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Double Depression

You may be surprised to learn that between 3% and 6% of the population is at risk for a serious, potentially life-threatening condition known as double depression. Many of those people can lower that risk. But even after double depression develops, many people delay or avoid getting treatment that could save their lives.

What Is Double Depression?

Double depression is a complication of a psychological condition called dysthymic disorder, or dysthymia. Dysthymia is a chronic, depressed mood that lasts at least two years. This low, dark mood -- sometimes referred to as a "veil of sadness" -- occurs nearly every day and persists for years. Some people may have this mood disorder for 10 to 20 years, or even more, before seeking treatment.

Over time, more than half of people with dysthymia experience worsening symptoms that lead to the onset of major depression on top of their chronically depressed mood. This is known as double depression.

How Is Double Depression Different From Major Depression Without Dysthymia?

The primary difference between a double depression and a major depression is the effect of the underlying dysthymia.

Major depression by itself, although severe, typically lasts a few weeks to a few months. There is a marked drop in mood accompanied by severe symptoms that may include:

  • Hopelessness
  • Insomnia or sleeping too much
  • Thoughts of suicide or death
  • Low self-esteem
  • Loss of appetite or overeating
  • Poor concentration
  • Loss of interest in things that the person used to like
  • Low energy or agitation
  • Thoughts of worthlessness or guilt

But when treated, the mood normally returns to normal as the other symptoms resolve. There is also often an awareness during treatment that depression is not the normal state and that that things can improve.

Many of the symptoms of major depression are also present in people who have dysthymia, but they are far less severe and not as debilitating. They typically don't greatly interfere with a person's day-to-day functioning. As a result, people with dysthymia tend to view their symptoms as normal for them. Some may regard the low mood as a part of their personality or as simply a part of life and out of their control.

When a major depression occurs on top of a chronic depressed mood, some people with dysthymia accept it as inevitable. This causes them to delay seeking treatment and makes them more resistant to normal treatment when it does start. Plus, unless the dysthymia is addressed along with the major depression, they are not really cured when the major depression is relieved. They go back to being chronically down with the accompanying risk of a new episode of double depression.

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