Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 11/7/2022
Depression is a relatively common mental health condition that can impact your quality of life. It’s estimated that about 10 percent of American adults will deal with a depressive illness each year. Now, imagine having double depression.
Yup, you read that right. Double depression is a thing. And while double of some things can be great — double ice cream, double fun, you get the idea — double depression sounds double awful.
Keep reading to find out exactly what double depression is, how common it is, what the depressive symptoms are and more.
Double depression occurs when someone experiences both major depressive disorder (MDD) and persistent depressive disorder (PDD). MDD is sometimes also called major depression and PDD used to be called dysthymia. To understand this better, it’s helpful to know about these depressive disorders.
Let’s start with MDD. When most people talk about depression, they are referring to MDD. MDD is marked by feelings of sadness and a loss of interest in things you once loved.
PDD is marked by mild or moderate chronic depression. People with PDD feel sad or depressed most of the day.
PDD tends to be less severe than MDD. However, PDD can be longer lasting. Generally, it lasts for at least two years with seldom breaks in between.
When these two disorders come together at once, it’s considered double depression. Another way to look at it is that double depression is when acute MDD is added on top of chronic depression.
There aren’t symptoms for double depression, per se. Instead, people with double depression have the symptoms for both MDD and PDD.
Because of this, it is important to understand the signs of both types of depressive disorders.
The most common signs of major depression are:
A sad or depressed mood
Feelings of hopelessness
Weight loss or weight gain
Trouble sleeping or sleeping too much
Feelings of worthlessness or guilt
Women are more likely than men to deal with MDD. To be diagnosed with MDD, depressive symptoms must last for at least two weeks.
When it comes to PDD, here are the common symptoms:
Sad or dark mood
Low appetite or overeating
Lack of energy
Difficulty at work or in school
As you can see, there are a lot of similar symptoms. The difference, as mentioned above, is that PDD is chronic and lasts for at least two years, whereas MDD can come in waves but go away for longer periods of time.
There is no criteria for diagnosing double depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 is a manual that helps healthcare providers define and classify mental health disorders.
Instead, a diagnosis of double depression is usually made by diagnosing both MDD and then PDD.
MDD is diagnosed if people experience any of the symptoms above for at least two weeks and there is a noticeable change in how they function.
PDD is diagnosed similarly — but those people have to have been experiencing symptoms for a much longer period of time.
To try and ascertain if someone has PDD, a mental health professional may ask a person things like how often they feel sad, if there are particular reasons they feel down and if the symptoms are around all the time or come and go and more.
Unfortunately, there aren’t exact statistics on just how many people suffer from double depression.
That said, research done on people with depression has found that a good number of them are navigating double depression.
Another study looked at men and women with double depression.
Though the researchers didn’t note whether double depression is more common in men or women, they did find that there are some differences in how it is experienced by women versus men.
The study found that women are more likely to be younger at the onset of double depression, and less likely to be married. Women were also found to experience more sleep changes as a result of this type of depression and were more likely to experience it on a severe level.
Because double depression is not in the DSM-5, there’s no official treatment for patients with it. Instead, a healthcare provider will likely use treatments for MDD and PDD to try and help.
Thankfully, the same treatments tend to be used to treat both depressive disorders. Those treatments include medication, therapy and lifestyle changes. A healthcare professional may prescribe one or a combination of these to help get you on the right track.
Therapy is an excellent way to help treat the symptoms of depression and is often at least part of someone’s treatment equation.
Research has found that cognitive behavioral therapy (CBT), in particular, can be a helpful tool in the treatment of MDD and PDD.
When you participate in CBT, you team up with a mental health provider to notice patterns and behaviors that add to your depression. Then, you’ll come up with ways to alter these behaviors so that you feel better.
Antidepressants are another treatment option for both MDD and PDD.
These medications work by affecting your brain chemistry. It is thought that depression is caused, at least, in part, by low levels of certain neurotransmitters like serotonin and dopamine.
These neurotransmitters are tasked with transmitting info between neurons. It is believed that antidepressants can help regulate the levels of some of these neurotransmitters. This, in turn, may lessen symptoms of depression.
Types of antidepressant medications include selective serotonin reuptake inhibitors (like citalopram and fluoxetine), serotonin-norepinephrine reuptake inhibitors (like venlafaxine) and tricyclic antidepressants (like nortriptyline).
Typically, antidepressants take four to eight weeks to really work. However, some symptoms may improve sooner and, conversely, some symptoms may not improve at all — at which point, your provider may either adjust your dosage or try a new medication.
Before you start taking any new medication, it’s important to disclose if you have a medical condition or any allergies. That way a healthcare professional can make sure whatever you are prescribed won’t interfere with these things.
Finally, your healthcare provider may suggest some lifestyle changes to help ease some of your symptoms. Things like diet, physical exercise and getting proper rest are all crucial to your mental health.
You may also consider things like relaxation techniques, mindful meditation, yoga or even getting out into nature — yes, really. There’s plenty of research out there to suggest that a connection to nature can play a big role in mental health treatment.
The truth is, both MDD and PDD can be complicated to treat and it may take time to find the treatment that fits perfectly for you.
Depression of any kind can seriously impact your quality of life — and this certainly holds true for double depression.
Though not a formal diagnosis, double depression is when someone has major depressive disorder (also called major depression) and persistent depressive disorder (formally called dysthymic disorder).
The former tends to involve depressive episodes that can be more acute, while the latter tends to be more mild but is a chronic depression that lasts for long stretches of time.
Double depression is diagnosed when people display depressive symptoms in line with both MDD and PDD.
The treatment for double depression tends to be the ones used for the two different forms of depression, and includes things like therapy, medication and lifestyle changes.
If you are concerned you may have double depression and would like to speak with a mental health professional, it may be time to start an online consultation.