Depression and Dysthymia, the two faces of sadness

Symptoms of Depression and Dysthymia

The WHO ensures that in 2020 the Depression will be the first cause of disability and death in the world, and that is that there are already more than one million people who die from this disease.

The two faces of sadness

A depression is characterized by being sad, not wanting to leave or doing anything, have low self-esteem and feelings of inferiority.
A dysthymia is a mild, but chronic, form of depression. The symptoms are less intense but they lengthen in time for years. Let’s see the symptoms of each of them:

Symptoms of Depression

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), used worldwide by Psychologists and Psychiatrists, the Depression is characterized by suffering 5 or more of the following symptoms in the same period of 2 weeks:

  • State of depressed mood most of the day, nearly every day , as indicated by either subjective report (p. Eg., Feels sad or empty) or observation made by others (p. Eg., Crying)
  • Acute decrease in interest or capacity for pleasure in all or almost all activities, most of the day, almost every day (according to the subject or observe the others)
  • Major weight loss without regimen or weight gain (eg, a change of more than 5% of body weight in 1 month), or loss or increase of appetite almost every day. insomnia or hypersomnia almost every day
  • Psychomotor agitation or slowing almost every day (observable by others, not just feelings of restlessness or slowness)
  • Fatigue or loss of energy almost every day
  • Feelings of excessive or inappropriate guilt (which can be delusional) almost every day (not simple self-reproach or guilt for being sick)
  • Decreased ability to think or concentrate, or indecision, almost every day (either a subjective attribution or an observation of others)
  • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan or a suicide attempt or a specific plan to commit suicide.


  • Symptoms cause clinically significant discomfort or impairment in social, occupational or other important areas of the individual’s activity
  • Symptoms are not due to the direct physiological effects of a substance (eg, a drug, a medication) or a medical illness
  • Symptoms are not better explained by the presence of a grieving (eg, after the loss of a loved one)
  • Symptoms persist for more than 2 months or are characterized by marked functional disability, morbid concerns of uselessness, suicidal ideation, psychotic symptoms or psychomotor slowing.

Symptoms of Dysthymia

If all the criteria of the major Depression are met continuously for at least 2 years, we would be talking about a chronic major depressive disorder or a Dysthymia.

Symptoms of dysthymia

  • A mood that is chronically depressing or most of the day of most days, manifested by the subject or observed by others, for at least two years
  • Presence, at times when you are depressed, of two or more of the following symptoms: loss or increase of appetite, insomnia or hypersomnia, lack of energy or fatigue, low self-esteem, difficulty concentrating or making decisions and / or feelings of hopelessness
  • During the 2-year period of the alteration the subject has not been without symptoms of the above criteria for more than 2 months
  • There has not been any major depressive episode during the first 2 years of the alteration.


  • The symptoms are not due to the physiological effects of a substance (for example a drug) or a medical illness
  • Symptoms cause clinically significant discomfort or impairment in social, occupational or other important areas of the individual’s activity.

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