PDD develops from a mix of biological, psychological, and social risk factors.
Unlike major depressive disorder (MDD), PDD tends to be more chronic, so its risk factors often involve long-term stressors, early-life issues, or ingrained patterns of thinking and behavior.
- Genetic vulnerability
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- People with a family history of depression, especially first-degree relatives, are at higher risk.
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- Genes involved in serotonin regulation (like 5-HTTLPR) may play a role.
Multiple members of my family have struggled with mood issues, heightening my risk of becoming depressed as well.
- Early childhood adversity
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- Emotional neglect, abuse, parental loss, or unstable caregiving environments increase the risk significantly.
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- PDD often starts early (in adolescence or young adulthood) and can go unnoticed.
- Personality traits
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- People who are more self-critical, pessimistic, or perfectionistic are more vulnerable.
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- High neuroticism (a tendency to experience negative emotions) is strongly associated with chronic forms of depression.
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- Low self-esteem and learned helplessness are also common cognitive patterns in PDD.
- Chronic stress and ongoing life problems
Long-term exposure to:
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- Financial insecurity.
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- Job dissatisfaction or instability.
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- Unhealthy or emotionally draining relationships.
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- Social isolation.
These low-level but persistent stressors can lead to or maintain PDD.
- Medical illnesses
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- Chronic health conditions such as diabetes, heart disease, and chronic pain are linked with higher rates of PDD.
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- Physical illness can affect mood biologically (via inflammation or fatigue) and psychologically (due to loss of function or independence).
- Substance use
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- Long-term alcohol or drug use can disrupt mood regulation and increase the risk of chronic depression.
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- Some substances (like alcohol or cannabis) may be used to self-medicate symptoms, but they usually worsen the cycle over time.
I know that drinking alcohol makes me feel better in the moment by making me not care about my problems, but it makes me feel much worse the day after.
- Age and gender
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- An onset often happens before age 21, particularly in those with early emotional challenges.
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- Women are more likely to develop PDD, likely due to both biological and social factors (hormonal fluctuations, caregiving roles, societal pressures).
- History of other mental health conditions
Individuals with:
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- Anxiety disorders (especially generalized anxiety).
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- Borderline personality disorder.
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- Major depressive episodes in the past.
They are more likely to develop a chronic form of depression.
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