Is Dysthymia better in the morning or worse?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Depressed person

Depression.
Photo courtesy of Pixabay.com

Which depression is worse in the morning? – Morning Question #14

Having more depressive symptoms in the morning is a characteristic of “Atypical features” of a mood disorder. Atypical does not mean unusual it means “not melancholy.”

Atypical features include the hibernating-like-a-bear symptoms, overeating, sleeping too much and being tired and grouchy in the morning. With atypical features, the person may be able to feel better temporarily if something they really like happens, but the happiness does not last long. They may also feel better in the evening but by morning the depression comes back.

Atypical features can occur during episodes of Dysthymia, Bipolar one or two Disorders and Major Depressive Disorder. In practice, the only time I remember seeing this on a file is as part of the diagnosis of a Major Depressive Disorder but having atypical features increases the risk that this will eventually turn into a Bipolar disorder.

If your mood is customarily worse at a particular time of day, make sure you are eating and sleeping well, that there are not environmental problems like relationship issues that are causing this and then seriously consider consulting with a medical doctor or psychiatrist. If the doctor rules out any medical problems then some counseling should help.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

What is the difference between depression and Major Depressive Disorder?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Depressed person

Depression.
Photo courtesy of Pixabay.com

Depression, Mood Disorder or Major Depressive disorder?

Major Depressive Disorder is a specific diagnosable disorder listed in the DSM (Diagnostic and Statistical Manual of Mental Disorders.)  Sometimes we use the term imprecisely to refer to both the common sense feeling of sadness and a series of specific mental disorders that we professionals call mood disorders.

The dictionary definition of depression is essentially sadness. In the mental health field, it means so much more.

The differences in mood or depressive disorders are largely a matter of certain specific features that the person has rather than saying anything about the cause. There are also some related conditions that are not currently official “depressive disorders” but for which depression is a feature.

Confused yet? It takes 4 years of college and two more of grad school to make it all this complicated.

Mood problems often occur in “episodes” so they can come and go with or without treatment. The episodes don’t get specific diagnoses, but they do get used to see if you have all the features of a specific diagnosis.

Now if you are depressed and suicidal, which specific mood disorder you have may not matter to you, but it matters a whole lot to the insurance person approving your treatment. Since not everyone agrees which things are severe enough to require treatment, the list fades in and out with time.

What makes depression into a Major Depressive Disorder rather than garden-variety depression is a few key factors.

How long you been feeling that way?

To be major depression it should have lasted for more than 2 weeks AND there should be at least 4 other symptoms of impairment. The effort here is to separate normal life problems from an illness that needs treating.

How has this affected you?

There needs to be some problem in your life over and above just being sad. Being over sad all the time but not quite getting bad enough to be diagnosed with Major Depressive Disorder is called Dysthymic Disorder.

So we look to see can you work? Do you have friends and family? Do you still do some things for fun? These things separate out the sad moods and the sad-for-a-reason from the sad-way-to-much-and-too-long that characterizes Major Depressive Disorder.

Major Depressive Disorder is also separated into “single episodes” and “recurrent.” The first time someone has Major Depression we look more for causes. If they have repeat performances of depression we look at this as likely to be something produced by the person, either biologically or thinking wise.

Depressive Episodes, hence Major Depressive Disorder can also be “graded” into mild, moderate and severe. For the treating professional this helps plan treatment. For the insurance company, it helps them known how big a bill they are getting for this treatment.

Sometimes the depression gets so bad that the brain starts making up stories. This looks a lot like the psychosis in Schizophrenia but it only happens to some people and then only when they are severely depressed.  This is called with (or without) psychosis depending on whether you have or do not have psychosis.

People who have Major Depressive Disorder do not all look or act the same. Some people become so depressed they have trouble moving. This is called Catatonia which is also associated with sleep paralysis.

The old fashion name for depression was melancholy. This is typically very severe in the morning but gets better as the day moves forward. People with this variety also wake up early. They don’t feel like eating and they either sit unable to summon up the energy to do anything, or they pace aimlessly about.  Often they also feel guilty about everything and hate to bother people.

People with atypical features are more like bears hibernating for the winter. They are hungry when awake and they sleep day and night but are still tired.  They are likely to feel that people are rejecting them and don’t what them around. People with atypical features can brighten a little for a while if you dangle something they like in front of them, but this improved mood doesn’t last long.

Postpartum Depression is also a recognized type. This is easy to understand in women soon after the birth of a child, due to the changes in the hormones in the woman’s body. It can also be seen in men especially after the birth of the first child as there is a change in the primary relationship. The fairy tale is over. Some men become excited about fatherhood, others feel like they have lost a lover.

There is also a seasonal pattern associated with depression. Sometimes this is referred to as Seasonal Affective disorder or “winter blues.”  This pattern can occur in the summer or at the spring and fall changes of weather, but those changes are more likely to be associated with Bipolar Disorder than Major Depressive Disorder.

For more on related conditions check the categories list to the right of the posts or watch for words to turn blue indicating they have been linked to other posts about this topic. My plan is to add links as quickly as I can finish the posts of these other topics.

Feel free to leave comments or email me about your questions. While I can’t provide therapy or counseling over the internet, you need to come to see me in the office for that, I will be glad to try to answer questions of general interest.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.