Depressive disorders are a set of psychopathological pictures collected in the diagnostic classifications DSM-5 (American Psychiatric Association) and ICD-11 (Organization World Health). In all of them, patients feel a pathological sadness that is accompanied by other symptoms and that occurs with greater or lesser duration and intensity.
Dysthymia is a very well studied disorder, widely published regarding its clinical characteristics, evaluation, treatment, etc. and that is closely related to "depression." In the following Psychology-Online article, we explain to you what relationship both concepts have and we tell you the differences between dysthymia and depression.
In order to see in depth the difference between depression and dysthymia, we will first look at the main characteristics of both diagnoses.
What is depression?
On a colloquial level, we use the label "depression" to refer to a low mood. When we say that someone is depressed we are usually describing a person with a state of deep sadness. Beyond this colloquial use, we usually use the term "depression" to refer to:
- To the set of depressive disorders ("That person has depression" referring to the fact that he has a diagnosis of this group) among which we find, among others, major depressive disorder and dysthymia.
- To the major depressive disorder (disorder with which we compare dysthymic disorder in this article), which is a depressive disorder whose episodes may appear in other disorders, such as bipolar disorder or disorder schizoaffective.
Causes of depression
Depressive disorders constitute a group of complex problems whose cause must be considered from different perspectives and theories.
At the biological level, although explanations such as those related to genetics or related to the endocrine system, highlight the theories that focus on the functioning of the neurotransmitters. These indicate dysfunction in the neurotransmission systems as a cause of mood problems. In this article we talk about Neurotransmitters involved in depression.
On the other hand, different explanations and theories have been established from psychological models that account for the origin, development and maintenance of depressive problems. These theories include:
- The cognitive models, among which we find Beck's theory and the theory of learned helplessness.
- The behavioral models, which focus on things like decreasing positive reinforcement.
- The psychoanalytic theory it also has an explanatory model for depression.
Symptoms of depression
Depressive symptoms and the clinical picture of depression is as extensive as it is complex. Since in this article we are going to compare major depressive disorder with dysthymic disorder, we are going to address the necessary diagnostic criteria for each one according to the DSM-5 (APA).
Regarding the major depressive disorder the symptoms that may appear are:
- Depressed mood
- Decreased interest or pleasure in all or almost all activities.
- Significant weight loss
- Insomnia or hypersomnia.
- Psychomotor agitation or retardation.
- Fatigue or loss of energy.
- Feeling of worthlessness or excessive or inappropriate guilt.
- Decreased ability to think or concentrate and make decisions.
- Recurring thoughts of death and suicidal ideas.
Another type of depressive disorder is dysthymia. We will detail its characteristics below:
What is dysthymia
Dysthymia or persistent depressive disorder it constitutes a diagnostic category encompassed within depressive disorders. In this case we refer to a more lasting disorder than the major and minor depressive disorder.
Causes of dysthymia
As we have pointed out in the previous section, the origin of depressive disorders corresponds to multiple and complex causes. In this regard, as has been stated, the different currents of psychology and biology have provided explanatory models to understand its causes.
Symptoms of dysthymia
The symptoms that the DSM-5 proposes for dysthymic disorder would be the following:
- Depressed mood
- Poor appetite or overeating.
- Insomnia or hypersomnia.
- Low energy or fatigue.
- Low self-esteem.
- Lack of concentration or difficulty making decisions.
- Feelings of hopelessness
Despite having many similarities, major depressive disorder and dysthymia have several differences that we detail below:
1. Duration
Major depressive disorder requires that symptoms be present for at least two weeks so that the diagnosis can be made.
Unlike this, the diagnosis of dysthymia requires that symptoms be present for at least two years (one year for children and adolescents) and requires that there have been no more than two months without symptoms being present.
2. Appearance in other diagnostic pictures
Major depressive episodes may appear in the context of other mental disorders, such as Bipolar disorder and the schizoaffective disorder. Dysthymia, on the other hand, does not appear as part of these disorders.
3. Seasonality specification
Given that in major depressive disorder we speak of episodes and dysthymia is a more lasting disorder, in the first we can specify whether these episodes appear with certain seasonality, specification that we will not do in the case of dysthymia.
4. Prevalence
The ESEMeD study (ESEMeD / MHEDEA 2000 Investigators, 2004; Haro et al., 2006; seen on Horse)[1] yielded the prevalence data in European countries on depressive disorders collected in the DSM-IV. These data indicated that major depressive disorder had a lifetime prevalence of the 12,7% and dysthymia 3,6%.
5. Symptom requirement for diagnosis
From the list of symptoms, major depression requires five or more, while dysthymic disorder only requires two or more.
6. Nuclear symptoms
Nuclear symptoms refer to those that must necessarily appear to establish the diagnosis. In this regard, to diagnose DSM-5 major depressive disorder it is necessary for the patient to experience a depressed mood or experience a decrease in interest or pleasure in activities you usually make. Unlike this, for the diagnosis of dysthymia only depressed mood is required.
7. Other required symptoms
For the diagnosis of dysthymic disorder, in the DSM-5, it is required that feelings of hopelessness and low self-esteem are present that are not present for the diagnosis of major depression (although in this case symptoms related to the feeling of worthlessness, guilt, excessive).
Regarding weight, a significant weight loss is required for the diagnosis of major depressive disorder, while for dysthymic disorder, poor appetite or overeating may appear.
Finally, one of the criteria proposed for the diagnosis of major depressive disorder is that of Recurring thoughts of death or suicidal thoughts, which do not appear for the diagnosis of disorder dysthymic.
8. Intensity
Given the symptoms, it is assumed that the intensity with which a major depressive disorder is displayed will be greater than the intensity with which a dysthymic disorder can show (more symptoms are required in less time for major depressive disorder and fewer but longer symptoms are required for dysthymic disorder).
This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
