Overcome persistent depressive disorder from the comfort of home.

Feel better in 12 weeks with a personalized treatment plan including medication, therapy, or both.
  • Expert providers
  • Medication delivered
  • Appointments within 48 hours.
Start your free assessment
Start your free assessment
woman smiling at phone on couch

What is persistent depressive disorder?

Persistent depressive disorder (PDD), formerly known as dysthymia, is a form of depression. The symptoms of PDD may be less severe than major depressive disorder (MDD), but they persist for longer periods of time.

While MDD is often episodic, PDD is more constant, sometimes lasting for years. For some people, the disorder starts during childhood, which can result in a person believing that depression is part of their character or personality.

Dr Mimi Winsberg headshot
Mimi Winsberg, MD

Chief Medical Officer
Stanford-trained Psychiatrist with 25 years of practice

The signs & symptoms of persistent depressive disorder.

The symptoms of persistent depressive disorder and major depressive disorder are similar. However, the main symptom of PDD is long-lasting low mood.

Other key symptoms of persistent depressive disorder include:

  • Irritability
  • Appetite or weight changes
  • Changes in sleep patterns
  • Fatigue
  • Low energy
  • Difficulty concentrating,
  • Feelings of hopelessness or pessimism.

Persistent depressive disorder is a common and treatable condition, don’t wait to get the care you need.

Start your free assessment

85%of Brightside members feel
better within 12 weeks
Start your free assessment

How we treat persistent depressive disorder

Once a diagnosis has been established, persistent depressive disorder is generally treated with therapy, medication, or both. Talk with your provider about the best treatment option for you.

Medication

Antidepressants are shown to be effective in treating the symptoms of persistent depressive disorder. At Brightside, we use your data and research to find the right medication for you.

Learn More
hand holding prescription pills

Therapy

We use evidence-based approaches to therapy such as cognitive behavioral therapy (CBT) that are proven to be the most effective in treating persistent depressive disorder.

Learn More
woman sitting on a couch looking at a laptop

Self-Care

A comprehensive approach to care leads to better outcomes. By practicing daily healthy habits and self-care, you can reduce your symptoms of persistent depressive disorder.

Learn More
woman exercising with child on floor

Commonly prescribed medications.

At Brightside we prescribe over 30 different antidepressant medications. We’ll work with you to find the right medication for your individual needs and symptoms.

Affordable plans to help you feel better.

Starting as low as
$45 / for your first month.


Woman sitting on couch looking at phone

Whether you choose medication, therapy, or both, our memberships include expert online care designed to help you feel better, faster.

  • Comprehensive video evaluation
  • Personalized treatment plan
  • Unlimited messaging
  • Unlimited video follow-ups with your provider
  • 4 video sessions with your therapist each month
  • Free medication delivery
  • Interactive Therapy lessons
  • Regular progress tracking

FSA/HSA accepted
Cancel anytime

We accept health insurance.

We're on a mission to make anxiety & depression care more affordable for all.
Cigna
BlueCross
BlueShield
Magellan

Getting started is simple.

Brightside app on a phone screen
Step 1

Fill out a quick questionnaire.

Start by answering a clinically-proven set of questions, which will help us understand your symptoms and recommend a treatment plan with Medication, Therapy, or both.

Phone screen with woman smiling
Step 2

Meet your provider & start treatment.

Within 48 hours, you’ll have a video consultation where you can share how you’re feeling and decide on next steps together. If prescribed, your medication will be delivered to your door monthly.

Brightside score screen on phone
Step 3

Make progress and feel better.

Unlimited messaging, video sessions, and regular check-ins help you stay in touch with your provider so they can monitor your symptoms and adjust until treatment is right for you.

Start your free assessment

You’re in good hands. Our licensed providers are experts in treating persistent depressive disorder.

  • Always see an expert psychiatric provider
  • All therapists hold a master’s degree or higher
  • Licensed in your state and background comprehensively checked
Doctor Laura Purdy headshot

Laura Purdy, MD

Psychiatrist
Doctor Michael Chen headshot

Michael Chen, MD

Psychiatrist
Doctor Frederica Boso LMHC headshot

Frederica Boso, LMHC

Licensed mental health counselor

Life-changing results from real members.

Read More Reviews
Melissa K.

“A literal life saver. So convenient, so effective, and more involved/high touch than my former psychiatrist was. I should have done this a year sooner.”

Kayla S.

“Brightside has made such a huge improvement on my quality of life. The ease of access, the convenience of the med delivery, and the intelligent check in scoring system all contribute to a next level quality of care.”

Anonymous

“My provider has answered every question I’ve had, listened to worries and concerns and symptoms, assured me and is truly invested in my quality of care. I’ve gone from moderate-severe depression to mild depression in just 2 months.”

