Major Depressive Disorder vs Dysthymia [2024]: What's the Difference, Symptoms, Cause, Treatments

Jun 5, 20249 min
MDD vs Dysthymia

Depression has multiple definitions and can range from sadness which goes into the realm of depression to extreme misery and suicidal thoughts. Many factors are to be considered to understand the complexities of this clinical disorder. In a report released by Forbes Health, around 280 million people are currently suffering from depression with all the age groups combined. Such a massive number is difficult to ignore. 

When we talk about depression, the first thing that pops up in our mind is for how long have you been suffering from depression. Depending upon the duration and symptoms, we can understand whether it is Dysthymia or a Major depressive disorder.  Both of them are mental health disorders, often thought of as similar by the people. Although both are similar in their effects, one must know the difference between them. 

Understanding Dysthymia And Major Depressive Disorder:

What Is Major Depressive Disorder (MDD)?

Major depressive disorder is diagnosed in patients who experience low mood or depressive symptoms like anhedonia and decreased interest in pleasurable activities. A person might not enjoy what they used to enjoy in the past. 

For a person to be diagnosed with MDD, an individual must experience symptoms continuously for two weeks and might also experience panic disorders, social anxiety disorder, and obsessive-compulsive disorder, as well as other mental health disorders which can be quite distressing and difficult to make sense of. 

A person having MDD might show a difference in their behavior from the usual baseline social settings.

For example, a person might become more irritable and lash out at their colleagues repeatedly for several days or a person might become less active and have difficulty performing the activities that they used to perform with ease. 

The symptoms can take a toll on an individual and affect their relationships and health. It is important to identify the symptoms and act actively to manage them. 

What Is Dysthymia? With example

Dysthymia is a milder but long-lasting form of depression. It is also called a persistent depressive disorder. It is a mood disorder with symptoms that are similar to major depressive disorder but they last longer. The classic spell of this disorder is the persistent presence of the symptoms for 2 years without much relief. 

For example, if you have dysthymia, you might notice changes in your sleeping patterns or appetite. You might also display the symptoms of dysthymia that have been discussed below. 

Yes. Since Dysthymia and Major depressive disorder, both are depressive disorders, they might have a common source of onset or common reasons for triggers. In many cases, Dysthymia can linger for 2 years during which a person might start to experience major depressive episodes. 

Symptoms of Dysthymia and Major depressive disorder (MDD)

Dysthymia Symptoms 

Major depressive disorder (MDD) Symptoms 

  1. Poor appetite or overthinking

  2. Insomnia or hypersomnia

  3. Low self-esteem

  4. Poor concentration

  5. Poor decision-making

  6. Hopelessness

  7. Low energy

  8. Depressed mood

1. Persistent low mood

2. Significant weight loss or gain

3. Sleep disturbances

4. Low energy 

5. Suicidal ideations

6. Decrease the ability to think

7. The feeling of guilt and   worthlessness

8. Change in general activity (less active or more active)

What are the Common/overlapping Symptoms of MDD and Dysthymia?

Dysthymia and MDD are separated by a hair’s breadth. The reason is that they have a lot of symptoms that are often found in both disorders. The treatment approaches to them might also be similar. 

Low/depressed mood, feelings of hopelessness, and trouble sleeping are some of the most common overlapping symptoms of dysthymia and MDD. 

Fatigue and weight loss or gain might be experienced by some. However, it must be noted that a significant weight change is a serious implication of a major depressive episode. 

To actively identify if an individual has dysthymia or MDD, one can consult a Psychiatrist or a Clinical Psychologist. They can offer you a clear diagnosis and help you start with the treatment for the same. 

Effect of Dysthymia and MDD on the brain? 

It is important to know that both Dysthymia and MDD affect the same part of the brain and have similar outcomes to the alterations in brain activity. Both of them have been shown to have reduced brain activity (the information passed and processed in the brain is reduced) and an effect on the Hypothalamic pituitary adrenal (HPA) function (Important for stress management). The causes might vary from person to person and so will the severity of the depression. 

