Hypothymia: What It Is, Causes, Characteristics And Treatment

The term hypothymia refers to the pathological sadness. According to the psychology dictionary of the American Psychiatric Association⁽¹⁾it is an obsolete term referring to said mood disturbance and that is present in cases of major depression.

Difference between hypothymia and sadness

As we have anticipated in the introduction, emotions are necessary for human beings due to their adaptive value. Although sadness turns out to be an unpleasant emotion, it is as important as those that produce pleasant sensations such as joy.

An example of adaptive sadness is found in the grieving processes (except, of course, in cases of complicated or pathological grieving). In the grieving process, people feel sad and it is this sadness that allows them to adapt to a new context in which what they have lost is no longer found (their family member, their pet, etc.).

When we refer to pathological sadness, the emotion no longer fulfills its adaptive function. The emotion causes intense discomfort to the person and interferes with their daily life (in the work, educational, family area, etc.).

The definition of the American Psychiatric Association that we have referred to above relates hypothymia to major depressive disorder, a disorder included in the DSM-5 diagnostic classification.⁽²⁾ of the same association. However, hypothymia can also appear in other diagnostic conditions such as bipolar disorder or schizoaffective disorder, in which major depressive episodes also occur.

The reason why people feel sad can be very diverse, so the professional must evaluate the particular case and determine what mechanisms are causing hypothymia.

However, given the link that the American Psychiatric Association makes of hypothymia with major depressive disorder, we review below what are the explanatory models in the development of said disorder.

Firstly, biologically, genetic explanations and endocrine problems have been established that explain the appearance of depressive symptoms. The monoaminergic hypothesis, on the other hand, suggests that it would be a norepinephrine, serotonin and/or dopamine deficiency which would explain the symptoms.

Secondly, explanations from psychology have been proposed from different perspectives:

• Psychodynamics.
• Behavioral (focused on aspects such as decreased positive reinforcement ).
• Cognitive (which has theories such as the theory of learned helplessness or Beck’s theory).

Hypothymia is, in itself, a symptom that appears and/or can appear in different psychological disorders. In the case of DSM-5 major depressive disorder, depressed mood is precisely one of the two symptoms necessary for its diagnosis and consists of the experience of sadness, a feeling of hopelessness, emptiness, irritability in the case of the child and youth population, etc.

Hypothymia is characterized by decreased mood, feeling dejected, slow and expressionless.

What disorders is hypothymia associated with? This symptom is mainly associated with depressive disorders. While hypothymia is the symptom which describes a low mood, both dysthymia and depression are psychological disorders that encompass other symptoms and that must meet a series of criteria to be diagnosed.

Along with a depressed mood, pathological sadness or hypothymia, we can also find the following symptoms:

• Loss of interest or pleasure in all or almost all activities. The inability to feel pleasure is called anhedonia, while the loss of interest is called apathy.
• Weight loss or gain.
• Sleep problems: insomnia or hypersomnia.
• Psychomotor problems: agitation or psychomotor retardation.
• Fatigue or loss of energy.
• Problems with concentration, decision making or difficulty in thinking.
• Feeling of worthlessness or inappropriate guilt.
• Recurrent thoughts of death or suicidal ideation.

If you present several of these symptoms, we could be talking about a mood disorder, like the ones we will see below.

Dysthymia is a psychological disorder characterized by a depressed mood, presenting several of the symptoms mentioned for at least two years. In the following article you will find What is dysthymia: definition, symptoms and treatment.

On the other hand, we find major depression, another mood disorder who presents at least 5 of the symptoms mentioned for at least 2 weeks.

Pathological sadness or hypothymia, as we have already pointed out, is a symptom that usually appears together with other symptoms, forming a psychological disorder. Depending on the context in which it appears, we must evaluate one treatment or another. In this article we are going to review the treatments for depressive disorders following the chapter by Carrobles, JA (2014)⁽³⁾.

Medical treatment

Regarding the medical or psychiatric treatment of hypothymia, different strategies are used:

• Administration of antidepressant drugs. In this article we explain the Types of antidepressants and what they are for.
• Prescription of mood stabilizers.
• Electroconvulsive therapy. In the following article we talk about what Electroconvulsive Therapy is and how it is used.
• Others brain stimulation techniques such as transcranial magnetic stimulation.

Psychological treatment

On the other hand, regarding the psychological treatment of hypothymia (and other symptoms of a depressive disorder), the cognitive behavioral therapy. Cognitive behavioral therapy has a series of techniques that can be applied depending on the needs of the case. The evaluation of each case will clarify the causes that are causing the drop in mood and, depending on what these causes are, some techniques or others will be chosen. Among them we can find:

• Behavioral activation or program of pleasant activities. Here we talk about behavioral techniques for treating depression.
• problem solving therapy. In this article you will find more information about Troubleshooting Techniques.
• Beck’s Cognitive Depression Therapy. Here we explain what Aaron Beck’s cognitive therapy is and what it consists of.
• Depression Coping Program (Lewinsohn).

Lastly, the interpersonal therapy has shown good evidence in the treatment of depression.

This article is merely informative, at PsychologyFor 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.

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