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Understanding the Risks of Double Depression

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There are many different types of depressive disorders, but double depression involves experiencing an overlap of two serious forms of this condition. Knowing the symptoms and when to seek help is critical in protecting your health.

Most people have heard of depression, but few are familiar with the increasing phenomena known as “double depression.” Researchers estimate that 3-6% of the population is at risk for this chronic condition, which can cause significant problems in daily life, and increase the potential for suicidal thoughts or behaviour. Understanding what this condition is, and being able to recognise the signs of it, is critical in seeking appropriate treatment and improving overall quality of life.

What is Double Depression?

To understand double depression, it is important to first recognise that not all types of depression are the same. In fact, psychologists have identified multiple types of depressive disorders, which include:

Double depression occurs when there are complications of one type of depression, persistent depressive disorder (PDD), that leads to the development of another type of depression, major depressive disorder (MDD). This results in the co-occurrence of the two disorders, which is what is behind the term “double depression.”

Persistent Depressive Disorder

Persistent depressive disorder, also known as dysthymia, is a chronic, low-grade type of depression that results in low mood as well as lack of energy, low self-esteem, changes in eating and sleeping habits, and difficulty concentrating. To be diagnosed, adults who have PDD must have had a depressed mood accompanied by at least one other symptom for at least two years. 

People living with PDD may not realise they are living with a treatable mental health disorder, as symptoms can occur at a low-level for a long period of time, leading some to believe that this is a normal state of mind. In fact, a constant depressed mood is a reliable indicator that something is off, and should prompt a visit to a doctor or mental health specialist for discussion and evaluation.

Major Depressive Disorder

Major depressive disorder is what many people think of when they think of depression. Marked by intense feelings of sadness, hopelessness, and emptiness, and accompanied by a loss of interest or pleasure in most things and activities, this disorder seriously impacts nearly every aspect of people’s lives. 

Other symptoms often associated with major depressive disorder include changes in appetite or sleeping habits, slowed body movements and lack of energy, persistent feelings of guilt or worthlessness, difficulties in thinking and making decisions, and suicidal thoughts or ideation. 

People who are diagnosed with MDD have had at least five of these symptoms for two weeks or more, and are not experiencing effects of medications or other medical conditions that could be causing the symptoms. Often people who have MDD will experience more than one episode in their life. Due to the profound challenges MDD causes to people’s wellbeing, it’s critically important to seek treatment for this condition. 

What Makes Double Depression Different from Other Forms of Depression?

Double depression is often a more acute type of depressive disorder due to the combined impacts of both PDD and MDD. This unfortunate combination has been linked to more severe symptoms, higher rates of suicidal ideation and suicide attempts, increased rates of hopelessness, and even a higher risk of developing heart disease. The significant physical and mental health impacts of double depression underscore the need for professional treatment.

What Causes Double Depression?

Research has not yet revealed one clear cause of double depression, but studies have shown that a variety of factors can contribute to this condition. These including things like:

  • Personality – those who tend towards low moods and anxious feelings are more likely to experience a depressive disorder
  • Other mental health disorders – having another mental health disorder, such as anxiety or a substance abuse disorder, can increase the likelihood of experiencing depression
  • Genetics – having a family member with a depressive disorder can increase the chances of developing one
  • Environment – people who have experienced abuse, neglect, or trauma are at greater risk for developing some type of depression
  • Neurological differences – differences in the levels of certain neurotransmitters, or in the size or shape of the brain, can also affect the likelihood of experiencing a depressive disorder

What are Symptoms of Double Depression

The symptoms of double depression tend to mirror those of PDD and MDD, and can include other things like:

  • Unexplained physical pain or a general feeling of unwellness
  • Thoughts of self-harm or suicide, including planning
  • Extreme guilt, worthlessness, or emptiness
  • Recurring thoughts of death
  • Slowed physical movements and severe fatigue

If you believe that you may be experiencing symptoms of double depression, it is important to seek help from a mental health professional as soon as possible.

What are Treatment Options for Double Depression?

There are a range of options available to effectively treat and manage symptoms of double depression, and many people find that a combination of different treatment modalities is most effective in ensuring a comprehensive approach that can address all aspects of the disorder. Some common treatment options for people with double depression include:

Cognitive Behavioural Therapy

Cognitive behavioural therapy (CBT) is an important tool for many mental health specialists in addressing depression. CBT works to uncover and understand the root causes of depression, and develops a plan to treat both PDD and MDD in order to fully address the symptoms of double depression.

People can participate in CBT in an individual or group setting depending on their needs and preferences. A typical CBT session will focus on identifying problematic thinking patterns, and examining how these thoughts impact quality of life. The therapist then works with the client to reshape these patterns, and develop coping skills that will reduce stress and build resilience around life’s challenges. 

Cultivating Regular Wellness Practices

Wellness practices like exercise, mindfulness meditation, and yoga have been proven to have positive effects on boosting mood and relieving symptoms of depression via the natural stimulation of mood-related neurotransmitters. Integrating these practices into your daily routines, as well as adhering to a healthy, balanced diet and practicing good sleep habits builds a strong foundation by which to heal from depression.


In some cases, a doctor may prescribe antidepressants or other drugs to help improve sleep and boost your mood. While these medications are effective for some people, there may be side effects, and medical professionals generally agree that they work best when used alongside other therapies or practices also targeted towards managing depression.

Transcranial Magnetic Stimulation

For those who have experienced difficulties in managing symptoms of depression and have found medication to be ineffective, transcranial magnetic stimulation (TMS) may be a successful alternative. This cutting-edge, FDA-approved technology is gentle and non-invasive, using magnetic waves to stimulate nerve cells in the brain linked to mood regulation and depression.

Finding Joy after Double Depression at The Dawn Thailand

Finding Joy after Double Depression at The Dawn Thailand

The Dawn Wellness Centre and Rehab is a mental health retreat in Thailand that offers holistic, compassionate mental health and addiction treatment for those looking to change their lives for the better. Our experienced, international staff work with each one of our clients to develop a personalised treatment plan designed to address your specific needs. We specialise in treating depressive disorders as well as co-occurring disorders, and are the only residential treatment centre in Asia to offer Transcranial Magnetic Stimulation (TMS) treatment, a highly effective, non-invasive therapy for treatment-resistant depression. 

A Depression Retreat in Thailand

Located in the stunning setting of Northern Thailand, the Dawn is internationally accredited by the American Accreditation Commission International (AACI), a widely recognised body overseeing clinical excellence and provision of health care, and licensed nationally by the Thai Ministry of Public Health. 

The Dawn offers resort-like facilities with a range of modern amenities available to complement your treatment and help you fully relax. Our safe, supportive, and welcoming environment is far away from the triggers and stressors of daily life. At The Dawn, you’ll be able to fully focus on your recovery so that you can return home feeling better than ever.

Call The Dawn today to learn more about how we can support you and help treat your depression.

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