For diagnosis of persistent depressive disorder, patients must have had a depressed mood for most of the day for more days than not for ≥ 2 years plus ≥ 2 of the following: Poor appetite or overeating Insomnia or hypersomnia Low energy or fatigue Low self-esteem Poor concentration or difficulty making decisions Feelings of hopelessness Premenstrual dysphoric disorder Premenstrual dysphoric disorder involves mood and anxiety symptoms that are clearly related to the menstrual cycle, with onset during the premenstrual phase and a symptom-free interval after menstruation.