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Double Depression

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Are There Other Characteristics of Double Depression That Make It Hard To Treat?

A recent study showed that people with double depression have a far greater sense of hopelessness than do people with dysthymia or major depression alone.

The constant stress response also causes changes in the body that increase the risk of heart disease, diabetes, and other medical conditions. The changes in the brain and the changes in the body complicate treatment for major depression when double depression occurs.

Another problem caused by the underlying, long-term depressed mood is that people with dysthymia tend to be more likely to abuse tobacco, alcohol, recreational drugs, or maintain an unhealthy diet. The resulting health problems further complicate treatment, and the unhealthy lifestyle choices get in the way of someone with double depression seeking treatment.

Can Double Depression Be Prevented?

The best way to prevent double depression is to treat dysthymia. Antidepressants can be helpful, but they take longer to work and are less effective for dysthymia than for acute major depression.

Cognitive therapy can also be effective in treating dysthymia. But often a combination of antidepressant medications and cognitive therapy is needed. Experts recommend starting on one approach, either cognitive therapy or an antidepressant, for a few months and watching its effect and then either switching to or adding the other if the results are not sufficient.

Exercise can help improve mood, and some studies have shown that the combination of exercise and antidepressants can have an additive effect. It also may help to improve sleep patterns because chronic sleep deprivation can worsen depression symptoms.

How Should Double Depression Be Treated?

People with dysthymia often feel as though they have little or no control over their own life. The feeling is that something else -- fate or other people -- are responsible for the course of their lives. This is not a typical feeling for people with major depression with no underlying dysthymia.

The fact that people with dysthymia have a feeling of having little or no control suggests that cognitive therapy in combination with antidepressants may be an effective treatment for  double depression. The goal of cognitive therapy is to change negative thinking patterns and to give individuals new ways of seeing and dealing with themselves and their environment. Taking such an approach addresses both the major depression and the dysthymia of double depression.

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on July 23, 2012
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