Persistent Depressive Disorder Treatment in West Ashley, Charleston
Care for a low mood that has lasted for years, in person in West Ashley or by secure video across South Carolina.
Understanding Persistent Depressive Disorder
The National Institute of Mental Health (NIMH) describes persistent depressive disorder as a form of depression with milder symptoms that last much longer, usually at least 2 years. NIMH's statistics page puts it as chronic, low-level depression that is less severe than major depressive disorder but may last longer, and notes that the diagnosis calls for a combination of depressive symptoms over two years or more.
For comparison, NIMH explains that a major depressive episode is diagnosed when symptoms are present most of the day, nearly every day, for at least two weeks, and one of them is a low mood or a loss of interest or pleasure in activities. Persistent depressive disorder is usually less intense than that, but it lasts much longer.
A mental health diagnosis is made by a qualified clinician using the DSM-5-TR, the American Psychiatric Association's diagnostic manual, and persistent depressive disorder is the name that manual uses.
What It Can Feel Like
NIMH lists signs of depression that include a sad, anxious or empty mood that does not lift; hopelessness or pessimism; irritability; guilt, worthlessness or helplessness; less interest in hobbies and activities; tiredness and low energy; trouble concentrating, remembering or making decisions; changes in sleep or appetite; and aches or pains without a clear physical cause. NIMH notes that some people have only a few of these signs and others have many.
If a low mood has been with you so long that it feels like part of who you are, that is still worth raising with a clinician. NIMH says that people with only a few symptoms may benefit from treatment, so you do not need to be at your lowest point to ask for an evaluation.
How Common Is Persistent Depressive Disorder?
NIMH reports survey estimates that about 1.5 percent of U.S. adults had persistent depressive disorder in the past year, with a higher rate in women (1.9 percent) than in men (1.0 percent). The past-year rate was highest among adults aged 45 to 59, at 2.3 percent. About 2.5 percent of U.S. adults will have it at some point in their lives.
Among adults with persistent depressive disorder in the past year, NIMH reports that about half (49.7 percent) had serious impairment, about a third (32.1 percent) had moderate impairment and the rest had mild impairment. These figures come from the National Comorbidity Survey Replication, a national household survey carried out from 2001 to 2003.
What Can Contribute
NIMH says genetic, biological, environmental and psychological factors all play a role in depression. It also notes that depression often occurs alongside other mental disorders and chronic illnesses such as diabetes, cancer, heart disease and chronic pain, and that each can make the other worse.
Some medicines and medical conditions, such as viral illnesses and thyroid disorders, can cause symptoms that look like depression. NIMH says a provider can rule these out with a physical exam, an interview and lab tests.
How We Evaluate
Your first visit is a 45 to 60 minute evaluation with a board-certified psychiatric nurse practitioner, at our West Ashley office or by video. Because this form of depression is defined by how long it lasts, your provider asks when the low mood began, how much of the time it is there, how it affects work, home and relationships, and what you have already tried.
NIMH suggests writing down your symptoms before a visit, including when they started, how long they have lasted, how often they happen and whether they get in the way of daily life. If lab work would help check for a medical cause, it is drawn at a local lab near you, and with your permission we coordinate with your primary care provider.
Treatment Options
NIMH says depression is usually treated with talk therapy, medication or both. It names cognitive behavioral therapy (CBT) among the evidence-based talk therapies and notes that therapy can take place in person or virtually. Our individual counseling uses CBT, behavioral activation and acceptance and commitment therapy (ACT), chosen around your goals.
Medication, when indicated, is decided jointly with you. NIMH notes that medicine for depression usually takes several weeks to work, so your provider plans follow-up visits to see how it is going and adjust the plan. If you have been treated before without much change, a second opinion visit can look at what was tried and what might come next.
NIMH also suggests steps that can help alongside treatment: staying physically active, keeping a regular sleep schedule, eating regular meals, staying in touch with people you trust and putting off major life decisions until you feel better.
Video Visits Across South Carolina
If getting to an office is hard, we see adults by secure video anywhere in South Carolina, on a smartphone, tablet or computer with a camera. You can also see us in person at our West Ashley office and switch between the two as your weeks change.
If You Are in Crisis
NIMH lists thoughts of death or suicide among the signs of depression. If you have thoughts of suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline at any hour. If anyone is in immediate danger, call 911 or go to the nearest emergency room. Hope Behavioral Medicine is not an emergency service.
Getting Care in the Charleston Area
Charleston County has about one mental health provider for every 214 residents, compared with one for every 437 across South Carolina. Our office is on Gardner Road in West Ashley, and we also see adults anywhere in South Carolina by secure video, so you do not have to wait for a local opening or take time off to drive.
We accept Medicare, most major commercial plans, and all South Carolina Medicaid managed care plans except Select Health (First Choice). New patients are often able to be scheduled within a week of requesting an appointment.
Sources
The facts on this page come from: National Institute of Mental Health, Depression (revised 2024); National Institute of Mental Health, Persistent Depressive Disorder (Dysthymic Disorder) (statistics); CMS National Provider Identification file, 2024, via County Health Rankings & Roadmaps, 2025.
Common Symptoms
Treatment Options
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Frequently Asked Questions
Yes. NIMH describes persistent depressive disorder as a form of depression with milder symptoms that usually last at least 2 years.
Yes. NIMH uses both names for the same condition, and persistent depressive disorder is the name in the DSM-5-TR.
NIMH reports that about 1.5 percent of U.S. adults had it in the past year, and about 2.5 percent will have it at some point in their lives.
NIMH says people with only a few symptoms may benefit from treatment. An evaluation can sort out what is going on and what might help.
Yes. We see adults anywhere in South Carolina by secure video, and in person at our West Ashley office.