Double depression: the overlap of depressive symptoms

The word depression is an old acquaintance not only for the field of psychologybut also for a large part of the general population. We all have a more or less approximate idea of ​​what it implies (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 known, as well as complications of these pictures that can cause great suffering for those who suffer them. suffers. This is the case, for example, of double depression.

• Related article: "Are there different types of 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 solely 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 during most of the time almost every day for at least two weeks of a sad state of mind (in children it can appear more irritable) and/or loss of interest or the ability to feel pleasure through previously motivating activities, along with other symptoms such as sleep or eating disturbances, hopelessness, lack of concentration, physical and mental slowdown, and loss of energy and appetite sexual. It is also not uncommon for there to be thoughts of death and suicide.

• Related article: "Major Depression: Symptoms, Causes, and Treatment"

dysthymia

With regard to dysthymia, we are facing a disorder very similar to depression. although less intense, 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 for at least two years, frequently appearing hopelessness, eating and sleeping problems, fatigue and low self-esteem.

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 normal activities, the subject does not present anhedonia or sluggishness 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 more temporary while dysthymia is less severe but lasts much longer or can become chronic (in fact, it is currently called depressive disorder persistent). 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 his symptoms, and can be diagnosed with depression double.

• You may be interested in: "Dysthymia, when melancholy takes over your mind"

What is double depression?

Double depression is called that situation in which a subject suffering from dysthymia appears for some reason episodes of major depression, overlapping with their usual symptoms.

It is a serious complication of dysthymia, since it means that in a person with a low mood and with a series of complications that are already basic suffer a moment of greater weakness, lose hope and the desire to do things or stop feeling pleasure. In addition, the fact that dysthymia lasts over time makes it easier to lose social support in the long run and, even before the major depressive episode, there is a decreased level of activity.

Recapitulating from what was previously written, we have a person who has been suffering from sadness for at least two damages, low self-esteemeating problems like loss of appetite and/or sleep such as insomnia and a feeling of lack of hope in the future in which, in addition to this, a 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 day to day in areas such as work or work. staff.

These people tend to recover before major depressive episodes than those who did not suffer from prior dysthymia, due to the existence of some habituation, but nevertheless it is much more frequent that they suffer relapses again since they continue to suffer from dysthymia.

Causes

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

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

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, he consumption of drugs or simply the persistence of dysthymia symptoms.

Treatment

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 usual 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, being especially used Currently, the SSRIs in order to reduce the reuptake of serotonin and facilitate its action in the brain.

Psychotherapy

In psychology, there is a wide variety of effective methodologies from very different theoretical currents. Negotiation with the patient is recommended about performing graded tasks that may challenge the subject but have a high probability of success, so that the subject sees that he is successful and increases his selfconcept.

The performance of 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 that he has in order to get closer to the core beliefs that generate and maintain suffering and sadness, stop later through cognitive restructuring to modify possible beliefs dysfunctional. Group therapy can be applied. It seeks to increase self-esteem and it can also be useful to improve the social skills of those affected.

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

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Massón, Barcelona.