What’s worse than depression? Double depression:

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 is not a new concept, but psychologists know little about the characteristics that distinguish double depression from dysthymia or major depression alone, according to Joiner.

The thing that’s always bothered us about the diagnosis of depression is that it’s often applied to people that have miserable lives and, therefore, have every reason to feel terrible. Sometimes traps are inescapable, sometimes problems are insoluble, and sometimes there is no reason to feel hope, or to have faith in the future. That one’s life is bad and is only going to get worse as they get older, deteriorate and die, on top of all their other problems, is a very real situation.

They 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.”

Is a person with insoluble financial problems double depressed? Is someone facing a terminal disease double depressed? The idea that, if one can’t face unmitigated horror with a sense of hope for the future, means that some is therefore suffering from a pathological mental disorder is dangerous. Because then we don’t have to worry about doing anything about their situation, we can say that it’s all in their heads.