Can depression recur?

Written by Pang Ji Cheng
Psychiatry and Psychology
Updated on September 08, 2024
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Relapse in patients with depression is a relatively common issue in clinical practice. Large-scale studies have found that even with systematic, standardized treatment with sufficient dosage and duration of antidepressant medications, still 15% of patients do not achieve clinical recovery. Even with persistent standardized treatment, the relapse rate remains at 20%. If treatment is discontinued, the relapse rate can rise to as high as 85%. For patients who have recovered, there is still a 20% chance of relapse within six months. 50% of patients relapse within two years after their first episode. Therefore, the relapse rate is higher in patients over the age of 45. Thus, depression is characterized by a high rate of relapse, yet it is also highly treatable. Therefore, during the course of pharmacological treatment, psychological and physical therapies should be concurrently employed as adjunctive treatments to improve cure rates and reduce the likelihood of relapse.

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What is the depressive mood of depression like?

Patients with depression primarily exhibit symptoms of low mood. They often experience persistent sadness and pessimism. Patients might find it difficult to feel happy, appear gloomy, and are unable to experience joy, particularly in activities that they used to find interesting. In severe cases, they might feel hopeless, in despair, and have thoughts of death, leading to an overwhelming sense that each day is unbearably long. Furthermore, patients might feel that life isn't worth living and that their existence has no meaning, which can lead to thoughts or actions of suicide or self-harm. In this emotional state, their self-evaluation is also typically low; they might feel utterly worthless, viewing themselves as a burden on their family and a parasite in society. Thus, feelings of worthlessness, helplessness, despair, and self-blame are significantly more pronounced.

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Causes of Postpartum Depression

The main reasons for postpartum depression occur because, after childbirth, there is a sharp change in hormone levels in women, which often leads to the development of postpartum depression. Additionally, aside from hormonal changes, there are also psychological changes in women after childbirth. Women may struggle with poor adaptation postpartum, as well as a lack of clear role identification and acceptance, leading to contradictory emotions that they find difficult to manage under normal stress. This situation is prone to lead to depression. Moreover, women tend to be physically weaker after childbirth, experiencing fatigue and physical discomfort, which can also affect their emotional state. Furthermore, the lack of care from family members or the husband can make it more likely for postpartum depression to occur.

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Written by Pang Ji Cheng
Psychiatry and Psychology
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Symptoms of depression

The symptoms of depression almost always include persistent low mood throughout most of the day, and patients generally lack interest or pleasure in all activities. Patients may exhibit psychomotor agitation or retardation, and experience fatigue, weakness, and feelings of inadequacy. They may feel that their lives are worthless and meaningless, have feelings of self-reproach or guilt, and suffer from poor concentration and indecisiveness. Recurrent thoughts or behaviors of suicide may occur, and some patients may even make specific plans for suicide. Therefore, these are the primary symptoms of depression. Some patients may present primarily with physical symptoms, such as dizziness, headaches, palpitations, frequent or urgent urination, and gastrointestinal discomfort. It is important to conduct relevant examinations to avoid misdiagnosis.

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Written by Pang Ji Cheng
Psychiatry and Psychology
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What causes depression?

The causes of depression are not yet clear, and it may be closely related to multiple factors such as biological, psychological, and social factors. Firstly, from a biological perspective, depression may involve genetics, biochemical factors, and endocrine factors, especially closely related to the secretion of serotonin and norepinephrine. Secondly, psychological factors. The psychological characteristics and personality traits of patients, especially before the onset of depression, are closely related. Particularly, individuals with a depressive disposition are often more likely to develop depression. Thirdly, social environmental factors. Particularly, encountering major negative life events is often an important contributing factor to clinical depressive episodes. Therefore, the onset of depression is not caused by a single factor, but likely the result of multifactorial interactions, ultimately leading to the disease onset.

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Written by Pang Ji Cheng
Psychiatry and Psychology
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Can people with depression occasionally feel happy?

Patients with depression may occasionally feel happy, but they predominantly experience low mood throughout most of their days. Patients perceive a significant and persistent sense of low spirits, pessimism, and despair. Their mood is such that they cannot feel joy, and they often seem easy to recognize by their facial expressions – furrowed brows, frowning, and looking deeply worried. Thus, these patients feel downhearted; nothing seems to interest them, they feel as if something heavy is pressing on their heart, devoid of pleasure, often crying, pessimistic, despairing, feeling as if each day lasts a year, and life not worth living. Sometimes, patients may feel that life is meaningless, hence might engage in self-harming or suicidal behaviors, blame themselves harshly, and have trouble concentrating. However, it's not that patients never experience happiness; it's just that they are in a depressed mood most of the time each day, with only occasional moments of happiness, which are relatively rare.