This mood disorder can significantly impair your ability to lead a happy life.
However, it is not the only mental health problem that manifests itself in the form of depressed mood. Other pathologies, such as dysthymia or adjustment disorder, also cause sadness and impaired ability to feel pleasure.
In this article we will address the reality of dysthymia, which often goes unrecognized or poorly understood, but can limit the ability to live a happy and meaningful life.
- Related article: “The 10 types of depression (and their causes and common symptoms)”
What is dysthymia?
Dysthymia is an elusive mood disorder . Those who suffer from it report having felt sad for a long time, to the point that such a way of living came to interfere with their perception of themselves. Not surprisingly, digging deeper into this feeling leads to the belief that it is not really a disorder as such, but rather a basic element of personality that has been present for “all life.”
Strictly speaking, dysthymia is a depressive mood whose duration lasts for two years or more, but whose intensity is not sufficient to be considered major depression. In adolescents it can be expressed as irritability or anger, and it would only take a year for diagnostic certification.
This last circumstance, on the other hand, can be overshadowed from the prism of the family environment (associated with the “normal” affects of age).
People with dysthymia, in addition to feeling sad or embarrassed, may report other symptoms. They often indicate alterations in physiological processes such as sleep or hunger , due to excess or deficit.
Self-esteem and expectations regarding the future are also damaged, emanating a feeling of hopelessness that leads to apathy and immobility. All this has an obvious impact on the ability to make decisions.
Dysthymic symptomatology is very resistant to change, so the person does not respond to the positive circumstances of his life in a way that is consistent with it, nor does he perceive that his sadness is significantly reduced for periods of time that exceed two months. . In any case, the pathology generates a decline in the functionality of areas that the person values as important, so they end up feeling progressively more dissatisfied and unhappy.
What are the differences between dysthymia and major depression?
The diagnosis of dysthymia requires that there has not been, at another time in life, an affective state that meets the diagnostic criteria for major depression.
In that case it could be considered as a residual and subclinical expression , but not as an independent problem. However, people who live under the yoke of dysthymia also have a higher risk of suffering from depression in the future, a circumstance baptized with the label of double depression.
Despite the fact that they are essentially different mood disorders, shared elements are known that lead to some confusion. The most relevant would be the negative mood itself and the difficulties to sleep, but also the pressing sensation of fatigue and the blockage in executive functions such as concentration. Such commonalities can contribute to an inaccurate diagnosis, which would directly affect the prognosis of the situation.
We proceed to indicate the main differential aspects between one and the other, in order to shed greater clarity on their discrepant points and contribute to their identification.
1. Family history
Major depression is a mood disorder that has shown an important genetic component.
Thus, certain studies have detected that up to 30% of people who suffer from it have at least one first-degree relative who also suffered from it at some point in their past . However, in these cases the question remains about other possible transmission mechanisms involved, such as observational learning itself (which takes place in the family setting).
Dysthymia, on the other hand, is usually associated with lower rates of family concordance, so hereditary factors may not be as relevant as they are in depression.
2. Starting way
Depression is an emotional response that emerges in the presence of an adverse circumstance in life. Most commonly, it originally took on the guise of a legitimate emotion (such as sadness), followed by a marked reduction in participation in enjoyable activities. This change in the dynamics of everyday life would translate into a host of new losses, of a more modest magnitude separately, but with a devastating cumulative effect.
Dysthymia, on the other hand, does not have such an easily identifiable cause . When investigating the life history of the person, it is not possible to locate a specific event from which the disorder will end up being shaped. The feeling is that it was built insidiously, silently but lurking, limiting both individual and social development. For all these reasons, its presence is less striking for those who live with it, although it is equally erosive.
3. Starting age
While major depression is usually a disorder that begins in adulthood, usually after the age of 25, dysthymia has its origins at a much earlier stage . By establishing itself on the nervous system in a period of greater plasticity, when the self-image is cemented, it promotes the appearance of secondary problems that are firmly rooted in the most basic substrate of the personality.
4. Evolution
Major depression is a disorder that tends to recur, so that most of those who suffered from it in the past will experience it again in the future. However, each of these acute episodes is usually mediated by a more or less extensive period of time in which a state of emotional balance is recovered, despite the fact that a certain vulnerability to relapse in risky situations continues to be preserved.
Dysthymia, on the other hand, remains stable over the years . The person experiences it as a persistent and regular flattening of emotion, highlighting a chronic course that does not motivate consultation with a specialist. It is not uncommon for it to end up being diagnosed as a problem other than the main reason for consultation, and for the person to react with surprise to learn that his sadness is not an indivisible element of her way of being.
5. Severity and prognosis
In general, the intensity of the symptoms is notably higher in major depression , leading to an ominous prognosis when there is no treatment with sufficient empirical evidence. However, the tremendous awareness of its existence (being one of the great epidemics of our time), facilitates its detection and efficient approach.
In the case of dysthymia, the symptoms are less severe, and if it were diagnosed at an early stage, its prognosis would be very favourable. However, when its presence is confirmed, it has managed to establish itself as the gravitational axis around which identity has been orchestrated, thus becoming more resistant to treatment. It is therefore essential to stimulate knowledge about it within society.
What treatment exists for dysthymia?
The treatment currently considered most effective is that which combines psychotherapy with antidepressant drugs. From the literature on this type of intervention, a greater probability of recovery is inferred, in contrast to programs in which only one of these options is used.
Regarding the use of antidepressants , the beneficial effect of SSRIs and tricyclics (compared to placebo) has been consistently demonstrated, despite the fact that approximately 40% or 50% of patients do not report benefits that can be attributed to them. In these cases, psychotherapy becomes more relevant .
Among the psychological treatments, those belonging to the cognitive-behavioral field (cognitive restructuring, assertive training, reinforcement of social skills, problem solving, etc.) and interpersonal (reinforcement of the buffering role of social support as a mediation factor) have shown greater efficacy. between perceived stress and emotional distress). Likewise, it is necessary to identify any comorbidity in the person with dysthymia, which occurs in up to 75% of all cases, as it can interact in unpredictable ways.
In short, dysthymia is a disorder that has effective treatment, but is overshadowed by difficulties in making a proper diagnosis. If you have been feeling sad for a long time, and you think you might be suffering from this mental health problem, do not resign yourself to living in this state and seek professional help.
Bibliographic references
- Jiménez, M., Gallardo, G., Villaseñor, T., González, A. (2013). Dysthymia in the Clinical Context. Colombian Journal of Psychiatry, 42(2), 212-218.
- Rosique, M. T. and Sanz, T. (2013). Cognitive-behavioral treatment in major depression, dysthymia and persistent suicidal ideation. Behavior Analysis and Modification, 39(159), 17-23.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.