By Johnston Kelso
If you’re someone who works in the mental health field or have ever seen a movie or a show where someone was extremely sad for long period of time, you can more or less have a good idea of what depression looks like, right? Nope, wrong.
A lot of us know the signs behind Major Depressive Disorder because they are extremely disruptive to that person’s quality of life. Symptoms include: sleeping all of the time, never sleeping, crying all the time, marked absence from work or class, pessimistic, and self-defeating thoughts. When many of us see these symptoms, we know that person is depressed. However, it is not always so obvious.
There are many different forms of depression. For example, there is Bipolar Disorder, Major Depressive Disorder, and Dysthymia. I wish to speak about the hardest to spot, and as a result, the least well-known form of depression previously mentioned: Dysthymia. Dysthymia is often extremely hard to spot, simply because the symptoms of Dysthymia are mild in nature, mild enough to hide, and mild enough for a person to function daily without much impediment. To get a better idea of what Dysthymia is, let us look at it in the contrast to the poster-child of depressive illnesses: Major Depressive Disorder.
Let us first look at the many similarities between Dysthymia and Major Depressive Disorder. Both of them obviously include the depressive thoughts, rumination, and pessimism. They both can involve over or under sleeping, a feeling of always being fatigued, and a lack of motivation. Both mental illnesses can launch someone into suicidal thoughts and thoughts of inadequacy. So by now you may be asking, “Well what’s the difference then?” There is one main difference between Major Depressive Disorder and Dysthymia: the intensity of these symptoms.
Under Major Depressive Disorder, a lot of the symptoms are so intense that it often gets in the way of that persons normal functioning. They experience crying spells they cannot control, are so fatigued, tired and unmotivated they cannot make it out of bed. They also have such a hard time concentrating that they cannot function in an environment that requires even minimal amounts of attention.
Dysthymia is not as intense. In many cases, those with Dysthymia are able to function under normal circumstances due to the diminished nature of its symptoms in comparison to Major Depressive Disorder. The symptoms of Dysthymia are much more subtle than Major Depressive Disorder, which is why it’s so difficult to spot. It’s important to actively listen to what people say and pay attention to the behaviors they display.
There is another feature of Dysthymia worth mentioning. This feature actually caused a change in name for Dysthymia in the DSM V (Diagnostic and Statistical Manual of Mental Disorders Fifth Edition). It is now called Persistent Depressive Disorder due to the feature that in order to diagnose Persistent Depressive Disorder one must have exhibited the symptoms for at least two years! This is one of the most notable features that separate Persistent Depressive Disorder from Major Depressive Disorder.
Finally, there is one last piece of information you should take into consideration when thinking about Dysthymia, or as we now call it, Persistent Depressive Disorder. This piece of information is that people who suffer from Persistent Depressive Disorder are more susceptible to having Major Depressive episodes.
If the reasons are not already apparent, imagine a boat that is filled with a little bit of water. At this point, the water is only weighing down the boat not sinking it. This represents a person with Persistent Depressive Disorder. Then a storm comes. This storm represents a traumatic life event. The storm causes waves that fill the boat up and eventually sink it. This is a metaphor for a traumatic life event throwing someone with Persistent Depressive Disorder into a Major Depressive episode.
In summation, Persistent Depressive Disorder and Major Depressive Disorder are equally as important to diagnose and to treat, but Persistent Depressive Disorder can be hard to see due to its muted symptoms. If you think a friend might be suffering from even a minute depression, take time to talk with them and really listen. You would surprise the good you can do by simply listening and asking the right questions.
Mayo Clinic article from their website www.mayoclinic.org which references these sources:
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