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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Written by Pang Ji Cheng
Psychiatry and Psychology
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What medication is used for depression?

The medications commonly used for depression in clinical settings are selective serotonin reuptake inhibitors, primarily used to increase serotonin levels in the patient's brain to improve depressive symptoms. Representative drugs in clinical use include paroxetine, sertraline, fluoxetine, fluvoxamine, citalopram, and escitalopram. There are also medications that inhibit the reuptake of both serotonin and norepinephrine, such as venlafaxine and duloxetine. Additionally, there's a type of antidepressant that acts on norepinephrine and is specifically serotonergic, with mirtazapine being the main drug. These medications are considered modern antidepressants and have a relatively significant clinical efficacy. Of course, there are also traditional tricyclic and tetracyclic antidepressants, which are not recommended as first-line treatments in clinical settings due to their more adverse reactions. (Please follow a doctor's guidance regarding the use of specific medications.)

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Obstetrics
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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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Is depression hereditary?

Depression has a certain hereditary tendency. Studies involving large samples have found that if first-degree relatives of patients with depression have the disorder, the incidence of the disease in their offspring is significantly higher than in the general population. Additionally, studies on twins have shown that the concordance rate of depression in monozygotic twins is significantly higher than in dizygotic twins. Research in genetic studies has revealed that depression is a polygenic disorder. Therefore, it is possible for offspring of parents with depression not to inherit the disease. The onset of depression is often influenced by genetic factors, biochemical factors, and various social and psychological factors. Thus, the genetic probability of developing depression is generally higher than in the general population.

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Written by Pang Ji Cheng
Psychiatry and Psychology
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Can mild depression recur?

Patients with mild depression also have the possibility of relapse. Clinical research investigations have found that systematic antidepressant treatment can lead to clinical recovery in 85% of patients. However, even with persistent and standardized treatment, nearly one-fifth of patients still experience relapse. This signifies that some patients may have a relapse rate exceeding 70% if they cease treatment. For those who recover, there is still a one-fifth chance of relapse within six months, and nearly half might relapse within two years after the initial episode. Therefore, relapse is a significant challenge for depression patients. Thus, treatment should be systematic and standard, including pharmacotherapy. Additionally, psychotherapy plays a crucial role in treating depression by improving patients' irrational cognitive patterns and adjusting their cognitive reconstruction systems, ultimately achieving a healed state.

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Written by Pang Ji Cheng
Psychiatry and Psychology
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What should I do about depression?

Once diagnosed with depression clinically, it is necessary to optimize and grade the treatment based on the severity of the patient's condition. Particularly for patients with moderate to severe depression, clinical doctors primarily consider pharmacotherapy, especially drugs that improve neurochemicals like serotonin and norepinephrine in the brain. The first-line medications recommended are serotonin reuptake inhibitors. In addition, during the medication process, it is important to ensure adequate dosage, full treatment duration, and systematic standardized treatment throughout the course of the disease. Additionally, in terms of psychological and physical therapies, cognitive-behavioral therapy is predominant in psychological treatment. It includes helping patients identify emotions, thoughts, behaviors, and effectively reconstructing systems to achieve therapeutic goals. For physical therapy options, repeated transcranial magnetic stimulation, light therapy, and electroconvulsive therapy can be considered. (Please follow professional medical advice for medication usage.)