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Do You Describe Yourself as Being Pessimistic? Don't!

You’re intensely insecure and self-conscious, so much so it feels like one of your prime attributes. You’d describe yourself as a true-blue pessimist or cynic. You don’t really get excited about anything. You have a hard time connecting with others. And you find yourself constantly exhausted and drained.


Because it’s been this way for so long—decades maybe, you’ve lost count—you just assume it’s you. You assume this is who and how you are. This must be your personality. This is just your way of life.

However, these supposed traits and tendencies might actually be diagnosable and treatable disorders. In other words, that pessimistic personality, that deep-seated self-doubt, or that sinking energy may be a symptom of an illness.

In her 2017 article in Open Journal of Depression, researcher Sherri Melrose, Ph.D., RN, noted that the above speaks to some of the ways health professionals have described individuals with a chronic form of depression called persistent depressive disorder (PDD). Before DSM 5 was published in 2013, PDD was known as dysthymia.

"PDD is one of the most under-treated and under-diagnosed conditions."

“Some people may have been depressed from an early age and thus are unaware that there is any other way to feel,” said J. Kim Penberthy, Ph.D., ABPP, a board-certified clinical psychologist and professor of psychiatry and neurobehavioral sciences at the University of Virginia School of Medicine who specializes in chronic depression.

“Many have parents or caregivers who also suffer from PDD and thus, again, these symptoms may seem ‘normal,’” she said.

Signs and Symptoms

Signs of PDD include, according to Penberthy: “sadness, tearfulness, low self-esteem, low energy, poor concentration or attention, and feelings of helplessness or hopelessness.”

Individuals with PDD also often “withdraw socially,” and have physical symptoms, such as: “headaches or pain, poor sleep, fatigue, [and] appetite changes,” she said.

PDD has been referred to as a “smoldering mood disturbance.” Adults with PDD experience symptoms for at least 2 years (with no longer than 2 months without any symptoms). In kids and teens, PDD lasts at least 1 year.

“Trauma during childhood or later in life has been hypothesized to play a role in the development of PDD,” Penberthy writes in her new book Persistent Depressive Disorders. “Retrospective and prospective studies have found increased rates of traumatic events, especially childhood trauma, in patients with PDD,” she writes.

After experiencing a severely traumatic event in her teens, Maddie Baldassari, a writer, speaker, and mental health advocate, was diagnosed with chronic depression. Baldassari felt exhausted all the time and too tired to read or hang out with friends.

“Probably the most noticeable symptom for me is not showering. The thought of having to wash my hair and dry it and fix it was so overwhelming I wouldn’t even try,” she said. “And then I would be too embarrassed to leave the house and it just became a cycle.”

PDD also frequently co-occurs with other conditions such as major depression, anxiety disorders, and substance abuse.

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