The 7 differences between major depression and dysthymia.

Summary of the differences between dysthymia and major depression, mood disorders.

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

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

Differences between major depression and dysthymia

The most remarkable differences that exist 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, has a minimum duration of 2 weeks (after which a diagnosis can be made). (after which a diagnosis can 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

In addition, major depression is characterized by the concept of "episode"; specifically, in the DSM-IV-TR a major depressive episode could be diagnosed (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 as to the number of episodes); 1 major depressive episode is sufficient.

Episodes are 2-week periods in which the diagnostic criteria for depression are fulfilled (the episode itself is the first episode of major depressive disorder). for depression (the episode itself is a diagnosis), although it no longer makes sense to speak of them as they have disappeared in the latest version of the DSM (DSM-5), as we have seen.

In the case of dysthymia (persistent depressive disorder), on the other hand, there is no such concept of "episode", neither in the DSM-IV-TR nor in the DSM-5; that is, dysthymia is always referred to (directly) as a disorder.

3. Intensity of symptoms

Continuing with the differences between major depression and dysthymia, we also find a very remarkable 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 of lesser intensity..

This makes dysthymia a less serious disorder than major depression, which does not mean that it should not be treated properly 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 dysthymic disorder. In other words, if there had been, dysthymia could no longer be diagnosed.

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

5. Level of interference

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 the interference is in major depression, the interference is much more significantIn dysthymia, although there may be some interference in the performance of daily activities, it is always less.

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

In summary, another of the differences between major depression and dysthymia is the psychological distress of the personwhich is greater in depression than in dysthymia. We insist that this does not imply that in dysthymia the person does not suffer.

6. Age of onset

The age of onset (average age) is also one of the differences between major depression and dysthymia; thus, while major depression usually appears later (between 30 and 40 years), dysthymia tends to appear earlier (from the age of 20). (from the age of 20).

In fact, in the diagnosis of dysthymia (DSM-IV-TR and DSM-5) there is this specification, with two possible conditions: early onset, before the age of 21 years, and late onset, at 21 years of age or later.

7. Other differences

In summary, while major depression usually involves more intense and severe symptoms, dysthymia involves less severe symptoms; the symptoms may be the same (e.g. apathy, insomnia, low self-esteem, hopelessness, etc.), but vary in intensity..

In addition, dysthymia at the clinical level manifests itself as a general and lasting state of discontentment, some sadness, pessimism, etc.. This makes that we can see people with dysthymia as more negative, and think that it is their way of being in "general", since it can make years that there is such an alteration.

On the other hand, in major depression the symptoms appear in a more intense form, and This often makes it possible to detect the trigger (or triggers) that have led to the depression.that is to say, 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 an important way.

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 (revised 4th ed.). Washington, DC: Author.
• Belloch, A.; Sandín, B. and Ramos, F. (2010). Manual de Psicopatología. Volume I and II. Madrid: McGraw-Hill.