. One of the major signs of dysthymia is low self-esteem, which is usually associated with a person’s ability to socialize with others. The only way to increase a person’s self-esteem is by giving him time to socialize with those around him. They may articulate the patients’ strengths in this case, they may complement how good Bonnies knitting and sewing is, making her gain a little courage, which is essential. According to The Havard Medical school, exercising is an excellent way of protecting and enhancing brain activity. This is because regular exercises release brain chemicals, which are vital concentration and prevent cognitive decline, which can help with the symptom of loss of concentration.

What I would do differently is advise her to take time and spend time with her father and learn to perceive her marriage as a result of love rather than the natural requirement of having a partner. Spending time with her father let her understand why He broke up with her mother. This is because the divorce took a toll on her, and probably it’s the reason why she changed her opinion about life. This might help her change the feeling of unworthiness, and maybe she might feel wanted again. Viewing her marriage as a result of love may make her engage in pleasurable activities such as sex more passionately and spend more time feeling worthy, showing full affection and wanted.

I would also advise her, although it might be challenging to keep up with the treatment she should do for her family since her family loves her. Her dedication and keeping faith in the medication which was recommended will help her get through this disorder. Also, advising her on the possible implications that this disorder has on her children should be advised. Children should be brought up in a positive environment. If parents are committed to work, they play, go to church, and participate in community activities. It makes the children avoid depression in the early stages of life

A meaningful engagement in life is where one engages either frequently and consistently in doing activities that make them happy. It is usually marked by purpose and belief. In Bonnie’s case, she is not even content with her marriage. She doesn’t spend quality time with her husband. Spending time with one’s significant other helps one have a happy marriage. She does not like socializing, which is probably why she is not included in out of office social events by her fellow co-workers. This shows she doesn’t like participating in meaningful engagements. She rather spend time doing her knitting and sewing than being with friends and family. Therefore I agree with the therapist’s suggestions.

Depression can be avoided by participating in daily activities. Some of these activities which shelter me as a person include visiting friends and family, taking part in a group outing, and attending community events. This is because social interactions improve physical, emotional health, and mental health. Physical activities such as participating in outdoor games and maybe doing yoga are also important. Depression can also be avoided by having a sense of purpose. Taking up a hobby or doing past time activities such as yoga can also help with preventing depression. Family, which is always associated with love and compassion, is crucial in one mentals health. The feeling of belonging and having someone you can talk to is sometimes undermined but essential in having a healthy mind. Speaking to a therapist can also help. Nowadays, therapy can be done through phone calls and video calls. Why should you suffer in silence when an expert is always a phone call away?

Persistent depressive disorder represents a disorder of chronic depression, and the outcome is similar or can be worse as compared to that of a major depressive disorder. If dysthymia is gone and treated, the complications can be very similar to that of untreated mental illness. Untreated depression can result in an increase in health costs and a decrease in adhering to medication and adhering to treatment such as Bonnie did. Therefore patients should be educated to have better knowledge and understanding of the causes and how persistent depressive disorder can be treated. This might result in a better outcome since they can adhere to medication after learning of its importance. Persistent depressive disorder should not be ignored since it’s a serious mental condition. One should seek medical attention or help in order to be treated or to reduce its side effects.



Patel, R., & Rose, G. (2020). Persistent Depressive Disorder. Retrieved 10 November 2020, from

Larson, S. L., Owens, P. L., Ford, D., & Eaton, W. (2001). Depressive disorder, dysthymia, and risk of stroke: thirteen-year follow-up from the Baltimore epidemiologic catchment area study. Stroke32(9), 1979-1983.Publishing, H. (2020). Regular exercise releases brain chemicals key for memory, concentration, and mental sharpness, from the May 2013.

Kriston, L., Von Wolff, A., Westphal, A., Hölzel, L. P., & Härter, M. (2014). Efficacy and acceptability of acute treatments for persistent depressive disorder: a network meta‐analysis. Depression and anxiety31(8), 621-630.

McCullough Jr, J. P., & Clark, S. W. (2017). Persistent depressive disorder (dysthymia) and its treatment.