The 7 Differences Between Major Depression And Dysthymia

Depression and dysthymia are two mood disorders, specifically two types of depressive disorders. Although they present certain similarities, they are independent psychological alterations

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

Differences between major depression and dysthymia

These two psychopathologies are associated with a low mood, but they have their own characteristics that should be taken into account, among other things because this has implications when it comes to overcoming these psychological disorders and applying psychotherapy techniques or even pharmacological treatment strategies (with medical assistance).

That said, the most notable differences that exist between these two depressive disorders are those that we will see below.

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 the DSM-IV-TR and Persistent Depressive Disorder in the DSM-5), lasts much longer, specifically at least 2 years in adults (1 year in the case of children and adolescents).

2. Existence of episodes

Furthermore, major depression is characterized by the concept of “episode”; Specifically, in the DSM-IV-TR a diagnosis could be made of a major depressive episode (single-episode major depressive disorder) or, in the case of 2 or more episodes, recurrent major depressive disorder.

However, in the DSM-5 this distinction disappears, and only major depressive disorder can be diagnosed (without the previous specification regarding the number of episodes); For this, 1 major depressive episode is enough.

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

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

3. Intensity of symptoms

Continuing with the differences between major depression and dysthymia, we also find a very notable difference: the intensity of the symptoms. Thus, 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 does not mean that it should not be treated appropriately and that it should not be given the importance it deserves.

4. Major depressive episode

Among the DSM-IV-TR diagnostic criteria for dysthymia (dysthymic disorder), it was established that there had been no major depressive episode (major depression) during the first 2 years of the dysthymia disorder. That is, if it had existed, dysthymia could no longer be diagnosed.

In the DSM-5, however, this criterion disappears, since dysthymia is renamed Persistent Depressive Disorder, and represents a consolidation of the dysthymic disorder and chronic depressive disorder defined in the DSM-IV-TR. That is In the DSM-5 it is possible that a major depressive episode may have existed during the first 2 years of dysthymia

5. Interference level

Beyond the diagnostic criteria, differences between major depression and dysthymia are also observed in clinical practice. One of them is the degree of interference in daily life; while in major depression interference is much more important In dysthymia, although there may be some interference in the development of daily activities, it is always minor.

That is, a person with major depression will have more difficulties leading a normal life; These difficulties can be translated into acts as simple as getting out of bed, showering or getting dressed. On the other hand, in dysthymia, the degree of affectation of the different spheres of life is lower, and therefore these actions can be carried out normally.

In summary, another difference between major depression and dysthymia is the person’s psychological discomfort , which is greater in depression than in dysthymia. We insist that this does not mean that dysthymia does not suffer.

6. Age of appearance

The age of onset (mean age) is also one of the differences between major depression and dysthymia; Thus, while major depression usually appears later (between the ages of 30 and 40), 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: early onset, before age 21, and late onset, at age 21 or with posteriority.

7. Other differences

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

Furthermore, dysthymia at a clinical level manifests itself as a general and lasting state of discontent, a certain sadness, pessimism, etc. This means that we can see people with dysthymia as more negative, and think that it is their way of being in ” general”, since such alteration may have existed for years.

On the other hand, in major depression the symptoms appear more intense, and This means that the trigger (or triggers) that have led to depression can often be detected ; That is, it is not perceived so much as a “general state” of the person or “way of being”, “personality” (as in dysthymia), but rather it is focused as a time or period where the person is suffering in a way important.

The distinction between having depression and being depressed

Beyond not losing sight of the differences between major depression and dysthymia, it is worth keeping in mind that It is not the same to suffer from Major Depressive Disorder, on the one hand, and to feel depressed, on the other

This last term refers to a wide variety of psychological phenomena characterized by a low mood; Thus, it can be applied to those who feel bad temporarily because they have consumed a drug that causes them to develop depressive symptoms for several hours, to those who are in the depressive phase of bipolar disorder, etc. And yes, since dysthymia is characterized by a lower degree of intensity of discomfort compared to that of major depression, it may happen that this alteration is spoken of in these more abstract terms, losing information along the way due to lack of accuracy in using words

In fact, it is such an abstract concept that it is sometimes used to talk about those who are sad despite not meeting the diagnostic criteria for any mood disorder; For example, those who are grieving the loss of a family member, or a breakup. In these situations, symptoms appear that are typical of depressive disorders, but which do not have to appear individually solely because of these psychopathologies (after all, psychological disorders are always expressed in sets of several symptoms at the same time). ). That is why it is recommended not to use the term “being depressed” lightly to avoid confusion, and to use it only to talk about those who have developed psychopathology of this type.