Persistent Depressive Disorder: Myths and Common Mistakes

Persistent depression often goes unrecognised for years — not because it hides well, but because it is surrounded by stubborn myths.

Myth 1. "It's just fatigue or stress — it will pass on its own"

In Dr. Saулitis's clinical observation, around 80% of people who believe they have depression are actually describing exhaustion, grief, or workplace difficulties. But this does not mean that true persistent depression is rare or self-resolving. The crucial marker is when a person stops responding to the world entirely: a lemon and a brick feel the same — no saliva, no reaction. A healthy person responds to something. When no trigger works at all, that is a sign to seek a specialist, not to wait it out.

Myth 2. "Antidepressants are a crutch — stopping them will make things worse"

A common fear is that taking medication creates dependency, and stopping leads to an even deeper crash. The doctor compares this to refusing blood-pressure medication: when the right drug is matched to the right person, it stabilises the disorder — just as antihypertensives prevent strokes. The real issue is that antidepressants are a highly diverse class: some are stimulating, others calming — exact opposites. Matching the medication "like a key to a lock" requires a doctor, not self-prescription.

Myth 3. "If someone is coming out of depression, the danger is over"

This is one of the most dangerous mistakes. During recovery, physical energy returns before thinking and mood fully normalise. The person can move and act again, but heavy thoughts and guilt persist. It is precisely at this stage — not in the depths of depression — that the risk of suicidal action increases, because the physical capacity to act has returned while the dark cognitions have not yet lifted. Reducing vigilance at this point is a serious error by both patients and their loved ones.

Myth 4. "I'll know when things get really bad"

Persistent depression specifically impairs the ability to evaluate one's own state: concentration fails, decisions become impossible, memory suffers. A person adapts to a chronically lowered baseline and stops perceiving it as illness. Waiting for things to become "obviously bad enough" means losing time when intervention would have been most effective.