Daily Archives: September 16, 2010

Is There More Than One Kind Of Depression?


Dysthymic Disorder and Major Depressive Disorder are actually two different versions of depression.  Dysthymic Disorder is noted for chronic depression.

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The definition for Dysthymic Disorder is that it is a “mood disorder with chronic depressive symptoms that are present most of the day, more days than not, for a period of at least two years.”  (Minddisorders.com).  The symptoms are usually present for years and can include low self esteem, decreased motivation, change in sleeping patterns and change in appetite patterns.  Causes of this type of depression are things like a person’s upbringing.  If a person is brought up in a home where abuse is prevalent an adult can suffer from depression for their entire life.  Treatment for this type of depression is generally psychotherapy but sometimes is combined with antidepressants.

Similarly Major Depressive Disorder is the next level of depression and is defined as, “a condition characterized by a long lasting depressed mood or marked loss of interest or pleasure in all or nearly all activities” (Minddisorder.com).   This form of depression has an intense impact on a person’s life.  It usually comes about when a person suffers a traumatic event, but this does not always happen.  Symptoms can include a disturbed mood throughout most of the day, a change in the sleep pattern, a change in the appetite pattern, a loss of interest in things that are considered pleasurable, but then go further to include problems when trying to concentrate or think in depth, psychomotor retardation or agitation and thoughts of suicide.  If this form of depression is left untreated it can last longer than four months and recurrence is eminent.  Treatments for Major Depressive Disorder include psychotherapy or talk therapy, electroconvulsive therapy or ECT and antidepressant medications or a combination of these treatments.

Nearly everything about these two disorders are similar, the main difference is that major depressive disorder is an extension of Dysthymic Disorder in that symptoms and moods are more severe therefore treatments need to be more involved and more inclusive.

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References:

Netherton, S.D., Holmes, D., Walker, C.E., Child and Adolescent Psychological Disorders

Blaney, P.H., Millon, T., Oxford Textbook of Psychopathology.

Depression (Major Depressive Disorder) http://psychcentral.com/disorders/sx22.htm

Dysthymic Disorder. minddisorder.com.  http://www.minddisorders.com/Del-Fi/Dysthymic-disorder.html

Dissociative Identity Disorder. Psychnet-uk.com. http://www.psychnet-uk.com/dsm_iv/dissociative_identity_disorder.htm

Major Depressive Disorder. minddisorder.com. http://www.minddisorders.com/Kau-Nu/Major-depressive-disorder.html

Can Symptoms Be False?


Having a person come into a clinician’s office and presenting with symptoms of one or more disorders can be a tricky process for the clinician to try to diagnose, even without the presence of factitious symptoms.  The presence of factitious symptoms can make the diagnosis very complicated because the clinician would need to have the patient go through their history, which would be a normal step, but then if the clinician suspects any kind of factitious disorder, generally a more thorough history would be required.  Because the person feels a need to continue to be sick they would be complaining of the same symptoms over and over again, or possibly complaining of the symptoms getting worse.  The problem would be that there isn’t anything real to back it up.  A misdiagnosis would come into play, probably several times. It could be possible that factitious disorders are responsible for the averages given when it comes to the length of time it takes to diagnose.

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People who suffer from factitious disorder don’t have an ulterior motive, people who malinger do.  Malingering is when someone gives factitious symptoms in order to gain something.  Malingering generally causes a person to choose not to follow a Doctor’s reference for psychiatric care.  In rare cases when someone who is malingering does choose to seek psychiatric help, the sessions don’t offer any kind of help to further the person’s treatment.  There are various things that motivate a person to malinger.  These could include trying to gain material items such as a car or jewelry or to win a lawsuit for monetary value.  It could also be something as simple as to gain someone’s attention.

Between having patients come in with factitious symptoms either controlled or uncontrolled and people who are malingering, it is easy to see how a clinician would need to be extremely cautious when it comes to giving a diagnosis.

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References: Malingering. Psychnet-uk.com.;  The Unexplained. Bellevue.edu

If Facebook Existed Years Ago (Humor)