Double Depression: The Overlap Of Depressive Symptoms

Woman crying a lot.

The word depression is an old acquaintance not only in the field of psychology, but also for a large part of the general population. We all have a more or less approximate idea of ​​what it entails (despite the fact that the majority of the population identifies with depression things that are not).

However, there are multiple disorders linked to this type of problem that may not be as well known, as well as complications of these conditions that can cause great suffering for those who suffer from them. This is the case, for example, of double depression

Some of the main depressive disorders: major depression and dysthymia

Within mood disorders there are different problems that appear with depressive symptoms. If we limit ourselves only to this type of symptoms (not taking into account those disorders in which manic or hypomanic episodes appear), the most well-known and prevalent disorders are two: depression and dysthymia.

major depression

Major depression is the best known and most common depressive disorder being the most prevalent mental health problem along with anxiety disorders.

It is characterized by the existence for most of the time almost every day for at least two weeks of a sad mood (in children it may appear more irritable) and/or loss of interest or ability of feeling pleasure through previously motivating activities, along with other symptoms such as sleep or eating disorders, hopelessness, lack of concentration, physical and mental slowing, and loss of energy and sexual appetite. It is also not uncommon for thoughts of death and suicide to exist.

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Regarding dysthymia, we are facing a disorder very similar to depression although of lesser intensity, but on the other hand it remains for a long time or even becomes chronic. A sad mood is maintained for most of the time, at least for two years, with hopelessness, eating and sleeping problems, fatigue, and low self-esteem frequently appearing.

Although the severity of the symptoms is less than in depression itself, the fact that dysthymia lasts over time causes a higher level of life dissatisfaction. However, there is a lower level of interference in usual activities, the subject does not present anhedonia or slowing and they do not usually have thoughts of death.

Although there are other depressive problems, these two are some of the most important and disabling. Major depression is more severe but is more temporary, while dysthymia is less severe but lasts much longer or can become chronic (in fact, it is currently called persistent depressive disorder). However, sometimes we can find that a person with dysthymia suddenly has a worsening of their symptoms, generally due to some external cause that exacerbates their symptoms, and may be diagnosed with double depression.

What is double depression?

Double depression is called that situation in which episodes of major depression appear for some reason in a subject who suffers from dysthymia. overlapping your usual symptoms

It is a serious complication of dysthymia, since it means that a person with a low mood and with a series of underlying complications suffers a moment of greater weakness, loses hope and the desire to do things or stops feeling pleasure. . Furthermore, the fact that dysthymia lasts over time makes it easier for social support to be lost in the long run and there is a decreased level of activity before the major depressive episode.

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Recapitulating from what was previously written, we have a person who has been suffering from sadness, low self-esteem, eating problems such as loss of appetite and/or sleep such as insomnia and a feeling of lack of hope in the future in which, in addition, major depression appears, accentuating the previous symptoms and adding a deficit in the ability to feel motivation or pleasure and generating great interference in their daily life in areas such as work or personal.

These people usually recover sooner from major depressive episodes than those who did not suffer from previous dysthymia, due to the existence of a certain habituation, but nevertheless it is much more common for them to suffer relapses since they continue to suffer from dysthymia.


The causes of double depression can be multiple. It has been discussed that the causes of depression can be found in biological factors such as presence of a serotonin and/or dopamine deficiency or due to environmental factors such as insufficient reinforcement of one’s own activity and/or the existence of unrealistic expectations and thought schemes with perceptual biases that generate the tendency to consider oneself, the world and one’s own future negatively.

The existence of dysthymia tends to be associated with the continued suffering of stressful elements, usually along with social isolation It is very common for there to be some chronic health problem (whether physical or mental). There is also a certain hereditary component as the existence of several cases of affective disorders within the same families is observed (although in part they may be due to learning).

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The appearance of episodes of major depression within a dysthymic disorder may be linked to the appearance of some stressor or situation that generates discomfort and sadness drug use or simply the persistence of dysthymia symptoms.


The treatment of double depression is practically identical to that of depression and dysthymia. Major depression is more easily treated, since dysthymia is often experienced by the patient as their normal functioning or way of proceeding. However, the treatment of this and double depression is equally possible, often through a combination of psychological and pharmacological treatments

Drug treatment

With regard to psychopharmacology, the use of antidepressants is common, with SSRIs currently being especially used in order to reduce the reuptake of serotonin and facilitate its action in the brain.


In psychology, a wide variety of effective methodologies are available from very diverse theoretical currents. Negotiation with the patient is recommended on performing graded tasks that can test the subject but have a high probability of success, so that the subject sees that he or she is successful and increases his or her self-concept.

Carrying out pleasurable activities and cognitive rehearsals of situations that may cost you can be very useful. At a cognitive level, it is recommended to first record the subject’s ideas and the type of thoughts they have to get closer to the core beliefs that generate and maintain suffering and sadness, stopping later through cognitive restructuring to modify possible dysfunctional beliefs. Group therapy can be applied. It seeks to increase self-esteem and it may also be useful to improve the social skills of those affected.

Finally, the use of expressive and emotional therapies can help the patient free himself from distressing sensations and find relief in them while learning to manage them successfully. Examples that could work are temporal projection or the empty chair.