The 7 Main Differences Between Depression, Cyclothymia And Dysthymia
Despite belonging to the same category of mood disorders, depression, cyclothymia and dysthymia both show distinctive characteristics that give rise to different diagnoses.
We must take into account all these differences so as not to confuse these psychopathologies and to be able to use appropriate measures when overcoming the disorder based on an appropriate diagnosis and treatment (always offered by mental health professionals).
In this article we present to you the main differences between depression, cyclothymia and dysthymiaso that you know its distinctive characteristics in an approximate way.
Before going on to name the main differences between the terms, let’s see how each one is defined.
Depression is understood as a mental disorder that is characterized by presenting pathological sadness as its main symptoms., decreased mood, low self-esteem, anhedonia or loss of the feeling of pleasure and decreased mental agility. In many cases, depression also leads to persistent suicidal ideation.
The definition of dysthymia or persistent depressive disorder is relatively imprecise, since it is understood as mild depression, but with a longer duration of involvement. Of course, it also poses a significant danger to the physical integrity of the person, since it gives rise to self-destructive behavior through unhealthy habits and increases the risk of developing other psychopathologies.
Finally, cyclothymia is defined as a labilityvariation of mood from one extreme to the other, that is, from a sad state to a relatively euphoric state.
Main differences between depression, cyclothymia and dysthymia
Despite the three mental disorders being classified within mood disorders, the characteristics that define the three terms are different and will give rise to different patterns of the presentation of the affective alteration.
1. Group of disorders to which they belong
As we have already pointed out, The three pathologies are classified within mood disorders.. Within this classification two groups appear: depressive disorders and bipolar disorders. Well, in reference to major depression and dysthymia, these two conditions are considered to be part of depressive disorders.
On the other hand, cyclothymia is defined as a type of bipolar disorder with quantitatively and qualitatively different characteristics from the rest of the variants, but which is nevertheless included in this clinical picture.
2. Main symptoms of each disorder
Major depressive disorder presents as characteristic symptoms: depressed mood for most of the day (pathological sadness), decreased interest or ability to experience pleasure (anhedonia), loss or increase in appetite or weight (a change in of 5% in a month), insomnia (difficulty sleeping) or hypersomnia (increased drowsiness), agitation or psychomotor slowing, fatigue or a feeling of loss of energy, feelings of worthlessness and guilt, decreased ability to think independently. concentrating or repetitive thoughts of death or suicidal ideation. Of all these symptoms, at least five must be met and one of them must be number 1 or 2.
Dysthymia shows, as its main symptom, which must be present, a sad mood most of the day., most days. Apart from the previous criterion, two or more of the following symptoms must be shown: loss or increase in appetite, insomnia or hypersomnia, lack of energy or fatigue, low self-esteem, difficulty concentrating and making decisions or feelings of hopelessness.
Finally, In cyclothymia, depressive symptoms and hypomanic symptoms must be present. without meeting the criteria to make a diagnosis of a depressive or hypomanic episode. Of the latter, hypomania is characterized by abnormal, elevated or expanded mood and increased abnormal energy or intentional activity, along with three or more of the following symptoms: exaggerated self-esteem and feelings of grandiosity, decreased need for sleep (only needs three hours), verbiage and very talkative, flight of ideas or accelerated thinking, easily distracted, increased activity or psychomotor agitation and high involvement in pleasurable activities with serious consequences.
3. Minimum duration of each disorder
Apart from showing different symptoms, different durations are also necessary to diagnose each disorder. Thus, for depression, five of the aforementioned symptoms must be present. for at least two consecutive weeks. On the other hand, in the case of both dysthymia and cyclothymia, the required duration will be longer, since in both cases they are disorders of greater persistence and chronicity.
To diagnose dysthymic disorder or persistent depressive disorder, which is the name given in the 5th edition of the Diagnostic Manual of the American Psychiatric Association (DSM 5), a sad mood on most days must be present for at least two years (one year if the patient is a minor). It must also be met that during this period of time you cannot go more than two months in a row without presenting criteria A and B, which refer to a persistent sad mood and the two or more complementary symptoms that you must show.
With reference to dysthymia, an episode of major depression may appear during the period of the illness. In this way we diagnose dysthymia and specify whether the depressive episode is currently present or not.
As we have said, cyclothymia is also a persistent alteration, but in this case of a bipolar type, It will be necessary for the symptoms to be present for at least two years, and there may be only one if the subject is a child or adolescent. Likewise, during this two-year time interval, the symptoms have been shown at least half of the time and the individual has not gone more than two months without having symptoms.
4. Age of onset of each disorder
The typical age of first onset of the disorder is also different. Regarding major depressive disorder, the age range where the condition is most likely to appear is between 18 and 29 years of age. On the other hand, the other two pathologies usually appear earlier, in the case of dysthymia it is common for the onset to occur in childhood (6-11 years) or adolescence (12-28) and cyclothymia during adolescence.
5. Sex in which each disorder is most prevalent
As a general rule, mood disorders are more prevalent in women, but In the case of bipolar disorders, the prevalence between sexes is equal. In this way, in both depression and dysthymia there will be a higher percentage of women affected, in depression with a proportion of 1.5 to 3 higher in women compared to men, and in dysthymia with a proportion double in the population. feminine.
On the other hand, when cyclothymia is related to bipolarity, the proportion of affected men and women in the general population is equal. It is true that if we look at the clinical population, that is, the subjects who come for consultation and have been diagnosed, we observe a higher proportion of women.
Of the three disorders, the most prevalent by far is major depressive disorder, the DSM-5 marks an annual prevalence of 7%.; This percentage may vary depending on sex or location, since, for example, in rural populations this prevalence decreases.
Regarding dysthymia, the percentage of the annual disorder is 0.5, although in childhood the prevalence of this condition is higher than that presented in major depression, since on average the depressive disorder shows 2%; instead, dysthymia reaches 6.4%.
Finally, cyclothymia shows a vital prevalence, which refers to the percentage of subjects who have had the disease at some point in their lives, 0.4-1%.
7. Recommended treatments
In reference to treatment, we observe that the mode of intervention in both major depressive disorder and dysthymia is similar, and pharmacological and psychotherapeutic treatment can be carried out.
In the case of pharmacological treatment, different medications have been tested, such as monoamine oxidase inhibitors (MAOIs). which act mainly by increasing serotonin, norepinephrine and tyramine; tricyclics that increase norepinephrine, serotonin and dopamine and serotonin reuptake inhibitors that increase the concentration of this neurotransmitter, the latter are the most used, since they show fewer side effects.
But it has been proven that drug treatment alone is not enough. For greater effectiveness, it needs to be complemented with psychological treatment. The most tested and the one that has obtained the best results is the cognitive-behavioral treatment, where both behavioral techniques are used (for example, planning pleasant and activating activities to provide sources of motivation and stimuli), as well as cognitive techniques (where for example cognitive restructuring with the purpose of improving the patient’s dysfunctional beliefs).
Instead, drugs used to treat cyclothymia will be more similar to those tested for bipolar disorder, but at lower doses. For example, mood stabilizers such as carbamazepine or lithium may be prescribed. Regarding therapeutic treatment, cognitive-behavioral treatment is also used, although emphasis is placed on another treatment that focuses on the interpersonal environment and social rhythm, since in patients with this psychopathology it is very important to maintain a stable sleep routine. food and activity schedules so that the person does not become destabilized.
