Dr. Tracey Marks
Can You Fully Recover From Depression?
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In this video, I'm going to talk about
whether or not it's possible to fully recover from depression and what you can do to increase
the chances of recovery. I'm Dr. Tracey Marks, a psychiatrist and I make mental health education videos. This video is based on
a viewer request from X, that's a shortened version of the name to talk about euthymia and
what it means to be euthymic. I expanded the topic to include recovery, which is not the same as being euthymic. Euthymia means having a normal mood state. In depression, you have
recurring episodes of dysthymia, which is a low mood state. And that state of dysthymia
includes your mood and other symptoms that come
with a depressive episode. Then when the episode resolves, you return to a euthymic state, which is your baseline state. Some people think of euthymia
as being symptom free, but that's usually not the case. Most people have some lingering symptoms, even at their baseline state. And here's what I mean by that. Depression is a chronic
illness that can come and go, over the course of your life. About 40% of people recover
from their depressive episode, within three months and 80%
will recover within a year. And this is spontaneous recovery
if you do nothing about it. Then the remaining 20% of people can develop chronic symptoms that can become what we call
persistent depressive disorder. By the way, this pattern refers unipolar depression and not bipolar depression, which behaves a little differently as you can have alternating
episodes of depression or mania as part of the illness. There are factors that lessen the chance that you will have the quicker
recovery within three months or even complete recovery
without medication. These factors are having severe symptoms that include psychosis, having a lot of anxiety
with your depression and having a personality disorder
underneath the depression. If those factors are present, you have a greater chance
of having a longer episode or having chronic symptoms. Although depression is a recurring illness that comes and goes, if you have a first episode, the longer you stay in remission, the greater the chance you
may not have another episode. So, let's say you suffer a loss of someone that you're close to and you grieve, but you also fall into a
depression on top of that grieve. You recover after several months and a few years go by
without another episode, it's reasonable to assume
that you may be someone who has the one off episode of depression that does not recur. Things that increase the chance of your depression coming back are, having a very severe previous episode, being very young when you
had your first episode and having multiple episodes. Once you start having
a recurring episodes, it's very likely that
that will be the pattern. Now, keep in mind, what I'm talking about with
these risks of having a return of your symptoms is if
you let the illness come and go naturally and do
nothing to intervene. Some people can have
their symptoms resolved with medication treatment
and remain stable for years, without any significant symptoms. And that brings me to
what we consider recovery. Another word for recovery is remission. The “Psychiatric Diagnostic Manual,” defines depression remission
as having at least two months with no significant symptoms. Partial remission is when
you have some symptoms, but not enough to meet criteria for still being in a
major depressive episode. Notice the definition for full remission is not zero symptoms, but that symptoms that
are not significant. I think it's more often than not that people have some leftover
symptoms that are manageable, but not completely gone. And the Star D Trial
supports this conclusion. It was a huge landmark study, funded by the National
Institutes of Health from 2006 that looked at how many
people achieved remission from some of the common antidepressants. Sadly, that study showed that the highest responding group that achieved remission was only 33% and that's pretty low. 33% is still a minority. And to make matters worse, the study defined remission
as scoring a seven or less on the Hamilton Depression Scale. Here's what that scale looks like. It has 17 items on it that
represent symptoms of depression and the items can get
a score of zero to four with zero meaning it's
not a problem at all and four meaning it's pretty bad. So, here's what a score
of seven can look like. You can score zero for
having a depressed mood if you feel like your
mood is back to normal, but you can get one point for having mild indigestion or diarrhea. And one point for waking up
in the middle of the night, you can get two points for
being tired all the time. And another two for having no sex drive, then another point for being
fidgety because you're tense. That's still a lot of things going on, yet you're considered to be in remission from your depression, according to this big authoritative study. So, even though it's still a lot of stuff, none of the symptoms are
severe enough to hold you back in major areas of your life. Having no sex drive may
impact your relationship or it may not if you've got
other positive things going on and you're still able to be active, even though you're not the initiator. Also some of these things, like waking up in the middle of the night, may be long standing issues or
