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Double depression is a term used to describe the combination of dysthymia and major depression.

There is no bright line dividing "normal" mood from low, moderate, or severe forms of depression. Thus, the various designations are relative to one another and serve as general reference points.

Sometimes major depression occurs in discrete episodes. In other words, most of the time, the person does not feel low. Then he or she goes through time-limited periods (weeks or months) where the person becomes very depressed, a so-called major depressive episode. After the episode, mood returns to its baseline.

In double depression, the person does have severe periods of depression, major depressive episodes. But between those episodes, instead of returning to "normal" mood, some level of less severe depression continues. Another way to think of this combination is always having dysthymia in the background, with more severe major depressive episodes superimposed from time to time.

Treatment in double depression is aimed at both the major depressive episodes as well as the background level of depression that the person struggles with. It usually requires a combination of psychotherapy and medication.


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