Thomas Joiner, Florida State University Distinguished Research Professor and the Bright-Burton Professor of Psychology, has identified hopelessness as a distinguishing feature of double depression in a new paper published in the Journal of Affective Disorders. The finding could help therapists diagnose and treat the mood disorder.
Double depression occurs when an individual who suffers from dysthymia, a persistent case of mild depression marked by low energy, falls into a major depressive state.
“It’s clinically important because it is under-recognized and harder to treat than either dysthymia or major depression by themselves,” Joiner said. “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.”
This study found that double-depressed patients had high levels of hopelessness, whereas patients with either major depression or dysthymia alone showed more moderate levels of hopelessness.
“A patient who is hopeless has really just given up,” Joiner said. “They feel that the world is against them, the future is bleak and they are incapable of fighting back.”
This entrenched sense of hopelessness is one likely reason why double depression is so hard to treat, according to Joiner. The chronic nature of the underlying dysthymia is another.
The study included 54 older psychiatric outpatients who completed a battery of cognitive and symptom measures, and underwent structured clinical interviews. Joiner cautioned that the findings of the study should be viewed with regard to its limitations… namely the small sample size, and also the results may not generalize to older adults with different demographic characteristics.
“Still, the results could have important implications for treatment of double depression. Cognitive therapy, which focuses on changing negative thinking patterns, and antidepressant drugs are particularly helpful in treating symptoms of hopelessness and perceptions of a lack of control over one’s own life”, he said.
Double depression in older adult psychiatric outpatients: Hopelessness as a defining feature
Joiner, T.E. / Cook, J.M. / Hersen, M. / Gordon, K.H. , Journal of Affective Disorders, 101 (1), p.235-238, Aug 2007
