What is Low-Grade Depression? Symptoms, Diagnosis & Treatment

Low-grade depression is a less severe but longer-lasting form of depression. It’s estimated that around 1.5% of adults in the U.S. experienced low-grade depression in the past year, and 2.5% will experience it at some point in their lives. In many cases, people don’t even realize that they’re depressed, but the symptoms linger behind the scenes to make everyday life much harder than usual. 

In this article, we share what to know about low-grade depression, including its symptoms, causes, diagnosis, and treatment.

What is low-grade depression?

Low-grade depression, also known as persistent depressive disorder (PDD) or dysthymia, is a type of chronic depression. Unlike major depressive disorder (MDD), which comes on suddenly and can feel very intense, low-grade depression involves less severe but more long-term feelings of sadness, hopelessness, and lack of interest in daily activities that can stretch on for years. 

People living with low-level depression often learn to push through and may not even realize they have depression. They may go to work, take care of family responsibilities, and even socialize as usual, but underneath is a persistent heaviness that makes life feel harder than it should. 

Some of the key features of low-grade depression include:

• Persistent symptoms: People with PDD experience symptoms most of the day, on most days of the week, for two years or longer (one year for children or adolescents). 
• Lower intensity: Symptoms of low-grade depression are generally less intense than those of major depression, which is why PDD is sometimes called mild depression. That said, they can still weigh heavily on a person’s daily functioning.
• Interference with daily life: People with PDD are often considered ‘high functioning’, but this type of depression can still disrupt a person’s work, relationships, and overall quality of life.
• Cyclical nature: Most people with low-grade depression will also experience episodes of major depression, a pattern known as ‘double depression’. 

If you think you’re struggling with low-grade depression, know that you’re not alone. With the right support and treatment, it’s possible to find relief and prevent symptoms from progressing into major depression.  

What’s the difference between low-grade depression and major depression?

Low-grade depression and major depression share many of the same symptoms, but they differ in how long symptoms last and how intensely they’re felt.  

Major depression tends to have more severe and overwhelming symptoms that last for at least two weeks, although episodes can stretch on for months. During that time, daily functioning can feel impossible and people often struggle to maintain work, relationships, or self-care during these episodes. 

Low-grade depression has less intense symptoms but they go on for a much longer period – two years or more in adults and at least one year in children and teens. People with PDD might seem like they’re functioning well, but there’s a constant undercurrent of sadness or emptiness that can take a toll on their energy, motivation, and quality of life. 

Even though PDD symptoms are milder, it doesn’t mean that they’re any less serious. Living with chronic depression can be exhausting and just as disruptive as more acute forms. 

What causes low-grade depression?

There isn’t a single, clear cause of low-grade depression and it usually develops from a mix of biological, psychological, and environmental factors that interact over time. For many people, PDD emerges gradually and can feel like it just became a part of who they are. 

Some of the factors believed to play a role in dysthymic disorder include: 

• Genetics: Depression often runs in families, so having a close relative with depression or another mood disorder may increase a person’s risk.
• Brain chemistry: Changes in how certain brain chemicals regulate mood and emotion might contribute to the ongoing low mood seen in PDD.
• Stress or trauma: Stressful life events, such as the loss of a loved one or financial hardship, can trigger or intensify depression symptoms. 
• Other health conditions: Physical health problems or other mental health issues can increase a person’s likelihood of developing long-term depression.
• Personality traits: Certain traits, like self-criticism, low self-esteem, or a tendency towards negative thinking can make someone more prone to developing depression.
• Environmental influences: Things like ongoing stress, social isolation, or sudden changes in routine can sometimes play a role in developing depression. 

Because low-grade depression often develops slowly and lasts for years, it can be difficult to connect your symptoms to a specific event or cause. What’s important to remember is that it’s not a personal weakness or character flaw, and with the right support and treatment, recovery is possible regardless of how or why symptoms began. 