influenced by other factors, like having a pain problem that wakes you up in
the middle of the night or a snoring spouse or barking dog. So, at the end of the day, what does all this mean
when it comes to depression? It means that when you are determining
your level of recovery, you have to consider that you will likely not be symptom free, but still have some mild symptoms that you may or may not have
had before you had the episode. And some of these symptoms, may be affected by your life situation. Also, you have to accept that you can have wellness
within the illness. And this is where the
silver lining is here. On the one hand, the results of the Star D Study show or at least make depression
treatment look pretty grim. To say that at best only a
third of people reach remission, where remission is defined by still
having a lot of symptoms, sounds pretty discouraging. However, these results reflect
the heavy focus on pathology and illness management that
is traditional psychiatry. But over the past 20 years, there has been some shift
toward what some call, positive psychiatry. It started with positive psychology and psychiatry is falling in line. What's the difference between traditional and positive psychiatry? The positive psychiatry framework, takes a more holistic approach
to address overall wellness. Instead of mostly managing pathology with a positive psychiatry view, we look more at prevention of symptoms by reducing risk factors and
identifying protective factors, which are the things that can
help prevent future episodes, like being a part of a
supportive community, prioritizing self-care and using
adaptive coping mechanisms. If you do develop symptoms, the treatment focus is on achieving your
best level of recovery, increasing overall wellbeing
and building resilience. So, in the case of
someone who gets depressed and then gets into remission
with medication or therapy or let's say it goes away spontaneously, the next step is to work
on lifestyle maintenance to keep the illness away or
minimize residual symptoms. What would some of those things be? Prioritizing your sleep to get seven to nine hours each night. And that is more than saying to yourself, “Yeah, I'm going to work on that.” It's a whole process of
sleep hygiene behaviors that you have to attend to. The Mediterranean diet
continues to be shown in studies to treat depression symptoms, independent of other treatment methods. Food is not something that's just going to snap
you out of depression. The effect of changing
your diet takes time. But when you add these natural things, like sleep, food, exercise,
self-care, meditation or some other kind of
mental strengthening, these things produce accumulative effect, like compounding interest. You get more benefit over time and that's how you can break through this dismal 33% recovery prognosis. Medication isn't the only
answer in neither is therapy. Taking a whole body and mind approach is the way to maximize your
mental and physical wellness. Watch this video for more
on what exercise does for your brain. And then I have a nutritional
psychiatry playlist that dives deep into how
food treats your mood. Thanks for watching, see you next time.
#Fully #Recover #Depression
source
I had depression for many years. At first, I didn't know that I am depressed but after a few years I hit rock bottom, and it got so bad. My depression reached the max point and one day it just clicked to me what was going on. I had no hope to even get a little better. I had to do something but thanks to depression I couldn't do anything. I tried to get better for 3 years, and I cried my way through it. I never reach the full recovery, but it got so much better. If you are depressed, I know how you feel, and I remember I used to mock every encouraging comment I saw when I was depressed. I told myself this people don't know what they are talking about and just want to give me fake hope and what some comment can do for my pain. I have to say I found 1 important reason that I wanted to heal for and decided I just trust and fight for it cause if I do nothing, I would be losing the battle against depression for sure. I got better and worst and this repeated every time. I cried a lot. I hated myself my life and whoever and whatever caused me to be like that. I used to believe that those survivors didn't actually have it hard. They had a loved one to fight for they had parents, friends, lovers, pets, money… I was just in pain and had no reason to live for. I thought If I die it wouldn't actually be bad for anyone and it benefits me and others. I wouldn't tell anyone because I didn't want my pain to be called fake or unimportant. I didn't want people to think I am a pathetic attention seeker. I know a sad person is just burden to others. I wrote this for other depressed people that think how I used to think. If you reached this far, I pray with my soul for you to understand this is not your fate or truth or personality. This is a sickness and as long as you understand this you can fight it. Life is really hard but if you are given this life, you should use it. You have rights and emotions as much as others. You can take space in this world. If you are born you are chosen for this opportunity so stop guessing if you are worthy or not, that has been decided already. Life is not great we are not great but there are still a lot you can do with your life you just can't see it for now so hang in there until you can see that light.