Rachael B

“I am so very grateful to have found Brightside. This is the most hopeful I have felt in maybe two years. Brightside isn't just working for me, it saved me. Brightside really turned may life around.”

Tyler K

“My life is so much better after starting with Brightside. My doctor truly cares about my well being and I’m just so grateful for this.”

Life-changing results from real members.

Melissa K.

“A literal life saver. So convenient, so effective, and more involved/high touch than my former psychiatrist was. I should have done this a year sooner.”

Kayla S.

“Brightside has made such a huge improvement on my quality of life. The ease of access, the convenience of the med delivery, and the intelligent check in scoring system all contribute to a next level quality of care.”

Anonymous

“My provider has answered every question I’ve had, listened to worries and concerns and symptoms, assured me and is truly invested in my quality of care. I’ve gone from moderate-severe depression to mild depression in just 2 months.”

Rachael B

“I am so very grateful to have found Brightside. This is the most hopeful I have felt in maybe two years. Brightside isn't just working for me, it saved me. Brightside really turned may life around.”

Tyler K

“My life is so much better after starting with Brightside. My doctor truly cares about my well being and I’m just so grateful for this.”

Read More Reviews

What you need to know.

How is persistent depressive disorder diagnosed?

PDD is diagnosed when someone has been experiencing a depressed or low mood for two years or more. In addition to a persistent low mood, at least two of the following symptoms must be present: poor appetite or overeating, insomnia or hypersomnia, low energy/fatigue, low self-esteem, poor concentration/decision making, and hopelessness.

PDD can be diagnosed by a doctor or medical professional. The medical professional’s evaluation will identify specific symptoms and explore medical and familial histories as well as cultural and environmental factors. In some cases, lab testing and blood work might be done to make sure the depression is not due to a medical condition like a thyroid problem or a vitamin deficiency.

Read More

What are the risk factors of persistent depressive disorder?

The reason why some people experience depression during their lifetime and others don’t is complicated, but it can be explained by utilizing the Biopsychosocial Model of Depression. The Biopsychosocial Model of Depression states that certain people are more vulnerable to developing depression because of biomedical and genetic risk factors, psychological risk factors, and societal, environmental, and social risk factors.

Biomedical & genetic risk factors
Certain physical illnesses, such as diabetes, cancer, heart disease, chronic pain, thyroid disease, and Parkinson’s disease can contribute to the onset of depression. Medications taken for these physical illnesses may also cause side effects that contribute to depression.

Further, some individuals have a genetic predisposition to developing depression. For example, if someone has a parent or sibling with major depression, that person has a two or three times greater risk of developing depression compared with someone who does not have depression in their immediate family members.

Psychological risk factors
Various aspects of how we automatically view the world, ourselves, and our relationships, may leave us to be vulnerable to developing depression. For example, a tendency to feel helpless when facing stressors in our life, having a natural tendency to ruminate about problems, having a negative perception of one’s self, the world, and the future, and having difficulty with relationships like feeling overly dependent on others, all can contribute to the development of depression. 

Societal, environmental, & social risk factors
As human beings, we live in a society with others. Exposure to certain stressful situations throughout the lifespan can contribute to one’s vulnerability to develop depression. For example, people who experienced child maltreatment (physical abuse, sexual abuse, neglect, and/or emotional abuse) are at a much higher risk for developing depression as an adult. Some recent research indicates that this group of people are twice as likely to develop depression as an adult than those who did not experience any child maltreatment. 

Living in poverty also makes people more vulnerable to depression. Those living in poverty are exposed to more violence and crime, and trauma, which all in turn also increase one’s risk for developing depression. 

Stressful life events can also make people more likely to develop depression. For example, experiencing a pandemic, as we are now, chronic stress, or single major life events that are threatening and/or impact one’s personal goals and vision of their future. These could be events like losing one’s job or going through a divorce. 

Protective factors
Certain personal characteristics, habits, and environments can help protect people at risk for depression from developing it. Some of these protective factors include: 

  • Social support
  • Supportive, loving family
  • Safe neighborhood
  • Self-compassion
  • Good health and healthy lifestyle
Read More

When to seek help for persistent depressive disorder.

It’s normal to feel sad or have days when you feel down. However, if you feel like a low or depressed mood has become your “normal,” it might be time to seek professional help.

The first step is to talk to a doctor or mental health professional about your symptoms. Symptoms of PDD may not improve on their own, so getting help is key to feeling better.

What are the treatment options for persistent depressive disorder?

PDD can be treated with medication, therapy, or a combination of the two. There are also a variety of alternative treatment options that can help ease symptoms, such as supplements, although some may not be regulated by the FDA.

