Signs of Double Depression
Disclaimer : Hey there, Psych2goers! Before we start, a friendly disclaimer, this article is not meant for a professional diagnosis or treatment. If you notice you or your loved ones experienced any signs stated below, please don’t hesitate to seek help from Psychiatrists or other mental health professionals.
According to Smitha Bhandari, MD (2019), 3%-6% of the population is susceptible to double depression which is a chronic (longstanding) form of depression. Similar to other forms of depression, double depression can affect daily functioning and quality of life and becomes a risk factor for suicidal thoughts and behaviours.
How can double depression develop?
This psychiatric condition generally begins as persistent depressive disorder (PDD), which is a depressed mood for most of the day accompanied by just at least two symptoms of clinical depression that lasts at least 2 years in adults, or one year in children or adolescents. Furthermore, symptoms cannot be absent for greater than 2 months for both groups (Patel & Rose, 2020). Gradually, more than 50 percent of people with PDD experience aggravating symptoms that causes the onset of a full syndrome of major depressive disorder (MDD) superimposed on PDD, resulting in what is called as double depression (Bhandari, 2019).
Now Psych2goers, let’s all take a look at the signs of double depression, shall we?
Signs of PDD and MDD
Since double depression is the coexistence of MDD and PDD, therefore it is imperative to get to know the signs of both disorders before double depression can be diagnosed.
According to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington 2013.), PDD is defined as follows:
A. Duration and mood : In children adolescents, mood can be irritable and duration must be 1 year or longer. In adults, depressed mood for most of the days, for more days than not, for 2 years or longer.
B. Presence of 2 or more of the following during the same period
-Poor appetite or overeating
-Insomnia or hypersomnia
-Low energy or fatigue
-Low self-esteem
-Impaired concentration or indecisiveness
-Hopelessness
C. Never without symptoms for more than 2 months
DSM-5 criteria for MDD are as follows:
5 or more of 9 symptoms (including at least 1 depressed mood and loss of interest or pleasure) in the same 2-week period; each of these symptoms represents a change from previous functioning
- Depressed mood (subjective or observed)
- Loss of interest or pleasure
- Change in weight or appetite
- Insomnia or hypersomnia
- Psychomotor retardation or agitation (observed)
- Loss of energy or fatigue
- Worthlessness or guilt
- Impaired concentration or indecisiveness
- Thoughts of death or suicidal ideation or suicide attempt
Distinguishing Signs of Double Depression
The Distinguished Research Professor for Florida State University and the Bright-Burton Professor of Psychology, Dr. Thomas Joiner (2007) has successfully identified hopelessness as a symptom that distinguishes double depression from MDD or dysthymia (which is later known as PDD) alone. He stated, “The hopelessness result is significant, and it suggests that therapists should especially focus on this feature early and often in the treatment of double-depressed patients.” From his research, it was reported that double-depressed patients had elevated levels of hopelessness, whereas patients with either major depression or dysthymia alone showed more moderate levels of hopelessness.
Apart from that, a person with double depression will develop a constant stress response which can become predisposing factors to heart disease and diabetes. These body responses and changes in the brain complicate the treatment for double depression (Bhandari, 2019).
Final thoughts
Depression causes a significant impact on both morbidity and mortality and if left untreated, its complications are similar to those complications of other untreated mental illnesses. Several studies have proven that depression can lead to additive functional impairment and increase symptom burden in those with chronic medical illnesses (Patel & Rose, 2020).
There are effective treatments and managements of double depression. Therefore, if you notice the above signs in you or your loved ones, don’t be afraid to take the first step to consult a mental health professional. Soon, you will be embarking on the journey to recovery and begin enjoying an improved quality of life.
REFERENCES
Bhandari, S. (2019, August 29). Double Depression: Definition, Symptoms, Treatment, and More. WebMD. https://www.webmd.com/depression/double-depression.
Florida State University. (2007, July 26). Double Trouble: Hopelessness Key Component Of Mood Disorder. ScienceDaily. Retrieved June 27, 2021 from www.sciencedaily.com/releases/2007/07/070723160142.htm
Ohwovoriole, T., & Gans, S. (2020, December 29). How Does Double Depression Develop? Verywell Mind. https://www.verywellmind.com/double-depression-symptoms-diagnosis-and-treatment-5089417#citation-1.
Patel, R. K., & Rose, G. M. (2020, October 7). Persistent Depressive Disorder. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK541052/.
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