You’re about to learn about a controversial topic known as double depression. It’s controversial because some suggest it doesn’t even exist. We’ll look at symptoms, how it differs from major depression and chronic mild depression, key features of double depression and how to have better outcomes from therapy.

Depression is more than feeling sad...

Sadness is one of our most commonly experienced emotions. It is only natural to feel sad in response to feeling alone, losing a friend or partner, or going through a difficult time. We can also feel sad without knowing why.

While sadness is an emotion we commonly experience at times in our lives, depression is more than feeling sad. Depression makes it harder to live our lives. The key is when depression becomes excessive enough to stop us functioning properly it is time to consider getting help.

Consider depression to be the common cold of psychology. Dr Martin Seligman used the term “learned helplessness” to describe the dysfunctional belief that nothing can be done to change or improve our situation.

Depression can also involve negative thoughts such as, ‘No one likes me’ or, ‘My life will never be good’. Dr Aaron Beck referred to these negative thoughts as “cognitive errors.” Such thoughts stop us improving our situation.


Depression involves a depressed mood. Physiological symptoms can include: appetite/weight changes; sleeping pattern changes; fatigue; less energy; reduced libido; irritability; difficulty concentrating; poor memory; anxiety; and, sometimes stomach pain and headaches. Psychological symptoms can include: hopelessness (believing things will not get better); helplessness (believing we cannot change our situation); feelings of worthlessness and guilt; social withdrawal and isolation; thoughts about suicide; and anhedonia, which is an inability to experience pleasure.

When we are depressed, we may experience some or many of these symptoms because everyone’s experience of depression is unique.

Major depression versus dysthymia...

A major depressive episode lasts for at least two weeks. Symptoms are more severe/ acute/ pronounced and tend to occur in temporary episodes. This means our mood lifts after being depressed for a while. Major depression can sometimes come back and this is known as a relapse.

Dysthymia is a mild yet chronic depression lasting for at least two years. While the type of symptoms are relatively similar (e.g., depressed mood, changes in appetite and sleep, less energy, etc.), the symptoms are less intense and the mild depression can persist for a few years.

Double depression: A controversy...

Double depression is a combination of dysthymia and major depression. At some point during chronic mild depression (dysthymia), we have a major depressive episode where our symptoms become more marked for a while, then after this episode we go back to our usual mild depression. But by looking at Dysthymia as though it is simply a mild form of Major Depression, does it exist in its own right?

Some features of double depression...

Dysthymia increases our chances of having an episode of major depression. Having chronic mild depression also increases our risk of developing double depression.

One reason relapse rates are higher for double depression (compared with major depression) is that the less intense dysthymic component is often not detected and only the major depression is treated.

While hopelessness can be a symptom both in dysthymia and in major depression, extreme hopelessness tends to be a key feature in double depression.

Double depression and extreme hopelessness increases our chances of experiencing suicidal ideation (e.g., thoughts). Giving up most/all of our hopes of things getting better sometimes leads to such thoughts about suicide.

Another key feature of double depression is feeling as though we do not have any control of our life / situation. This lack of a feeling in control is associated with feelings of both hopelessness and helplessness.

Better outcomes in therapy can often be achieved alleviating feelings of hopelessness right from the start of therapy. This is because a belief that our situation cannot possibly improve really can influence our behaviour.

Help is available...

Effective evidence-based interventions include Cognitive Behaviour Therapy (CBT), interpersonal and mindfulness therapies. Depression-education helps develop insight and identify symptoms. Proper diagnosis, skills-building and social support also helps prevent relapse.

Simply call our Psychologists on 0407 676 192 for more information.

Australian Psychology Solutions – the completely bulk-billed service
0407 676 192

Psychologist services provided in the Eastern Suburbs of Sydney, Australia

Author's Bio: 

David Pollak is a Senior Psychologist in private practice in Sydney, Australia.
He has worked as a Psychologist since 1999.

Even before starting as a Psychologist, David volunteered for years and was presented with an award for creditable service to the community. He has also taught Psychology-related subjects to students and supervised students on placements. While David has worked with children and teenagers, he specialises in working with adults and the elderly. In every position he has held, David has helped people overcome such things as anxiety, depression and a range of other issues.

Australian Psychology Solutions – the completely bulk-billed service
0407 676 192

Psychologist services provided in the Eastern Suburbs of Sydney, Australia