Thank you!
Dr. Marks. I just stumbled onto this video. I have just entered therapy and I'm hearing a lot of "shifting your perspective," but isn't think just lying to yourself to try to make you feel better?
I have been depressed for 6 long years….i am so done 💔
Depression after sobriety. Day 106
There's no such thing of fully recovering. Ever. Realistically it's not a goal you want. It's natural.
I think sadly depression could potentially be permanent .
Finding a corrective strategy that does indeed work over time and that you can stick to, is a solution. Having the available resources of talking therapy- specifically CBT and medications are essential and not as accessible as they should be however. This clip was a lot of text book babble for me. Remember depression and depressive behaviours are always at their root linked to underlying unresolved emotional trauma.
Trauma does not have to only constitute a single or several instances where your psyche and emotional state was compromised i.e. via an overwhelming sensory experience, it can also take the form of conditioning i.e. neglect, lack of social connection and isolation over a long period of time. Habituated clinically defined depressive behaviours can be countered and informed by psychiatry and statistical analysis but of the most fundamental importance is to address underlying unresolved emotional needs, combined with science, to form a strategy.
Consistency is key, scientific analysis is valuable. Having a skilled professional who really has the ability and talent to connect with you at your most vulnerable in a true, human and authentic way is most important.
NIH is showing more and more corruption. It seems that it's all about pharmaceuticals and getting $$$$.
No alcohol
I have months ofnbeing fine euphoric even and the months of being severely depressed.Could that be bipolar? and not major depression even though it feels like major depression
I've been suffering from depression and anxiety for years but I'm getting better thanks to meditation, though it's hard to stay well because all my family is severely depressed
Dr Marks is the real deal. Having had severe bouts of depression over 65 years what she explains matches my own experience. Very grateful for your guidance.
I forgot how feeling euthymic feels I’ve been in this dark whole for almost 8 years I don’t even know what to do anymore I lost all hope, I’m losing my 20s to depression all I remember of my teen years and twenties is sadness and despair when these are the “fun years” of life. It makes me so mad thinking I have to go through this why can’t I just be normal like other people? Not feel like I’m procrastinating life and avoiding everything just because everything is too much work or energy that I barely have. Such a depressing reality I honestly wish to end soon
What’s normal mood ?
Depression is the most cruel suffering that has to be experienced to understand.
Please. After all this time, all the medical "industry" can do is "best guess" about depression. And I'm convinced that even if there were a cure, it would never be made available to the public because of all the money that would be lost.
How does one's age play into this? When do we know when we need outside help?
I suffered depression due to injustice knowing your trigers is half the cure, seek nervous system regulation after such an impact folks don't ignore or skip this episode please
I recommend what helped me after diagnosis of Bipolar 2 (treatment resistant): ketogenic therapy.
From personal experience after 19 years on rx meds and told numerous times in the past that I'd need to be on meds the rest of my life by 2 highly credentialed psychiatrist MDs.
I am trying in all sincerity the therapeutic keto diet plus moderate exercise.
It's been working for me over a year.
I'm no longer on any meds as of 2017.
I had previously gained 135 lbs from rx meds for my most acute point of mental illness.
I lost 60 lbs after going off olanzapine and lithium, two of the meds that caused my worst weight gain.
In 2022 I lost 60 more lbs (120 lbs total after gaining so much weight from meds).
I lost it all on Mediterranean diet 50g protein a day).
I found I was unable to lose down to my original weight after months of weight loss plateau…15 more lbs to go.
I researched and discovered I was lacking protein and Vit B12.
So I increased my animal protein to 100g-130g per day, which caused my animal fat to increase even more, and I decreased carbs to <20g total per day.
Keto diet can be in different forms.
My type was Low Carb High Fat (<20g total carbs per day) started in 2024.
After reading Brain Energy by Chris M Palmer MD, I tried ketogenic therapy diet.
After a week, I had the best sleep of my life.
From there, over the next 4 months, my mood, energy, IBS symptoms were vastly improved.
I already walked briskly most days and did resistance training 3 days a week for years.
I leaned away from carbs almost completely, eating only animal protein and fat (got rid of all dairy except a little aged European cheese like gruyere & goat gouda).
