From Our 2007 Archives

Double Depression Dims Hopeful Outlook

Hopelessness Tends to Be Worse in Double Depression, Compared With Other Types of Depression

By Miranda Hitti
WebMD Health News

Reviewed By Louise Chang, MD

July 26, 2007 -- Hopelessness, a hallmark of depression, tends to be even worse in double depression, a new study shows.

Never heard of double depression? The term refers to chronic, less-severe depression (dysthymia) that worsens into major depression.

Double depression isn't a new condition. But it's making news in the August edition of the Journal of Affective Disorders.

The journal includes a study on double depression by researchers including Thomas Joiner, PhD, Distinguished Research Professor and the Bright-Burton Professor of Psychology at Florida State University.

They found heightened levels of hopelessness among patients with double depression, compared with patients with major depression or dysthymia alone.

In light of the findings, therapists should watch for hopelessness "early and often" in treating patients with double depression, Joiner says in a Florida State University news release.

Double Depression and Hopelessness

Joiner and colleagues studied 54 people treated for double depression, major depression, or dysthymia at a Florida outpatient psychiatric clinic for older adults.

All of the patients were at least 55 years old. Forty of the patients had major depression, eight had double depression, and six had dysthymia.

The patients completed surveys about their depression, anxiety, hopelessness, and feeling of control (or lack thereof) over their lives.

Patients with double depression reported "high levels of hopelessness, whereas patients with either major depression or dysthymia alone showed more moderate levels of hopelessness," write Joiner and colleagues.

"A patient who is hopeless has really just given up," Joiner says in the news release. "They feel like the world is against them, the future is bleak, and they are incapable of fighting back."

In addition, patients with double depression or dysthymia alone reported feeling less control over their lives than patients who only had major depression.

The study included a relatively small number of patients, which may mean it doesn't represent all patients with double depression, major depression, or dysthymia.

"We hope that our preliminary findings serve as a springboard for future studies investigating the phenomenon of double depression," Joiner's team writes.

No matter what type of depression you have, get help. Depression can often be treated.

Depression symptoms include:

  • Persistent sadness, pessimism
  • Feelings of guilt, worthlessness, helplessness, or hopelessness
  • Loss of interest or pleasure in usual activities, including sex
  • Difficulty concentrating and complaints of poor memory
  • Worsening of co-existing chronic disease, such as rheumatoid arthritis or diabetes
  • Insomnia or oversleeping
  • Weight gain or loss
  • Fatigue, lack of energy
  • Anxiety, agitation, irritability
  • Thoughts of suicide or death
  • Slow speech; slow movements
  • Headache, stomachache, and digestive problems

People with major depression have at least five depression symptoms for at least a two-week period. People with dysthymia have fewer and less-intense symptoms that are long-lasting.

SOURCES: Joiner, T. Journal of Affective Disorders, August 2007; vol 101: pp 235-238. News release, Florida State University. WebMD Medical Reference: "Understanding Depression -- Symptoms."

© 2007 WebMD Inc. All rights reserved.