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Permanent Link: Differences between Major Depressive Episode and Dysthymic Disorder

Posted Jan 24 2010 12:00am

DSM-IV-TR

Criteria for Major Depressive Episode

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either \

1) depressed mood or 2) loss of interest or pleasure

1) Depressed most of the day, nearly every day, as indicated by subjective reports or observation made by others.

2) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.

3) Significant weight loss (whhen not dieting), or weight gain.

4) Insomnia or hypersomnia nearly every day.

5) Fatigue or loss of energy nearly every day.

6) Feelings of worthlessness or excessive or inappropriate guilt nearly every day.

7) Diminished ability to think or concentrate, or indecisiveness, nearly every day.

8) Recurrent thoughts of death or suicide, or recurrent suicidal ideation without a plan, or a suicide attempt or plan.

The symptoms cause clinically significant distress or impairment.

Dysthymic Disorder

Dysthymia is quite common, and the average duration is 4 to 5 years, but can persist for 20 years or more. Dysthymia often begins during the teenage years, and over 50% of those who present for treatment have an onset before age 21.

The following case is typical of this disorder:

A 28-year-old junior executive complained of being ‘depressed’ about everything: her job, her husband, and her prospects for the future. Her complaints were of persistent feelings of depressed mood, inferiority and pessimism, which she claims to have had since she was 16 or 17. Although she did reasonably well in college, she constantly ruminated about students who were ‘genuinely intelligent’.

Just after graduation, she had married the man she was going out with at the time. She thought of him as reasonably desirable, though not ‘special’. She was very critical of his clothes, his job, and his parents, after the marriage, and he, in turn, found her moody, controlling, and rejecting.

She feels she will never go very far in her profession because she does not have the right ‘connections’ and neither does her husband, yet she dreams of money, status, and power. Her social life with her husband involves several other couples. The man in these couples is usually a friend of her husband. She is sure that the women find her uninteresting and unimpressive and that the people who seem to like her are probably no better off than she.

Under the burden  of her dissatisfaction with her marriage, her job, and her social life, feeling tired and uninterested in ‘life’, she now enters treatment for the third time.

Differences: Dysthymic Disorder is of milder intensity than a major depressive disorder, but its primary hallmark is its chronicity.

Celebrities with disorders: Britney spears had unipolar disorder (constantly very depressed) – hope she doesn’t sue me, Ris Low had bipolar disorder (characterized by moments of severe depression and alternating moments of high elation and happiness) – still, doesn’t excuse her cheating in exams and shoplifting, eh?

I think my father has General Anxiety Disorder! He keeps worrying about stuff in life. And I was sure I had obsessive-compulsive disorder cos I keep imagining germs everywhere and I wash my hands a lot, but apparently, that’s not enough. haha. People with a cleanliness OCD wash their hands till their hands bleed and for it to be a disorder, it must disrupt their social life and functioning. Such as not going out cos they must be beside a tap to wash their hands all the time.

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