Differences between cyclothymia and major depression

Psychological disorders They are very varied, but many of them coincide in terms of symptoms. Sometimes it is difficult to differentiate clearly and sharply between a disorder such as major depression from others such as brief recurrent depression or Bipolar disorder.

That is why there are diagnostic manuals, such as the DSM or the ICD, which allow carrying out a differential diagnosis and ensure that the patient receives the diagnosis and treatments suitable.

Sometimes major depression and cyclothymia, which have hypomania-depression cycles, can be confusing.. For this reason we are going to explain them in this article, in addition to mentioning the 4 main differences between both disorders.

• Recommended article: "Differences between unipolar depression and bipolar depression"

Brief definition of both disorders

First of all, we are going to know the definition and the basic characteristics of both disorders.

Major depression is a psychological disorder characterized by manifesting deep pathological sadness for at least two weeks

. Depressed people often have very low self-esteem, little interest in doing activities they used to like, and lack of energy and pain for no apparent reason. Due to all this, the disorder can have a very serious impact on the life of the depressed person, affecting their social relationships, work, studies and health in general.

Cyclothymia, also called cyclothymic disorder, is a psychological disorder in which there are periods with depressive symptoms and periods with hypomanics. The occurrence of these episodes has to be about two years

Differences between the two disorders

We are going to know below what are the differences between cyclothymia and major depression.

1. Episodes vs. steady state

The main difference between the two disorders is that in cyclothymia there are hypomanic and depressive episodes while in major depression only depressive symptoms occur.

In depression, the episodes are unipolar, that is, there are no sudden changes in mood as occurs in the bipolar disorder or cyclothymia, in which you go from a low to a high mood, with symptoms manic.

In major depression, these symptoms last for at least two weeks, and can last for months and years.

In contrast, in cyclothymia, as with bipolar disorder, there are episodes that go from one extreme of the mood to the other.

While the symptoms are not as severe as in bipolar disorder, some episodes lead to depressive symptoms while others lead to hypomaniacs.

When depressive episodes occur without being accompanied by episodes with mania, depression is usually referred to as unipolar.

In cyclothymia there are depressive episodes, in which symptoms typical of depression are manifested, but hypomanic episodes also occur. Thus, in cyclothymia there are variations in the state of mind that go slightly beyond euthymia.

2. Severity of symptoms

The symptoms of major depression are various, some of them being insomnia and hypersomnia, weight gain and loss without dieting, fatigue and loss of energy, feelings of worthlessness, trouble concentrating, along with deep sadness, suicidal ideation, and attempts autolytic.

All these symptoms are serious and have a very negative impact on the life of the depressed person.

Although cyclothymia also affects the life of the person, it does not do so in a way as serious as major depression does.

It is true that in cyclothymia there are depressive symptoms, however, these do not acquire the seriousness of those of major depression. Furthermore, depressive episodes in cyclothymia do not usually last as long as in depression, rarely exceeding two weeks.

Due to all this, cyclothymia is not as harmful as major depression, although it should be noted that it is not adaptive to have depressive episodes frequently, since it can make it difficult to maintain a partner or continue studies and job.

The same happens with the hypomanic episodes of cyclothymia when compared with the manic highs typical of bipolar disorder. While in bipolar disorder there is euphoria and a feeling of invincibility, in cyclothymia these symptoms are less severe.

3. Help search

Although all people would need to go to the psychologist, either to check that we are well or to see if something happens to us and start treatment as soon as possible, the truth is that not all people with psychological disorders decide to seek help.

Relating it to the previous point, due to the difference in the severity of the symptoms of both disorders, there are also differences on the part of those affected by these disorders when looking for help.

In major depression, as there is a very noticeable impact on life, professional help is usually sought more often and earlier than in the case of cyclothymia.

It is true that there may be reluctance to go to a psychologist or psychiatrist, but since the person with major depression is very aware that they suffer and their environment there is also usually more pressure from the family to go in search of help than so much needs to.

However, the same does not happen with people affected by cyclothymia. How changes in mood can be confused with normal and healthy changes in a somewhat unstable person or related to their personality, the degree of concern is lower and considering the fact that you are suffering from a psychological problem is not so frequent.

However, seeking help never hurts, given that it is estimated that between 15% and 50% of the population of people with cyclothymia will evolve to a bipolar disorder with episodes of greater severity.

4. Differential diagnosis

For cyclothymia to be diagnosed, the patient must have manifested depressive and hypomanic episodes for a period of more than two years.

In the case of major depression, the diagnosis can be given if the person reports suffering from depressive symptoms for more than two weeks.

Major depression is classified in the DSM-5 as a mood disorder and such a disorder is diagnosed when there has been at least one depressive episode, without the symptoms of a mania or hypomania

Usually, if there has been an episode with manic symptoms, major depression is ruled out and the possibility of a cyclothymic or bipolar disorder is raised.

Cyclothymia is classified as a subtype of bipolar disorder. The intervals in which neither depressive nor hypomanic symptoms occur are not longer than two months.

It should be said that during the diagnosis of cyclothymia it is necessary to find out if the person has used drugs, since some of them can affect in the mood in such a way that there are episodes of euphoria followed by emotional lows that can be misinterpreted as a disorder cyclothymic.

Bibliographic references:

• American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing.
• Barlow D. H., Durand V. M. (2005). Abnormal psychology: An integrative approach (5th ed.). Belmont, CA: Thomson Wadsworth.
• Beck A. T., Rush J., Shaw B. F., Emery G. (1987) [1979]. Cognitive Therapy of depression. New York: Guilford Press.
• Perugi, G.; Hantouche, E.; Vannucchi, G.; Pinto, O. (2015). Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder. Journal of Affective Disorders. 183: 119–33