March 10th, 2026
Have you ever felt “down” for exceptionally long periods of time but didn't know why? Maybe you even automatically ruled out depression because although you felt emotionally heavy, you were still able to go about your life and complete tasks. The feelings were not severe enough to stop you from functioning, but they were constant and definitely impacting you.
Well, to many people’s surprise, there are different types of depression, each with unique manifestations. For instance, some depressive episodes are shorter but more intense, lasting for weeks or months at a time. In other cases, depression can feel like a constant, mild to moderate hum that lingers for years.
You might be able to go to work, commute on the CTA, meet up with friends in your neighborhood, and keep up with daily responsibilities. But internally, something feels heavy or off. For many people in Chicago balancing careers, family life, and the fast pace of the city, that persistent low mood can quietly affect quality of life and the way you see yourself and the world.
In some situations, people experience a combination of both patterns. These experiences are consistent with major depressive disorder (MDD), persistent depressive disorder (PDD), and what’s sometimes referred to as “double depression” (a combination of PDD and MDD).
While research estimates that persistent depressive disorder affects about 2.5% of U.S. adults at some point, much of the public conversation around depression focuses primarily on major depressive episodes (MDD). That can make it harder for people to recognize chronic, long-standing symptoms that don’t always feel dramatic but are still deeply impactful (PDD).
Both major depressive disorder and persistent depressive disorder can significantly interfere with daily functioning, relationships, and overall wellbeing. However, they present in distinct ways and may require different treatment approaches.
Getting an accurate diagnosis from a qualified psychiatrist in Chicago can provide clarity and validation. Keep reading to learn more about these two types of depression and where you can find expert depression treatment in Chicago.
MDD is the most commonly diagnosed depressive disorder. It’s characterized by episodes of depression symptoms, typically lasting for weeks to months.[1] To be diagnosed with MDD, you must experience five or more of the following symptoms for at least two weeks on most or all days. At least one of them must be either low mood or anhedonia (loss of interest or loss of pleasure).
Additionally, for a diagnosis to occur, major depressive disorder symptoms must impact functioning or cause significant distress. The episode must not be better attributed to a substance or another medical condition.
PDD is another mood disorder, distinct from MDD. It’s characterized by ongoing, more mild depression symptoms lasting for at least two years in adults or at least one year in kids and adolescents.[2] The main symptom of PDD is a depressed, low, or down-in-the-dumps mood that is experienced for most of the day, more days than not. People with PDD will also have two or more of the following symptoms.
Sometimes, PDD is also called dysthymia. The chronic nature of persistent depressive disorder symptoms means that they can become embedded in the way you think and how you see the world. This can make it harder to detect PDD.
MDD and PDD share some similarities, like the fact that they have some overlapping symptoms. However, there are three key differences between major depressive disorder vs. persistent depressive disorder:
Knowing the difference between MDD and PDD can be beneficial for those seeking a diagnosis. If both sound familiar, you are not alone; it is possible to have more than one depressive disorder.
Major depressive disorder and persistent depressive disorder are not the same. However, they can sometimes occur at the same time, this is called “double depression.” Double depression is not a formal clinical term. Instead it refers to having symptoms of two different depression diagnoses, MDD and PDD.
When someone lives with both PDD and MDD, they experience the chronic, lower-level symptoms PDD causes persistently, but they also have more severe, major depressive episodes like MDD.
About 75% of people with PDD will, at some point, meet the criteria for at least one major depressive episode.[3] Although it can be trickier, double depression can be effectively treated and managed.
Usually, depression treatment involves a combination of therapy, medications, and lifestyle changes. No matter what kind of depression you have, trial and error can be necessary to find what works for you. That said, here’s a general idea of what to expect from treatment for MDD, PDD, and double depression.
MDD can range from mild to severe. Treating mild MDD may include therapy, lifestyle changes (e.g., nutrition, sleep, physical activity, and engaging in hobbies), and medication.
For moderate to severe MDD, a combination of therapy and medication is commonly used.[4] The same is true for cases of any severity level that don’t respond to therapy alone.
