The 7 differences between major depression and dysthymia

Depression and dysthymia are two mood disorders, specifically two types of depressive disorders. Although they have some similarities, they are independent psychological disorders.

In this article we will know the main differences between major depression and dysthymia. In addition, we will examine the changes that have occurred between DSM-IV-TR and DSM-5 in relation to these two disorders.

    Differences between major depression and dysthymia

    The most notable differences between these two depressive disorders are these.

    1. Duration

    According to the Diagnostic Manual of Mental Disorders (DSM-5), major depression, which is actually called major depressive disorder, lasts at least 2 weeks (From which the diagnosis can already be made).

    Dysthymia, on the other hand (called dysthymic disorder in DSM-IV-TR and persistent depressive disorder in DSM-5), lasts much longer, especially at least 2 years in adults (1 year for children and adolescents).

      2. Existence of episodes

      In addition, major depression is characterized by the concept of “episode”; more specifically, in the DSM-IV-TR, a major depressive episode could be diagnosed (major depressive disorder in one episode) or, in the event of the onset of 2 or more episodes, major recurrent depressive disorder.

      However, in DSM-5 this distinction disappears, and only major depressive disorder can be diagnosed (without the above concretion in terms of number of episodes); for this 1 major depressive episode is sufficient.

      Episodes are 2-week periods in which diagnostic criteria are met for depression (the same episode is a diagnosis), although it no longer makes sense to talk about it when they disappear in the latest version of DSM (DSM-5), as we have seen.

      In the case of dysthymia (persistent depressive disorder), however, this concept of “episode” does not exist in either the DSM-IV-TR or the DSM-5; that is, dysthymia is always referred to (directly) as a disorder.

      3. Intensity of symptoms

      Continuing the differences between major depression and dysthymia, we also find a very remarkable difference: the intensity of the symptoms. So while in major depression the symptoms are more intense, in dysthymia, although the duration is longer, the symptoms are less intense.

      This makes dysthymia a less serious disorder than major depression, which doesn’t mean it shouldn’t be treated properly and given the importance it deserves.

        4. Major depressive episodes

        Among the DSM-IV-TR diagnostic criteria for dysthymia (dysthymic disorder), it was established that there was no major depressive episode (major depression) during the first 2 years of the dysthymic disorder. -even. In other words, in the event that it existed, dysthymia could no longer be diagnosed.

        In DSM-5, however, this criterion disappears, as dysthymia becomes known as persistent depressive disorder and represents a consolidation of dysthymic disorder and chronic depressive disorder defined in DSM-IV-TR. Which means in DSM-5 if there may have been a major depressive episode in the first 2 years of dysthymia.

        5. Interference level

        Beyond the diagnostic criteria, we also observe in clinical practice differences between major depression and dysthymia. One is the degree of interference in everyday life; while in major depression the interference is much greaterIn dysthymia, although there may be some interference in the development of daily activities, it is always minor.

        In other words, a person suffering from major depression will have more difficulty leading a normal life; these difficulties can translate into things as simple as getting out of bed, taking a shower, or getting dressed. In contrast, in dysthymia the degree of affectation of different spheres of life is less, and therefore these actions can be performed normally.

        In summary, another of the differences between major depression and dysthymia is the person’s psychological distressThis is more important in depression than in dysthymia. We stress that this does not mean that you do not have dysthymia.

        6. Age of onset

        One of the differences between major depression and dysthymia is the age of onset (middle age); thus, while major depression usually appears later (between 30 and 40 years), dysthymia usually appears earlier (From 20 years old).

        In fact, in the diagnosis of dysthymia (DSM-IV-TR and DSM-5), there is this specification, and two conditions can be given: an early onset, before age 21, and a late onset, in 21 years. or more.

        7. Other differences

        In summary, while major depression usually involves more intense and severe symptoms, dysthymia has less severe symptoms; the symptoms may be the same (eg apathy, insomnia, low self-esteem, hopelessness, …), only they vary in intensity.

        In addition, dysthymia at the clinical level is manifested by a general and lasting state of discontent, a certain sadness, pessimism, etc. This makes us see people with dysthymia as negative, and think that it is their path in “general”, as such the alteration can exist for years.

        In contrast, in major depression, symptoms appear more intensely, and this can often detect the trigger (s) that led to depression; that is to say that it is not perceived as much as a “general state” of the person or a “way of being”, a “personality” (as in dysthymia), but rather as a period. or a period when the person is in pain. .

        Bibliographical references:

        • American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.
        • American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed. Revised). Washington, DC: author.
        • Belloch, A .; Sandín, B. and Ramos, F. (2010). Manual of psychopathology. Volumes I and II. Madrid: McGraw-Hill.

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