Dysthymia: How To Differentiate It From Depression?
Depressive disorders have increased after the COVID-19 virus pandemic, even in children and adolescents.
We commonly associate sadness with depression, but it is worth differentiating between the states of sadness that we can all experience as adaptive and the different depressive disorders that can occur. It is important to make this very common problem visible and know, as it allows us to identify the symptoms and ask for professional help when required.
Dysthymia or persistent depressive disorder is a little-known, but highly prevalent, depressive disorder. in society. As it has less intense symptoms than major depression, it is more difficult to detect by the environment or the person themselves, and it can evolve for years without receiving professional help.
However, dysthymia has a negative impact on people’s quality of life, generating health problems, social relationships and work problems.
Persistent depressive disorder (dysthymia) is a disorder with a chronic course and less intensity than major depression. Consists in a depressed mood most days for at least two yearsaccompanied by sleep disturbances, low energy, low self-esteem, lack of concentration, difficulties making decisions and/or feelings of hopelessness.
Dysthymia usually has an age of onset prior to major depression, often beginning in adolescence or youth in an insidious manner, this fact being an indicator of a more chronic course. In relation to gender differences, the prevalence is higher in women.
The symptoms of dysthymia can vary over the years in appearance and intensity. They tend to cause discomfort and affect the proper performance of daily activities. Among the most frequent are the following:
To be diagnosed with persistent depressive disorder The aforementioned symptoms must persist for at least two years in adults or one year in adolescents and children.. In the latter, symptoms of dysthymia can include depressed mood and irritability.
Can dysthymia affect social functioning?
Although it is not a central symptom of depressive disorders, both social functioning and the ability to maintain and enjoy relationships are compromised by the symptoms of dysthymia. The most prominent are anhedonia, lack of motivation and loss of interest.. Therefore, it is common for people with persistent depressive disorder to have poorer intimate relationships and less satisfactory social interactions.
The main alterations in social functioning arise from a reduced desire to communicate, increased sensitivity to rejection or negative evaluation, problems in emotional identification, and a reduced ability to find effective solutions to interpersonal problems.
Difficulties in interpersonal relationships can contribute to maintaining the disorder and they are one of the main focuses of therapy.
Can dysthymia occur along with other mental disorders?
The literature confirms that comorbidity in this disorder is common, especially with major depressive disorder and other anxiety disorders, as well as with substance abuse disorder.
Among anxiety disorders, social anxiety disorder and generalized anxiety disorder have turned out to be those most commonly associated with dysthymia. Additionally, it is estimated that 10% of people with dysthymia end up developing major depression.
The etiology of the disorder is still unclear, but its multifactorial nature has been studied, that is, dysthymia can arise from the interaction of biological, social and psychological factors. At a biological level, effects have been observed in brain structures such as the amygdala, hippocampus, prefrontal cortex and anterior cingulate cortex; as well as the hypothalamic-pituitary-adrenal axis and the noradrenergic system.
At a psychosocial level It has been seen that experiencing stressful events during childhood or youth can predispose to dysthymia.. At the socio-familial level, dysthymia has been associated with being without a partner and/or the loss or separation of parents in childhood.
The vulnerability factors that have been observed are: history of depression in first-degree relatives, substance use disorder, and antisocial personality disorder.
How do you work in therapy?
Treatment for dysthymia is similar to that for major depression, with cognitive-behavioral therapy being the treatment of choice. for dysthymia with mild symptoms.
For moderate and severe episodes, the combination of cognitive-behavioral therapy with pharmacological treatment is recommended. The main objectives of the psychotherapeutic intervention are the following:
Improving mood, reducing symptoms such as anhedonia, the inability to experience or perceive positive events and hopelessness, among others.
Behavioral activation, establishing a series of activities with the intention of recovering the pleasant areas of life.
The identification of dysfunctional beliefs and behaviors and the subsequent replacement with more adaptive ones.
Stress management and learning appropriate coping strategies to adapt to other crises or difficulties.
Training social and communication skills to develop satisfactory social interactions that reduce isolation.
Effective and functional problem solving and decision making.
