Psychological disorders are very diverse, but many of them coincide when it comes to symptoms. It is sometimes difficult to clearly and vigorously differentiate between a disorder such as major depression and others such as recurrent brief depression or bipolar disorder.
That is why there are diagnostic manuals, such as the DSM or the CIM, which provide a differential diagnosis and ensure that the patient receives the correct diagnosis and treatment.
Sometimes major depression and cyclothymia, which exhibit cycles of hypomania-depression, can cause confusion.. For this reason, we will explain them in this article, in addition to mentioning the 4 main differences between the two disorders.
Brief definition of the two disorders
First, let’s learn the definition and basic characteristics of the two disorders.
Major depression is a psychological disorder characterized by profound pathological sadness lasting at least two weeks.. Depressed people often have very low self-esteem, little interest in activities they previously enjoyed, as well as a lack of energy and pain for no apparent reason. Because of all of this, the disorder can have a very serious impact on the life of the depressed person, affecting their social relationships, work, education, and general health.
Cyclothymia, also called cyclothymic disorder, is a psychological disorder in which periods of depressive symptoms and periods of hypomania occur. The onset of these episodes should be around two years
Differences between the two disorders
Let’s see below what are the differences between cyclothymia and major depression.
1. Episodes Vs. constant state
The main difference between the two disorders is that in cyclothymia there are hypomanic and depressive episodes while in major depression only depressive symptoms appear.
In depression, the episodes are unipolar, that is, there are no sudden mood swings as in bipolar disorder or cyclothymia, in which one goes from low mood to low mood. high, with manic symptomatology.
In major depression, these symptoms last for at least two weeks and can last for months and years.
In contrast, in cyclothymia, as in bipolar disorder, episodes occur throughout the mood.
Although the symptoms are not as severe as in bipolar disorder, some episodes occur with depressive symptoms while others do with hypomania.
When depressive episodes occur without being accompanied by manic episodes, the depression is often referred to as unipolar.
In cyclothymia, there are depressive episodes, in which symptoms of depression occur, but hypomanic episodes also occur. So, in cyclothymia, there are mood swings that go slightly beyond euthymia.
2. Severity of symptoms
Symptoms of major depression are varied, some of them being insomnia and hypersomnia, Weight gain and loss without dieting, fatigue and loss of energy, feelings of worthlessness, problems concentrating, as well as deep sadness, suicidal ideation and autolytic attempts.
All of these symptoms are severe and have a very negative impact on the life of the depressed person.
While cyclothymia affects a person’s life as well, it is not as serious as major depression.
It is true that in cyclothymia there are depressive symptoms, however, these do not acquire the severity of those of major depression. Additionally, depressive episodes in cyclothymia usually do not last as long as in depression, rarely exceeding two weeks.
Due to all of this, cyclothymia is not as bad as major depression, but it should be noted that having frequent episodes of depression is not adaptive as it can be difficult to keep a partner. or to continue studying and working.
The same goes for hypomanic episodes of cyclothymia compared to high manic episodes of bipolar disorder. While in bipolar disorder there is euphoria and a feeling of invincibility, in cyclothymia these symptoms are less severe..
3. Seek help
While everyone should go to the psychologist, either to check that everything is okay or to see if something is happening to us and start treatment as soon as possible, the truth is, not all people with psychological disorders decide to seek help.
Related to the previous point, due to the difference in severity of symptoms of the two disorders, there are also differences in the part of people affected by these disorders when they seek help.
In major depression, the impact on life being very sensitive, professional help is often sought more often and earlier than in the case of cyclothymia.
It is true that there may be a reluctance to go to a psychologist or psychiatrist, but since the person with major depression is very aware that they are in pain and their surroundings, there is also usually more pressure from the patient. family to go looking for help. so desperately needed.
However, the same is not true for people with cyclothymia. As mood swings can be mistaken for normal, healthy changes in someone who is somewhat unstable or related to their personality, the level of worry is lower and the fact that they are in pain is increased. is not so common.
however, the search for help never goes beyondAs it is estimated that between 15% and 50% of the population of people with cyclothymia will progress to bipolar disorder with episodes of greater severity.
4. Differential diagnosis
In order to diagnose cyclothymia, the patient must have experienced depressive and hypomanic episodes. for a period exceeding two years.
In cases of major depression, the diagnosis can be made if the person reports having suffered from depressive symptoms for more than two weeks.
Major depression is classified in DSM-5 as a mood disorder and such a disorder is diagnosed when at least one depressive episode has occurred, without symptoms of mania or hypomania having manifested themselves.
Usually, if there has been an episode with manic symptoms, major depression is ruled out and the possibility of cyclothymic or bipolar disorder is raised.
Cyclothymia is classified as a subtype of bipolar disorder. The intervals in which neither depressive nor hypomanic symptoms appear are more than two months.
It should be noted that when diagnosing cyclothymia it is necessary to know whether the person has taken drugs, as some of them can affect the mood so that there are episodes of euphoria followed. of emotional decline which can be misinterpreted as cyclothymic disorder.
- American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing.
- Barlow DH, Durand VM (2005). Abnormal Psychology: An Integrative Approach (5th ed.). Belmont, Calif .: Thomson Wadsworth.
- Beck AT, Rush J., Shaw BF, Emery G. (1987) . Cognitive therapy for depression. New York: Guilford Press.
- Perugi, G .; Hantouche, E .; Vannucchi, G .; Pinto, O. (2015). Reloaded Cyclothymia: A Reassessment of the Most Ill-conceived Affective Disorder. Journal of Affective Disorders. 183: 119–33