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Keeping Depression at Bay

Keeping Depression at Bay

Some people have only one episode of depression, but many have problems and recurrences that may last a lifetime. In the U.S., about 6.7% of adults have depression every year. 

The risk of recurrence

Some people are more at risk for recurrence than others.

Depression is more likely to recur if:

  • You have had 1 or more episodes of depression in the past.

  • Your depression has gone untreated for a long period.

  • You have lingering symptoms of depression, even after treatment.

  • You've had a past episode of severe depression with suicidal thoughts or very poor functioning.

  • Other family members have been diagnosed with depression.

  • You abuse alcohol or drugs.

  • You have a lot of stress in your life.

  • You have other mental problems or serious chronic physical health problems.

If any of these situations apply to you, tell your therapist. He or she can help you weigh the risks and benefits of stopping treatment.

Ongoing drug treatment

If antidepressants have worked for you, your therapist will probably suggest that you continue your drug treatment for at least 6 to 9 months. At that point, you may decide to continue the treatment. Or you and your therapist may try lowering your dosage or decide to stop the medication.

Mental health experts say it's important to watch out for suicidal thinking in a person who is starting drug treatment. This is especially true for children and teenagers.

The FDA advises health care providers, patients, families, and caregivers of adults and children to closely watch anyone who is starting therapy with antidepressants. Also closely watch when doses are either increased or decreased. Depression may get worse and the person may have suicidal thoughts at either of these times. The FDA also says that a person taking antidepressants should also be watched for anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, severe restlessness, hypomania, and mania. This is especially true for a person who has bipolar disorder.

The FDA issued a warning in September 2004 that antidepressants may cause some children and teenagers to become suicidal. But the overall risk for suicide is low. If 100 people are given the drugs, 2 to 3 more will become suicidal than would have had they been given placebos. What's important is to carefully watch the person's behavior and encourage to person to share any suicidal thoughts. 

Ongoing psychotherapy

Ask yourself the following questions if you've been using psychotherapy to treat your depression:

  • Am I feeling better?

  • Do I understand my problems or myself better?

  • Have I made the changes I wanted to make?

  • Do I believe I can maintain these changes?

  • Have I met my goals?

How often and how long you'll need psychotherapy depends on your goals and on the type of psychotherapy used. You may have learned what you need to know to change your behaviors and have better control over reactions to stress or triggers for your depression.

But you may need maintenance visits if you slip back to old patterns. For some people, the ongoing support of the therapist is key to maintaining stability.

In any event, you should always discuss your thoughts about discontinuing treatment with the therapist. Stopping abruptly can be at least self-defeating and sometimes dangerous; it may even be a sign that your depression is worsening.