Symptoms of low-grade depression

Persistent depressive disorder symptoms will look different from person to person, but some common signs include:

• Persistent low mood, sadness, or sense of emptiness
• Lack of pleasure or interest in activities once found enjoyable
• Fatigue or consistently low energy
• Trouble concentrating, focusing, or making decisions
• Feelings of hopeless, worthlessness, or guilt
• Changes in appetite (i.e. eating more or less than usual)
• Sleep problems (i.e. sleeping more or being unable to sleep)
• Withdrawing from social activities or feeling disconnected from others
• Low self-esteem or self-criticism
• Negative thought patterns or always expecting the worst.

How is low-grade depression diagnosed?

Chronic low-grade depression is diagnosed by a licensed healthcare or mental health professional, either in person or through telehealth. The process usually involves: 

• Consultation: Your provider will ask about your mood, thoughts, behaviors, and daily functioning. They’ll want to know how long you’ve been experiencing symptoms and how they affect your life. 
• Medical history: You may be asked about your past or current health conditions, family history of depression or other mental health concerns, and any medications or substance use. 
• Diagnosis: To be diagnosed with PDD, your symptoms will be compared to guidelines in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). For adults, diagnosis requires experiencing a low mood for most of the day, on most days, for at least two years. For children and adolescents, symptoms only need to be present for one year.
• Physical exam or lab tests: In some cases, you might be asked to take a blood test or other assessment. This helps rule out medical conditions that mimic depressive symptoms, like thyroid disorders or vitamin deficiencies.  

If you’d like to speak to a mental health professional about your depression, book a consultation with our supportive team at Psychiatry Treatment Centers today.

How is low-grade depression treated?

PDD is usually treated with a combination of therapies, including antidepressant medications and talk therapy. 

Psychotherapy (talk therapy)

One of the most effective ways to manage persistent depressive disorder is by talking with a licensed mental health professional. Some types of psychotherapy that may help with PDD include cognitive behavioral therapy (CBT), which helps identify and shift unhelpful thoughts and behaviors, or interpersonal therapy (IPT), which focuses on relationships and communication. 

Antidepressant medications

Antidepressants are often prescribed to help balance brain chemistry and relieve symptoms. These might include selective serotonin reuptake inhibitors (SSRIs), such as Prozac or Lexapro, or selective norepinephrine reuptake inhibitors (SNRIs), like Cymbalta or Effexor XR, as well as other types of medication. 

It can take a few weeks to begin to notice the effects of antidepressants, and sometimes trial and error is required to find the right medication and dosage for you. This may be a little frustrating, but it’s important to be patient and avoid stopping or changing doses without guidance from your medication management provider.

TMS therapy

If you’ve tried talk therapy and medication without success, or you experienced unpleasant side effects, you may be a good candidate for transcranial magnetic stimulation (TMS) therapy. TMS uses gentle magnetic pulses to stimulate parts of the brain involved in mood regulation, helping relieve depressive symptoms without the systemic side effects associated with medication. 

We offer this innovative treatment at our Psychiatry Treatment Centers in Los Angeles and throughout Georgia. Click here to learn more about TMS therapy or book a consultation. 

Lifestyle and self-care

Combining lifestyle and self-care strategies with traditional therapies can help lift your mood and improve the outcomes of your treatment. 

Some helpful tips include:

• Getting regular exercise (even light movement can help)
• Eating a balanced, nourishing diet
• Prioritizing sleep
• Limiting alcohol and avoiding substance use
• Spending time with supportive friends and family
• Engaging in meaningful activities like hobbies, time outdoors, or volunteering
• Practicing mindfulness, relaxation, and other stress-management techniques 

Find support for low-grade depression

Living with depression can make everyday life feel harder, but you don’t have to navigate it alone. At Psychiatry Treatment Centers, our supportive team of mental health professionals is here to provide the best care possible. We believe in a personalized approach and work closely with you to find the treatment that best fits your needs, whether that’s medication, psychotherapy, TMS therapy, or a combination. 

If you’ve been struggling with persistent low mood, know that help is available. Reach out to us today to schedule a consultation.