What should you know about double depression?

A person may have a long period of low mood, reduced interest, low energy or poor self-worth, followed by a more severe depressive episode. The overlap can make it difficult to recognise a change because feeling unwell has become familiar. Depression can also occur with anxiety, sleep problems, irritability, difficulty concentrating, daytime sleepiness or fatigue.

A clinician assesses mood, functioning, sleep, physical health, medicines and safety rather than diagnosing from one symptom. Sharing how symptoms affect work, relationships, appetite, self-care and sleep can make the assessment more useful.

Book an appointment with a primary-care clinician or mental-health professional. Treatment may combine talking therapy, practical support and prescribed medicine, tailored to the pattern and severity of symptoms. Keep regular meals, gentle activity and contact with trusted people where possible; these steps support care but do not substitute for it.

If you already take an antidepressant, do not stop suddenly or change the dose without clinical advice. A simple daily record of mood, sleep, energy and medicines can help identify worsening or improvement.

Arrange prompt help if low mood is worsening, daily tasks feel unmanageable, or sleep and eating have changed substantially. Seek emergency support now if you may harm yourself, feel unable to stay safe, or have severe agitation, confusion or loss of contact with reality; contact local emergency services or go to the nearest emergency department.

Could my symptoms fit persistent depressive disorder, a major depressive episode, or another condition? What treatment options suit me? How will we monitor safety, sleep and side effects, and what should I do if my mood suddenly deteriorates?