If you suffer from persistent depressive disorder, you are likely more than familiar with feeling worn down, tired, and stuck. You may have been feeling this way for as long as you remember.

Perhaps you have tried medication or talk therapy, but it just did not help.

NeuroStar Advanced TMS therapy is an FDA-cleared procedure that is effective against depression when other treatments have fallen short.

Read on to learn more about persistent depressive disorder and how TMS therapy can help alleviate your symptoms.

What Is Persistent Depressive Disorder?

Persistent depressive disorder is a chronic form of depression that is typically less severe than major depressive disorder. However, it lasts longer. It often develops early on in life, typically sometime during childhood to the young adult years.

Persistent depressive disorder is correlated with:

  • Reduced quality of life
  • Suicidal thoughts and/or behavior
  • Other mood and mental health disorders
  • Substance abuse
  • Difficulties with relationships
  • Problems at school and work caused by decreased productivity
  • Chronic pain and general illness

Causes of Persistent Depressive Disorder

Persistent depressive disorder has a variety of causes. The causes include any combination of genetic, physical, or environmental factors.

You are at a higher risk of developing persistent depressive disorder if:

  • An immediate family member has a depressive disorder
  • A traumatic or stressful life event occurs
  • A tendency towards low self-esteem, overdependence, self-criticalness, or pessimism is present
  • A history of other mental health disorders is present

Biological Factors

It is widely agreed that there is a biological disposition to developing a depressive disorder, meaning it can be inherited.

Brain chemistry also can play a role in persistent depressive disorder. Persistent depressive disorder can be caused when certain neurotransmitters’ functions and effectiveness change.

Physical changes in the brain have also occurred in those with persistent depressive disorder. It is uncertain what these changes signify and whether the changes cause the disorder or the other way around.

Environmental Factors

Life events also play a part in the development of persistent depressive disorder. This is especially the case for those with a genetic disposition for having depression.

Traumatic events, such as the death of the loved one, can lead to the development of persistent depressive disorder. High levels of stress can also act as a trigger.

Signs and Symptoms

Many who have persistent depressive disorder report having felt depressed for as long as they can remember. They may also feel like they are constantly going in and out of depression.

Symptoms of persistent depressive disorder DSM-5 include:

  • Feelings of hopelessness
  • Feelings of sadness or emptiness
  • Lack of interest in daily activities
  • Lack of pleasure in previously enjoyable activities
  • Decreased activity and productivity
  • Irritability or excessive anger
  • Withdrawal
  • Low self-esteem
  • Low energy and fatigue
  • Lack of motivation and productivity
  • Insomnia or hypersomnia
  • An increase or decrease in appetite and weight
  • Difficulties concentrating and in making decisions
  • Feelings of guilt and increased self-criticism
  • Worrying over the past and feeling incapable


Persistent depressive disorder can be easy to miss.

A person may receive a diagnosis if they experience a depressed mood the majority of a day, for most days in a two-year period. However, for children and adolescents, it can be diagnosed after a period of one year.

A person will not receive a persistent depressive disorder diagnosis if:

  • They do not have at least two symptoms for two months
  • A manic, mixed, or hypomanic episode occurs
  • Symptoms are caused by a general medical condition
  • Symptoms are caused by the use of a substance, whether it is prescription or illegal
  • Symptoms do not cause significant distress or negatively impact functioning

Persistent depressive disorder may not be diagnosed if it seems another mental illness is a more likely cause. This includes major depressive disorder, which has similar symptoms.

If major depressive disorder is determined to be the cause but symptoms are present for a two-year period, a person may receive a diagnosis for both types of depression. This is otherwise known as double depression.

Treating Persistent Depressive Disorder

There are many treatment methods available for persistent depressive disorder. Each treatment will have a varying degree of effectiveness, depending on the person.

Persistent depressive disorder is typically treated by medication, talk therapy, or a combination of both.

Therapy and medication are equally effective in treating depression. Talk therapy may be beneficial in addressing the social impacts persistent depressive disorder can have on a person. Medication is also often beneficial, especially in cases where the root cause of the disorder is an imbalance of chemicals in the brain:

TMS Therapy

In cases where medication and psychotherapy are not sufficient, NeuroStar Transcranial Magnetic Stimulation (TMS) may be beneficial. TMS is an FDA-cleared treatment that stimulates specific areas of the brain to aid in mood regulation and help improve symptoms. 

TMS therapy relieves symptoms in 30-40% of cases in which medication and talk therapy were insufficient.

TMS therapy has many benefits, including:

  • Having little to no side effects
  • Being non-invasive
  • Causing no pain or discomfort during sessions
  • Not requiring sedation or general anesthesia

TMS Therapy for Persistent Depressive Disorder

Persistent depressive disorder can wear you down to the point of being debilitating. If medications or therapy prove ineffective, it may not be long until you are feeling stuck.

TMS therapy has been effective to treat depression where other methods have failed.

If you are interested in learning more about how TMS therapy can help you, reach out today for a free consultation.