What is the likely diagnosis for a patient feeling sad and hopeless for three years with chronic sleep and eating issues?

The diagnosis of persistent depressive disorder is appropriate in this scenario due to the duration and nature of the symptoms described. This condition, previously termed dysthymia, is characterized by a chronic form of depression that lasts for at least two years in adults, during which the individual experiences a continuously low mood along with other depressive symptoms.

In this case, the patient has been feeling sad and hopeless for three years, which clearly exceeds the two-year duration required for a persistent depressive disorder diagnosis. Additionally, chronic sleep disturbances and eating issues are common features associated with this disorder. While major depressive disorder also includes similar symptoms, it is defined by discrete episodes of depression that can last for at least two weeks. The specified time frame in this scenario suggests that the patient’s symptoms are more consistent with the persistent nature of persistent depressive disorder rather than episodic major depressive disorder.

The other diagnoses like premenstrual dysphoric disorder and seasonal affective disorder do not fit the criteria as they are typically governed by specific cycles or seasons, rather than chronic, long-term symptoms, which further supports the diagnosis of persistent depressive disorder.