What are the Common Causes of Dysthymia and MDD?

#4 Causes of Dysthymia:

  1. Network dysfunction
  2. Hyperactivity in Amygdala
  3. Serotonin dysfunction 
  4. Chronic stress, for example - financial stress

#5 Causes of Major depressive disorder:

  1. Childhood trauma
  2. Substance abuse
  3. Change in the function of neurotransmitters (signal-transporting molecules) in the brain
  4. Hormone imbalance
  5. Isolation

Traumatic events, genetic predisposition, and chronic stress can be common causes of both Dysthymia and MDD.

How to get diagnosed? Recognizing if it is Dysthymia or MDD:

Many times, people going through Dysthymia or MDD get accustomed to its symptoms and hence do not seek help. It is important to identify the signs at the correct time and seek treatment immediately. Especially if the symptoms start to affect your routine life significantly. 

Dysthymia diagnosis:

To diagnose a patient with Dysthymia, an adult must have a depressed mood for at least 2 years (can be 1 year in children and adolescents). The signs and symptoms of Dysthymia are quite similar to other mental health disorders hence seeking help from a medical professional is advisable. 

Lab tests can be conducted to check the hormone levels in an individual to understand if other physical health concerns are causing dysthymia-like symptoms.

For example, both excess and insufficient thyroid hormone can lead to mood abnormalities and depression. For diagnosing Dysthymia, a psychological evaluation is also done to determine if the symptoms indeed match the disorder. 

Major Depressive Disorder diagnosis:

In certain cases, people suffering from major depressive disorder often deny having depressing feelings and are brought in by their family by observing the change in their behavior. One of the most crucial diagnoses for MDD can be understanding if a person is having suicidal thoughts. 

Apart from the depressed mood, a person suffering from major depressive disorder must have at least five of the symptoms that last nearly all day for two weeks and should be a part of the DSM-5 category. 

Multiple screening tools are available to diagnose MDD. They are:

  • Hamilton depression rating scale (HDRS)
  • Beck depression inventory (BDI)
  • Patient health questionnaire (PHQ)
  • Major depression inventory (MDI)

Depression like symptoms can  manifest as a secondary result of many metabolic disorders and nutritional deficiencies and lab tests can be done to rule out the same

If you feel that your symptoms are getting severe, you can contact the professionals to guide you through your problems. Doctors will take a detailed clinical history which takes the factors of family history, and physical and social history into consideration. 

Can Dysthymia be misdiagnosed as a Major Depressive disorder?

There is a scarce chance of the disorders being misdiagnosed. The criteria set in the Diagnostic and Statistical Manual for Mental Health Disorders’s Fifth Edition (DSM-5) clearly distinguishes both disorders. Psychologists and psychiatrists abiding by these rules effectively diagnose the disorders as they are and make an accurate diagnosis. 

Treatment: Dysthymia and MDD 

Dysthymia and MDD both fall under the umbrella of depressive disorders and hence the treatment and symptom management approach is quite similar. The duration and frequency of the treatment might vary according to the severity of the depression.  There may be a difference in the individualization of the plans but overall, the plans for psychotherapy and pharmacotherapy remain the same.

#4 Common Treatment Approaches for Dysthymia and MDD:

A person suffering from either of the disorders might have to seek medical advice from mental health professionals to begin their healing journey. The treatment approach that is recommended will depend upon the symptoms the patient displays. 

1.Medications:

Pharmacotherapy is the most common approach opted by doctors if the disorders are taking a big toll on the patient’s life. 

SSRIs (Selective serotonin reuptake inhibitors) are given as a first line of medications. SNRIs are also administered depending on the needs of the patient. Other antidepressants like monoamine oxidase are also used but research has shown that SSRIs show the best tolerability. 

Tricyclic antidepressants such as amitriptyline, nortriptyline, protriptyline, and imipramine are effective medicines advised for treating depression

2.Psychotherapy:

Commonly known as “Talk therapy”, psychotherapy creates a collaborative space for sharing, listening, and enabling coping mechanisms that can help you with your well-being. You will learn to understand your emotions, behaviors, negative patterns, and bodily patterns that are most likely to be linked to one’s experiences of depression. 

