Psychological disorders are very varied, but many of them have the same symptoms. Sometimes it is difficult to differentiate clearly and sharply between a disorder such as major depression and others such as recurrent brief depression or bipolar disorder.

That is why there are diagnostic manuals, such as the DSM or the ICD, which allow a differential diagnosis to be carried out and ensure that the patient receives the appropriate diagnosis and treatment.

Sometimes major depression and cyclothymia, which presents hypomanic-depressive cycles, can generate some confusion . For this reason we will explain them in this article, as well as mentioning the 4 main differences between both disorders.

Brief definition of both disorders

First of all, let’s get to know the definition and basic characteristics of both disorders.

Major depression

Major depression is a psychological disorder characterized by a profound pathological sadness for at least two weeks . Depressed people often have very low self-esteem, little interest in doing activities they used to enjoy, as well as lack of energy and pain without apparent cause. Because of 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

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

Differences between the two disorders

We will now learn what the differences are between cyclothymia and major depression.

1. Episodes vs. constant state

The main difference between both 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 abrupt changes in mood as in bipolar disorder or cyclothymia, in which one goes from a low mood to a high one, with manic symptoms.

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

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

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

When depressive episodes occur without being accompanied by manic episodes, depression is often 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 of mood 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 uselessness, concentration problems, together with deep sadness, suicidal ideation and self-consciousness.

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

Although cyclothymia also affects a person’s life, it does not affect it as severely as major depression.

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

Because of all this, cyclothymia is not as harmful as major depression, although it is important to note that it is not adaptive to have frequent depressive episodes, since it can make it difficult to maintain a relationship or to continue studies and work.

The same is true for the hypomanic episodes of cyclothymia as compared to the high manic episodes of bipolar disorder. While in bipolar disorder there is euphoria and a feeling of invincibility, in cyclothymia these symptoms are less severe .

3. Searching for help

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

Related 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 seeking help.

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

It’s true that there may be reluctance to see a psychologist or psychiatrist, but because the person with major depression is very aware of his or her suffering and his or her environment, there’s often more pressure from family members to go get the help they need.

However, this is not the case for people affected by cyclothymia. Since changes in mood can be confused with normal, healthy changes in a somewhat unstable person or related to personality, the degree of concern is less and the question of whether one is suffering from a psychological problem is not as frequent.

However, the search for help never goes too far , given that it is estimated that between 15% and 50% of the population of people with cyclotimia will evolve into a bipolar disorder with episodes of greater severity.

4. Differential diagnosis

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

In the case of major depression, a diagnosis can be made 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 is diagnosed when there has been at least one depressive episode, without the symptoms of mania or hypomania.

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

Cyclothymia is classified as a subtype of bipolar disorder. The intervals in which neither depressive nor hypomanic symptoms occur are no longer than two months.

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

Bibliographic references:

  • Asociación Americana de Psiquiatría (2013), Diagnostic and Statistical Manual of Mental Disorders (5ª ed.), Arlington: American Psychiatric Publishing.
  • Barlow D. H., Durand V. M. (2005). Psicología anormal: Un enfoque integrador (5ª ed.). Belmont, CA: Thomson Wadsworth.
  • Beck A. T., Rush J., Shaw B. F., Emery G. (1987) [1979]. Terapia cognitiva de la depresión. Nueva York: Guilford Press.
  • Perugi, G.; Hantouche, E.; Vannucchi, G.; Pinto, O. (2015). Ciclotimia recargada: Una reevaluación del desorden afectivo más mal concebido. Journal of Affective Disorders. 183: 119-33