Animal protein from grassfed beef, sardines, salmon for a 30-day trial.
This change significantly elevated my mood and energy results and led to breaking my weight plateau (we'll see how much, 12 lbs more is all I need).
So now I'm in my second 30 days of carnivore.
Always wondered if there are any studies on ways to improve provisions, reduce chance of losses so individuals dont get abandoned or left to suffer in all manner of ways by most societies?
Thanks
been in a deep depressive state now for a year. GAD Depression, and borderline personality disorder. i truly feel like it’s getting worse
Spaniards eat A LOT of bread. But if that is decreased everything else is quite good. Also, canned tuna would usually be sold in olive oil exclusively (as opposed to sunflower oil) and if you go out and buy fried food, for example, it'll usually be fried with olive oil too. Food for thought. 😅
EMDR worked for me
When you have to get up to go to the bathroom every two hours you will never sleep eight hours a night😂
Hello!
My name is Asmin, I am a senior psychology student, currently doing a research on the topic of depression (approved by ethics review board). I am conducting this research to learn more about the diverse experiences of people who are in remission from depression right now, how they understand resilience and what role it plays for their recovery now and also the narratives that surround the recovery.
Key criteria:
1.Being in remission from depression
2.Being in therapy now
Would anyone be interested in learning more or participating?
3.Adults (from 20 years)
Thank you!
Hello!
My name is Asmin, I am a senior psychology student, currently doing a research on the topic of depression (approved by ethics review board). I am conducting this research to learn more about the diverse experiences of people who are in remission from depression right now, how they understand resilience and what role it plays for their recovery now and also the narratives that surround the recovery.
Key criteria:
1.Being in remission from depression
2.Being in therapy now
Would anyone be interested in learning more or participating?
3.Adults (from 20 years)
Thank you!
Hello!
My name is Asmin, I am a senior psychology student, currently doing a research on the topic of depression (approved by ethics review board). I am conducting this research to learn more about the diverse experiences of people who are in remission from depression right now, how they understand resilience and what role it plays for their recovery now and also the narratives that surround the recovery.
Key criteria:
1.Being in remission from depression
2.Being in therapy now
Would anyone be interested in learning more or participating?
3.Adults (from 20 years)
Thank you!
I believe you can't avoid in this day and age.
Cet article sur la dépression contient plusieurs affirmations qui sont en désaccord avec l'état actuel des connaissances. 1) "S’il ne fait plus de doute aujourd’hui que la dépression est une maladie organique," On est autorisé à parler de maladie organique quand il est prouvé qu'une anomalie organique est la cause de la maladie. Pour la dépression rien de tel. Par exemple l'anomalie cérébrale la plus constamment associée à la dépression est une réduction du volume de l'hippocampe (une structure cérébrale impliquée dans la mémorisation). Cette atrophie est modeste (-1,2%) et uniquement détectable chez des patients souffrant de dépression chronique depuis des années. Par contre chez les patients présentant un premier épisode dépressif cette anomalie n'est pas observée. Cela suggère donc que l'atrophie minime de l'hippocampe est bien plus la conséquence que la cause de la dépression (voir Schmaal et col. 2016, Molecular Psychiatry, 21(6):806-812). 2) "Ainsi a-t-on mis en lumière les mécanismes biologiques de la dépression : un taux anormalement bas de sérotonine se traduit généralement par un état dépressif, un taux de dopamine trop faible par une perte de motivation. En jouant sur la quantité de neurotransmetteurs présents au niveau de la connexion entre deux neurones (ou synapse), les antidépresseurs permettent de rétablir leur équilibre." Cette théorie d'un déficit de sérotonine et de dopamine, qui serait la cause de la dépression, et qui expliquerait l'effet bénéfique des antidépresseur, a été invalidée depuis au moins vingt ans. Parmi d'innombrables articles on peut par exemple consulter : Delgado (2000), Depression: the case for a monoamine deficiency. J Clinical Psychiatry, 61(Suppl 6) 7-11. Cette théorie a été très largement mise en avant par l'industrie pharmaceutique pour promouvoir la prescription d'antidépresseurs, mais toutes les tentatives pour la valider ont abouti à des échecs. 