Type 2 depression, also called dysthymia or persistent depressive disorder (PDD) in DSM-5, is a chronic, low-grade form of depression that lasts at least two years (one year in children/adolescents). Unlike major depressive disorder (Type 1 or “clinical depression”), which hits hard and fast with intense symptoms, Type 2 feels like a constant gray cloud never crippling enough to stop you completely, but heavy enough to rob joy from daily life.
Key symptoms include:
- Persistent sad, empty, or “flat” mood most of the day, nearly every day
- Low energy or constant fatigue
- Poor appetite or overeating
- Sleep problems (too much or too little)
- Low self-esteem or excessive guilt
- Difficulty concentrating or making decisions
- Hopelessness
People often describe it as “functioning but not thriving.” You still go to work, raise kids, smile in public but inside everything feels muted, like living at 50% battery.
Why “Type 2”? The terms Type 1 and Type 2 come from older psychiatric literature (similar to Type 1/Type 2 diabetes) to distinguish episodic severe depression (Type 1) from chronic milder depression (Type 2). Many clinicians now prefer “persistent depressive disorder,” but patients still search “Type 2 depression” online.
Double depression: When someone with Type 2 experiences a full major depressive episode on top, it’s called double depression suddenly the gray cloud becomes a thunderstorm.
Causes mirror major depression: genetics, brain chemistry (low serotonin/dopamine), chronic stress, trauma, or medical conditions. It often starts in childhood or adolescence and can run in families.
Treatment works:
- Therapy (CBT, interpersonal therapy)
- Medications (SSRIs, SNRIs, bupropion)
- Lifestyle changes (exercise, sleep hygiene, social support)
- For treatment-resistant cases: TMS, ketamine, or MAOIs
Early treatment prevents double depression and improves long-term outcomes. If you’ve felt “down” for years and think “this is just who I am,” talk to a doctor Type 2 depression is highly treatable, and full color can return to life.