Double depression occurs when a person who suffers from dysthymia ends up with major depression. These are situations where the vital dissatisfaction, despair and fatigue of the first illness can intensify until reaching a psychological state much more obscure and crippling. We are faced with an increasingly frequent reality of clinical practice.
It is possible that many people have not heard of this disease. However, double depression is a constant object of study for a very obvious reason: over the last ten years, more and more patients (adolescents included) have gone from a persistent depressive disorder (dysthymia) to a major depression. .
Thus, work such as that carried out by the Department of Psychology at the University of Illinois at Chicago and published in the Journal of Psychiatric Research indicates to us that the origin of double depression lies in the chronicity of dysthymia. Some people live for years in a reality marked by low motivation, constant sadness, fatigue and discouragement and sooner or later must recognize something: that they have completely lost control of their life.
When this type of thinking arises, with the vulnerability that comes with it, mild depression turns into major depression. At this time, anhedonia appears, as do feelings of guilt and suicidal thoughts. These are, as we see, very complex situations. Specialists face a great challenge: treating the symptoms, understanding the causes and deciding the best treatments based on the specific needs of each patient. Now let’s take a look at more data.
Double depression: symptoms and causes
We know that double depression arises after a serious complication of persistent depressive disorder (dysthymia). It should be noted that the term appeared in the 1980s but that it has not been clarified and defined with greater rigor than in the last ten years. In fact, in the new edition of DSM-5 ( Diagnostic and Statistical Manual of Mental Disorders) it already appears with distinctive features. Here they are :
- Double depression starts from a persistent depressive disorder (dysthymia). In other words, the patient has already spent much of their life in despair. These are chronic conditions that cause a person to have low energy, feel sadness, and have problems making decisions, almost repeatedly.
- Persistent depressive disorder is difficult to detect. Many people suffer from it but manage to fulfill their obligations, do their jobs and continue their relationships without seeking clinical help. However, at some point in their lives, they realize that this condition is getting worse.
- A total loss of interest in everything around them suddenly appears. Nothing attracts them, nothing motivates them. Everything becomes insignificant.
- Hypersomnia or insomnia appears.
- We also see motor slowness, difficulty moving or performing daily activities.
- Thoughts of suicide start to appear (something that doesn’t happen with persistent depressive disorder).
This change, this moment when we go from despair to the idea of “disappearing” is the hallmark of what is known as double depression.
Why does double depression appear?
In a 2013 Boston University study published in the journal Molecular Pharmacology, we are told that 10% of the population suffers from dysthymia, and among these people, around 75% are at risk of developing double depression. . The causes are as follows:
- A chronic state of sadness and hopelessness leads, sooner or later, to other problems: poor diet, social isolation, lack of motivation … All this harms the reality of the patient, until problems arise in the relationships. personal, at work, etc.
- The bad emotional state leads to a bad quality of life. There is an obvious risk that dysthymia leads to major depression.
Treatment for double depression
Experts tell us something that may grab our attention: Major depression is easier to treat than dysthymia. As we have been able to deduce, the key lies in responding to persistent depressive disorder so that it does not drift into major depression.
Therefore, once double depression is diagnosed, it is necessary to put these different strategies in place:
- Treatment with drugs: According to a study published in the journal Neuropsychopharmacology Psychiatry and carried out by Drs Hellerstein, Yanowitch and Rosenthal, treatment with serotonergic antidepressants is very effective.
- In addition, expressive and emotional therapies are very therapeutic in releasing emotions, channeling them and transforming them.
- Finally, cognitive behavioral therapy, with practices like cognitive restructuring to modify dysfunctional beliefs, is another highly recommended strategy.
We need to be able to seek professional support whenever we feel this chronic hopelessness that doesn’t seem to want to leave us. Living in this state, in this recurrent and sticky dysthymia, places us on the edge of an extremely dangerous precipice. Let’s avoid this situation, let’s be able to ask for help from an expert.