Medication
Medication is an effective form of depression treatment for many people. Because there are many forms of depression and each individual is unique, getting the best result requires matching each individual to the right medication. Then, once a treatment plan has been established, your doctor can fine-tune further treatment based on your response to the medication.

Medications commonly prescribed as a first line of treatment for depression include selective serotonin reuptake inhibitors (SSRIs) and norepinephrine-dopamine reuptake inhibitors (NDRIs). Common examples include Sertraline (Zoloft), Escitalopram (Lexapro) and Bupropion (Wellbutrin). There are other categories of medications that are used as well. Have a conversation with your doctor to figure out if medication is the right treatment option for you.

It typically takes at least two to six weeks of taking an antidepressant to see improvement. It may also take several trials to find the medication that works best. Once the right medication is found, dosage may be adjusted to optimize results.

We believe that everyone with depression should get specialized, expert care. This includes an experienced clinician taking the time to complete a comprehensive diagnostic evaluation, using data and clinical decision support to make an informed prescribing decision (if medication is appropriate), and practicing measurement-based care to monitor progress and adjust treatment accordingly.

Brightside offers medication plans to treat MDD. Click here to learn more about our medication plan offerings.

Therapy
Therapy may help alleviate some of the symptoms of depression by allowing you to:

  • Understand how your thoughts and behaviors contribute to your symptoms and learn ways to change them.
  • Identify and understand how past or current events may have led to the development of unhelpful patterns of thought or behavior that can be maintaining your distress. 
  • Develop skills to cope with intense emotions that may be interfering with your ability to live life the way you want.
  • Develop healthy relationship and communication skills 
  • Increase confidence in your ability to handle challenging situations. 

Therapy can help you develop the skills you need to improve your depression. It can also be a helpful tool if depression is getting in the way of feeling your best and living the life you want.

If you’re ready to take the plunge into therapy, click here to get connected with our providers today.

Supplements
Research has shown that depression is influenced by a number of processes inside the body, including inflammation, oxidative stress, and more. Because of this, certain supplements have been used to help alleviate symptoms in people with depression for decades. However, the frontline treatment of depression is medication and/or therapy.

Fish oil (high EPA)
Fish oil is high in omega 3 fatty acids, which are key to certain brain functions and may help reduce inflammation associated with depression. There are two types of omega 3s in fish oil: EPA and DHA. Researchers found that EPA is the one that helps the most when it comes to depression.

Vitamin D
Our bodies produce vitamin D naturally with adequate exposure to the sun; however, studies have found that most people actually have insufficient levels, especially those living in northern latitudes with less sunlight exposure, and that people with low vitamin D levels are prone to higher rates of depression. There are vitamin D receptors in parts of the brain associated with depression and it may be involved in the creation of certain neurotransmitters.

L-Methylfolate (a specific type of folic acid)
Certain people have a genetic makeup that actually impairs their use of folic acid in cellular processes, which may be associated with depression. L-Methylfolate can help bridge this gap and keep the cellular processes moving. In fact, there is already an FDA-approved form of L-Methylfolate that doctors prescribe to patients who don’t initially respond to antidepressant treatment.

SAM-e (S-adenosylmethionine)
SAM-e is a prescription drug in Europe but is available over the counter in the U.S. It’s a natural substance present in every cell in the body and brain that plays a role in numerous cellular processes. SAM-e is believed to work by increasing levels of serotonin in the brain, creating a similar effect to antidepressant medication.

If you are considering supplements to help combat depression, it’s important to talk to a doctor about what is right for you. Some nutritional supplements are not FDA regulated and tests have consistently shown variable quality and purity across manufacturers. 

Self-Care, Coping and Support
Many treatment plans for depression involve aspects of self-care. Getting regular exercise and good quality sleep can have a major effect on managing the symptoms of your depression. Practicing mindfulness, keeping a healthy and balanced diet, and connecting with loved ones or a support group are also highly impactful ways to aid in treating depression.

Read More

The Brightside difference.

We designed Brightside to deliver the best psychiatric care available.

Unlimited
access

Receive ongoing online care from hand-selected providers who are experts in treating anxiety & depression.

Precision-
prescribing

Data-driven prescribing that analyzes over 100 unique data points and decades of clinical research to pinpoint your match.

Science-backed
approaches

Build the skills needed to overcome anxiety and depression with an evidence-based approach to therapy that is proven to work.

Measured care for
better outcomes

Track your progress at every step, so you and your provider can make informed decisions and adjust your care until it’s right for you.

Start your free assessment
741-741

If you’re in emotional distress, text HOME to connect with a counselor immediately.

911

If you’re having a medical or mental health emergency, call 911 or go to your local ER.