3) "Les cliniciens et les scientifiques reconnaissent que les antidépresseurs ont leurs limites : 30 à 50 % des patients y restent, en effet, insensibles. " Selon la méta-analyse la plus récente et la plus exhaustive (Cipriani et col. 2018, The Lancet 391:1357-1366) l'efficacité des antidépresseurs peut se résumer ainsi: pour dix patients adultes souffrant de troubles dépressifs, deux sont en rémission après deux mois de traitement placebo et trois après deux mois de traitement par un antidépresseur. Autrement dit le traitement antidépresseur ne profite qu'à un patient sur dix, mais expose les neuf autres à leurs effets indésirables, dont des problèmes de sevrage. Selon les auteurs ceci prouve l'efficacité des antidépresseurs chez le patient adulte (25 à 65 ans). Les auteurs n'ont pas considéré les traitements plus longs car les études sont alors trop hétérogènes. Pour les patients plus jeunes, en particulier les adolescents, cette efficacité n'est pas démontrée, toujours selon les auteurs. On trouvera un commentaire critique de cette méta-analyse, et plus généralement de l'efficacité des antidépresseurs, dans l'article de Jakobsen et col. (BMJ Evidence Based Medicine, publié en ligne le 25 septembre 2019). 4) "La composante génétique de la dépression reste cependant avérée et importante." Cette affirmation n'est soutenue dans le texte par aucun argument. Il est souvent affirmé que certaines personnes présenteraient des risques génétiques les rendant plus vulnérables à la dépression lorsqu'elles sont exposées à des facteurs déclenchant comme les stress de vie. Cependant, aucune des interactions gène x environnement mises en avant à propos de la dépression n'a été confirmée (Border et col. 2019, American J Psychiatry, 176(5):376-387)
Cannabis in my early 20s imo made my mind weak ass hell, when something went wrong I'd flip out and over react, making things worst leading to depression.. for decades.. smoking weed is not worth is folks
Disabled veterans should leave or heal other wise we are useless garbadge cost the government to much and body and mind is unhealing horrible to be me
This channel has changed my life. Sincerely
From someone who recovered dramatically but later relapsed: you can recover to a point where depression feels like a distant past life. What helped me reach that point? A complete change in lifestyle. I went from having no work to a job I enjoyed, where I earned good money. I moved from boredom to living in a place with a vibrant lifestyle. I went from being single to being in a committed relationship. Many of the factors that brought my depression to the surface were addressed, giving me the chance to begin moving forward. I learned to respect myself more, practice self-love, and felt immense support and validation from my new circumstances.
So why did I relapse? After COVID, I lost my job, my support network, and my relationship. I was forced to move back to the dead-end town I grew up in.
What’s the lesson? While depression can feel like a constant due to the experiences that put us there, a change in lifestyle and attitude can spark hope—and hope can restore you.
As someone diagnosed with depression, One thing that has tremendously helped me in my recovery is having an amazing therapist and close, supportive and meaningfull friendships. Being able to converse with someone who understands my struggles and not willing to give up on me has helped me to be stronger and continue to make the best out of life. It allowed me to remind myself that despite my physical challenges and my situations that lead me to a depression, There are positive things about me and positives things i could achieve if i continue to live. Sometimes remembering those things about myself is difficult but being mindfull of my emotions and making the effort to remember my strenghts has all been worth it.
it is to say ; good diet
a good night sleep
exercise
etc, etc,
when one can’t eat, no appetite,
can’t even try to exercise
try very hard to sleep and so on
then what do you do?!?!
Depression is worse feeling every no one should go through it. Is really
wow this was so helpful. factual, practical, and measured. thank you!
does depression effect your memory.
I'm part of the 20%. Medication fixed my problem and I'm feeling normal now. Still a bit low but the medecine desvenlafaxine really helped me. Been on it for 4 days and it seems the tough part of the journey is over.
Your hair looks really good like that Doc.
I was completely cured with antibiotics thanks to a Chinese doctor who traced my severe depression to bad gut bacteria.