How Can Someone Recover from Depression?
While depression is a common and treatable illness, the individual affected is not the only one who suffers. If someone experiences a bout during their formative school years, the lost time in the classroom, suffering grades and attendance can have a major, lifelong impact on that person’s future.
Although the symptoms are painful and debilitating, depression is highly treatable. A combination of therapy and medication, or in some instances, deep-brain stimulation treatment, is the recommended course of action.
Most who seek effective treatment will not go on to experience a relapse, but half who seek treatment from their first episode of depression will have a recurrence.
An individual is not considered ‘cured’ of depression until they are symptom-free for at least four months. Sometimes, people will have a lessening of symptoms, but then they will return before the four-month period is up. If this happens, it is called a relapse.
A recurrence of depression is when someone is symptom-free for at least four months and then goes on to experience another depressive episode. If someone experiences two recurrences of depression, they are 80% likely to experience another. People who experience recurrences will have an average of between five and nine distinct depression episodes over the course of their lifetimes.
What does recovery from depression look like?
Depression has a high likelihood of relapse, and ongoing maintenance is required. Therapy is highly effective in staving off a relapse and preventing recurrence. Which course of therapy is most affective will depend on the individual and the type of depression they have.
With talk therapy, sufferers can discuss what is happening in their lives in the present, and how to respond to current stressors and events positively to prevent depression from reoccurring or to lessen the severity of their current symptoms.
Cognitive behavioral therapy (CBT) is a form of talk therapy that explores deeper thought patterns and beliefs. Sessions do not necessarily center around current life circumstances. This type of therapy is highly effective at treating mild to moderate depression, and for more severe cases, it has been found efficacious if sessions are led by a highly-trained therapist who specializes in the technique.
Patients in CBT are encouraged to explore their specific depression triggers. From there, they are prompted to explore their beliefs and thought patterns surrounding the triggers. Once these are thoroughly explored, patients are then prompted to change these negative thoughts into positive ones.
With new learned coping methods, patients can go on to make positive, life affirming choices. These changes in attitude and perspective can either prevent relapses or recurrences, easing current symptoms.
Furthermore, the act of making more positive choices when faced with stressors and triggers eliminates the possibility of negative consequences linked to choices made while under the cloud of depression. Studies have shown that less than 30% of patients were treated with CBT relapse, whereas 60% who were only treated with medication relapse.
Group therapy is usually not recommended for depression sufferers unless they have a comorbid drug or alcohol dependence. But, family and close friends are encouraged to work with their depressed loved one’s therapist, so they can help them maintain their recovery and maintenance plans.
What medications are used to treat depression?
There are several types of medications used to treat depression. If depression is treatment-resistant, a combination of medications from different drug classes is usually prescribed.
SSRIs are newer and effect the reuptake of serotonin, a brain chemical directly responsible for mood. SNRIs are similar and effect the reuptake of serotonin and also norepinephrine.
Norepinephrine is responsible for feelings of motivation, alertness, and energy. Some sufferers of depression will have a marked decrease in energy regardless of how much sleep they get.
MAOIs are an older line of medication, first prescribed in the 1950s. MAOIs inhibit the neurotransmitter MAO. MAO breaks down brain chemicals serotonin and norepinephrine. By preventing their breakdown, these chemicals responsible for mood and motivation can stay in the brain longer, improving the sufferer’s mood. These drugs are no longer prescribed as often; they can interact dangerously with certain fermented foods and alcohol, but they are still highly effective at treating depression and are sometimes used as a last resort.
How can someone stay on the right path after treatment?
Clinical depression does have a high relapse rate, but with the right support, about half of individuals go on to live a life free from the disease.
It is very important for depression sufferers to be aware of their specific triggers. Once aware, sufferers can avoid these triggers, within reason. If poor diet, poor quality of sleep or a stressful job are triggers, a person can easily fix their diet, make lifestyle changes to get enough rest, and once well, look into finding another line of work.
With therapy, patients can learn effective ways of managing unavoidable triggers or formulating realistic goals with a therapist.
It’s important that family and friends are supportive of their loved one’s efforts in recovery. Also, if loved ones are aware of the sufferer’s triggers and their ongoing treatment plan, they can lend their support, and help the individual stay on the path to recovery.
Patients must stay on their prescribed medication plan and avoid drugs and alcohol. If they presented with comorbid drug or alcohol addiction, they must continue to attend rehabilitation meetings and remain sober.
Relapse is incredibly common with people who stop taking their depression medication. After a period of time, they start to feel better and think they don’t need to continue medication. This is usually a mistake. Antidepressants require a period of weaning and monitoring. Sudden cessation can trigger a severe relapse of symptoms.
If patients are given adequate familial support and continue therapy sessions and medication under their doctor’s care, the risk of relapse and recurrence is lessened. Most depression sufferers who get help for their disorder can go on to live free from the disease.
What are deep brain stimulation treatment methods for depression?
ECT is a highly invasive technique but is effective for treating medication-resistant depression and other forms of severe mental illness; schizophrenia, bipolar mania, and psychosis.
ECT induces a brain seizure, and seizures alter the brain’s wiring. Patients usually feel relief from symptoms after the first session, but doctors typically prescribe three sessions a week for four weeks.
Patient’s must undergo an electrocardiogram prior to the first session. Seizures cause increased heart rate and blood pressure, and if patients have heart problems, they should not undergo treatment.
General anesthesia and muscle relaxants are administered for ECT treatments. Patients are unconscious and do not feel any pain. They can usually return to school or work after a brief recovery period.
Long-term side effects may include short or long-term memory loss, but this is rare. Short-term effects can include confusion, jaw pain, headache, nausea, or fatigue. These usually subside after about an hour, although some patients may need up to a day to recover.
This is a new treatment option and is much less invasive than ECT. It is an outpatient procedure, and it works by creating a magnetic field around the patient’s cranium. From there, a magnetic coil is put against the patient’s head and used to target specific areas of the brain. A low-dose electrical pulse is used to stimulate certain neural pathways in the targeted brain region.
Patients are usually prescribed four or five sessions per week for four to six weeks. Side effects are mild, including headaches or tingling of the scalp where the coil was placed and are typically resolved with over-the-counter pain relief medication.
Most patients who undergo TMS for depression find relief from their symptoms.