What is Double Depression?

The term “double depression” refers to a dual diagnosis of dysthymia and major depression. Double depression is a serious combination of two medical conditions, and it is more difficult to treat than either of the conditions on their own. It is characterized by extreme hopelessness, compounding already severe depressive symptoms. Mental health professionals are working to identify other specific characteristics that distinguish double depression from major depression or dysthymia.

Dysthymia is a chronic mood disorder, but the symptoms are less severe than major depression. In order to receive a dysthymia diagnosis, an individual must experience a sad or low mood nearly every day for at least two years. Additional possible symptoms include hopelessness, sleeping too little or too much, changes in appetite, fatigue, lack of concentration and low self-esteem. Professionals don’t know what causes dysthymia, but it is more likely to occur in women, people who have a family history of the illness and individuals under persistent stress. It is a chronic condition, so some people could have dysthymia for years.


Major depression involves more severe symptoms than dysthymia, though the illness is not as chronic. A person is diagnosed with major depression if he has been experiencing at least five symptoms for two weeks or more. Symptoms of major depression can include appetite changes, loss of interest in favorite activities, irritability, fatigue, difficulty concentrating and feeling helpless, hopeless, guilty or worthless. People with major depression might experience insomnia or hypersomnia. In some cases, an individual has thoughts of death or suicide.

Individuals with dysthymia are at a greater risk of developing major depression than the general population. Severe dysthymia symptoms can trigger a major depressive episode, and then the individual is suffering from double depression. In addition to a person’s chronic and persistent low mood, he or she will experience more severe symptoms. The two disorders share many of the same symptoms, so it can be difficult for a health care provider to recognize when a patient is suffering from both at the same time.

Though double depression can be more difficult to treat than dysthymia or major depression alone, individuals should seek help if they are experiencing symptoms. A physician might recommend medication, such as selective serotonin re-uptake inhibitors or tricyclic antidepressants. Most professionals also will recommend some form of counseling, such as cognitive therapy. Treatment approaches that combine medication and therapy typically provide the most improvement. Individuals with even mild symptoms of dysthymia should seek help before the problem can devolve into double depression.



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