A 60-year-old male presents with a depressed mood most of the day, diminished interest in activities, and recurrent thoughts of death. He also mentions he has been feeling this way for the past two years, with symptoms waxing and waning but never completely resolving. What might be the potential diagnosis and next steps?
The patient's long-standing, persistent depressive symptoms suggest a diagnosis of persistent depressive disorder (PDD), also known as dysthymia. PDD is characterized by a chronically depressed mood that occurs for most of the day, for more days than not, for at least two years. The next steps should involve further evaluation of his symptoms, ruling out underlying medical conditions, and discussing treatment options, which may include psychotherapy, antidepressant medication, or a combination of both.