Psychologists will guide you through these emotions and provide tools and techniques to effectively encounter your problems. 

There are various kinds of models in psychotherapy that are used by psychologists:

  1. Behavior Therapy 
  2. Psychodynamic Therapy
  3. Expressive Art Therapy
  4. Cognitive behavioral therapy

3. Brain stimulation therapy:

Sometimes, antidepressants and psychotherapy might work only up to a certain extent to treat depression. There are possibilities that a person might feel the same as soon as the effects wear off. 

However, there is another option that can treat depression effectively. Brain stimulation uses implants (invasive)  or mild electric currents and magnetic fields (non-invasive) to increase the functioning of the brain. Out of these, non-invasive brain stimulation is rapidly gaining popularity to be termed an effective method to treat depression. 

It acts on the part of the brain that is causing depression and stimulates the neurons (brain cells) to uplift the functioning of the brain. The best part about using this therapy is the reduced risk of side effects and great remission rates in the patients. This includes Transcranial Magnetic Stimulation (TMS), Transcranial Direct current stimulation (tDCS), Transcranial Alternate Current Stimulation (tACS), Vagus nerve stimulation (VNS), etc. 

4. Complementary and Alternative Medicine:

Complementary and Alternative Medicine (CAM) are being widely used alongside medications and psychotherapy. These are therapies that can help to manage the symptoms of depression. They are not definite therapies to treat depression completely but research has shown that they reduce the effect it has on an individual significantly. This includes acupuncture, biofeedback, meditation, etc.

Can you have both Dysthymia & MDD?

Yes, dysthymia and MDD can co-exist together and this occurrence is known as “Double depression”. It is a superimposition of major depressive disorder in patients suffering from Dysthymia. The concern with double depression is that it becomes difficult to treat a patient with such severe symptoms. The treatment follows the same route as that of treating Dysthymia and MDD individually.

It is a difficult condition to sustain but with effective diagnosis and treatment, each problem can be targeted and solved one by one. 

How to treat Both Dysthymia & MDD at the same time?

Treating both the conditions at same time might include psychotherapy medications or even a combination of the above-mentioned interventions. Medications mentioned in the article above can certainly help to manage the symptoms. It might take time to experience the therapeutic effects of therapy while treating both dysthymia and MDD at the same time. While doctors make their efforts to create an effective treatment plan, one can make changes in their lifestyle as a contribution to the treatment. 

This includes:

  1. Eating nutrition-rich food
  2. Exercise daily
  3. Take in the sunlight
  4. Take stress management lessons
  5. Perform activities that used to bring them joy. 

If you know somebody who is struggling to break the cycle of depression, you can always advise them to seek professional help. At Mave Health, our priority is to become the most reliable support for people to fall back on. 

With the brain stimulation therapy called ARC-tDCS, Mave Health aims to treat and manage depression without any side effects. With experienced psychologists on board and the wearable NIBS technology, Mave Health can provide with an exceptional personalized treatment plan for those in need. 

Conclusion:

Dysthymia and Major depressive disorder, both, can cause a great ordeal in an individual’s life. Early diagnosis and personalized treatment can help to manage the symptoms and possibly prevent the condition from turning too grave. 

With the right support and treatment, it is possible to live a joyful life again. Just remember, depression is never a battle to be fought alone. It takes an army to defeat it and Mave Health makes sure to be alongside at every single step. 

REFERENCES:

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  5. Karrouri, R., Hammani, Z., Benjelloun, R., Otheman, Y., 2021. Major depressive disorder: Validated treatments and future challenges. World J. Clin. Cases 9, 9350–9367. 
  6. Marx, W., Penninx, B.W.J.H., Solmi, M., Furukawa, T.A., Firth, J., Carvalho, A.F., Berk, M., 2023. Major depressive disorder. Nat. Rev. Dis. Primer 9, 44. 
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Mave
Clinical Psychologist