A client asks a nurse about the differences between major depressive disorder (MDD) and dysthymia. Which of the following responses by the nurse is accurate?

Choice A rationale:

Increased interest in activities is not consistent with the clinical presentation of MDD. In fact, a hallmark symptom of MDD is anhedonia, which involves a reduced interest or pleasure in most activities.

Choice B rationale:

Weight gain is not typically associated with MDD. In contrast, significant changes in appetite and weight loss are more common symptoms, often accompanied by feelings of worthlessness or guilt related to body image.

Choice C rationale:

Excessive guilt and self-blame are common cognitive and emotional symptoms of MDD. Individuals with MDD tend to have a negative self-perception and may blame themselves for their difficulties.

Choice D rationale:

Insomnia, or difficulty falling asleep or staying asleep, is a common sleep disturbance associated with MDD. Sleep problems can exacerbate the symptoms of depression and impact overall well-being.

Choice E rationale:

Elevated mood and increased energy are actually more indicative of conditions like bipolar disorder or manic episodes, where there are distinct periods of abnormally elevated mood, known as mania or hypomania.

Choice A rationale:

Bipolar disorder involves both depressive episodes and manic episodes. The client in question denies any history of manic episodes, making bipolar disorder less likely as a diagnosis. Manic episodes are characterized by elevated mood, increased energy, impulsivity, and risky behavior.

Choice B rationale:

Dysthymia, also known as persistent depressive disorder, involves chronic feelings of sadness and a lack of interest or pleasure in activities. It is a milder form of depression that persists for at least two years in adults. The client's persistent feelings of sadness align more closely with the criteria for dysthymia.

Choice C rationale:

Substance-induced mood disorder occurs when the client's mood disturbances are a direct result of substance use or withdrawal. Since there is no mention of substance use or withdrawal in the client's history, this choice is less relevant to the scenario.

Choice D rationale:

Adjustment disorder is characterized by the development of emotional or behavioral symptoms in response to an identifiable stressor, and these symptoms typically resolve within six months of the stressor's resolution. In the scenario, there is no indication of a recent stressor, and the client's symptoms seem to be chronic rather than time-limited, making adjustment disorder less likely.