Cognitive behavioral therapy and its variants, interpersonal psychotherapy, and medications like selective serotonin reuptake inhibitors (SSRIs) are typically the first line of treatment. Common major depressive disorder medication options include:[5]
If a person doesn’t respond to these, there are options. For example, other antidepressant medications, like serotonin norepinephrine reuptake inhibitors (SNRIs), Wellbutrin (bupropion), and older antidepressants, like tricyclic antidepressants (TCAs), or TMS for depression.
Long-term, tailored approaches are best for managing persistent depressive disorder due to the chronic nature of the condition. The most effective strategy usually entails a combination of therapy and medication.
When it comes to medication, SSRIs or SNRIs are highly recommended. Again, if a person does not respond to these, alternatives are available. That said, common persistent depressive disorder medications often include:
In addition to cognitive behavioral therapy and interpersonal psychotherapy, a treatment called Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is often ideal for people with PDD. CBASP is a specialized treatment developed for chronic depression.[6] It has high efficacy rates for PDD and can be conducted in individual or group therapy settings.
Like with PDD alone, double depression is best treated via a long-term approach. Combining medication and therapy, including therapies that target long-term depression symptoms, is the most effective approach. The first type of medication you’re prescribed will usually be an SSRI or SNRI, much like with standalone MDD or PDD.
However, other medications–such as TCAS or mood stabilizers–might be recommended when other prescriptions do not work. These can be used to treat standalone MDD or PDD as well, if you don’t respond to other medications.
Finding a depression psychiatrist and therapist you can work with consistently is one of the best things you can do as part of any depression treatment plan. They can help you look out for worsening symptoms of depression and address them right away.
Staying consistent with lifestyle adjustments, like physical activity, avoiding drugs and alcohol, and getting enough sleep, can be essential for symptom management and overall health.
One of the most important things to remember when it comes to depression treatment is that no two people are exactly alike. Whether you have PDD, MDD, or another depressive disorder, treatment is not one size fits all. It’s essential to have healthcare professionals you can trust by your side.
Clarity Clinic offers quality mental health care in Chicago. We take a caring, whole-person approach that helps people manage symptoms of MDD, PDD, and other depressive disorders from an individualized, person-centered perspective. From medication management, therapy, TMS therapy, and structured mental health programs (PHP/IOP) we proudly offer a wide range of depression treatment services.
Whether you’re pursuing a diagnosis or need a psychiatrist or therapist who can help you find effective depression treatment tailored to your needs, we’re here to help. We provide both in-person and online mental health care in Chicagoland and the surrounding areas.
To learn more or start the intake process, give us a call (312) 815-9660 or book online today.
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References
[1] Clinical depression (major depressive disorder): Symptoms. Cleveland Clinic. (2025c, September 11). https://my.clevelandclinic.org/health/diseases/24481-clinical-depression-major-depressive-disorder
[2] U.S. National Library of Medicine. (n.d.-b). Persistent depressive disorder: Medlineplus medical encyclopedia. MedlinePlus. https://medlineplus.gov/ency/article/000918.htm
[3] Jerry L Halverson, M. (2024, November 5). Dysthymic disorder. Background, Etiology, Epidemiology. https://emedicine.medscape.com/article/290686-overview?form=fpf
[4] Dunlop, B. W. (2016, April). Evidence-based applications of combination psychotherapy and pharmacotherapy for depression. Focus (American Psychiatric Publishing). https://pmc.ncbi.nlm.nih.gov/articles/PMC6519650/
[5] Bains, N. (2023, April 10). Major depressive disorder. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK559078/
[6] Furukawa, T. A., Schramm, E., Weitz, E. S., Salanti, G., Efthimiou, O., Michalak, J., Watanabe, N., Cipriani, A., Keller, M. B., Kocsis, J. H., Klein, D. N., & Cuijpers, P. (2016, May 4). Cognitive-Behavioural Analysis System of Psychotherapy (CBASP), a drug, or their combination: Differential Therapeutics for Persistent Depressive Disorder: A study protocol of an individual participant data network meta-analysis. BMJ open. https://pmc.ncbi.nlm.nih.gov/articles/PMC4861112/
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