# Prevention of depression



## Into The Light (Sep 25, 2006)

once i recover completely from my depression i would like to know if it is possible for me to prevent myself from ever going through it again. this is the second time i have suffered it. the first time i did not get help with it, this time i am. i know statistics are high nce you've had it more than once but i would really like to know what i could do to stop this from happening again.

thanks.


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## Retired (Sep 25, 2006)

*Re: prevention of depression*

I don't know if there are any guarantees that once the illness of depression has been treated successfully and that the person has not had a relapse for a specified time that the potential for relapse can be ruled out.

My understanding from the reading I have done, and I am _not_ a clinician, is there is always the potential for relapse.  

However it appears that with time, the occurrence of relapse can be less frequent and less intense, and as one becomes familiar with the illness, can weather a short term relapse with greater ease.

According to what I have read, being treated with anti depressants for the illness of depression, which attempt to return one's brain chemistry to a state that would preclude a recurrance of the illness,  can be a long term treatment.  IOW one can anticipate taking the medication for a long time to maintain the right brain chemical balance.

*Here is some statistical information on depression and relapse from Psychology Today*

Percentage of families of depressed patients manifesting significant family dysfunction: 50-75%

Proportion of families that continue to have significant dysfunction even after recovery of depressed member: 40-50%

Strongest predicator of relapse among depressed patients from dysfunctional families: Amount of perceived criticism

Percentage of depressed women who report marital difficulties: 50%

Lifetime prevalence of major depression, for women: 7%

Direct workplace cost of depression in terms of time lost per year: Over 172 million days

Assuming treatment, amount of time it takes for recovery of work function: 4 to 6 months.

Difference in long-term symptomatic effectiveness between drug therapy and cognitive psychotherapy: None

Increase in average relative risk of major depression in each successively younger generation born since 1935, in the U.S.: 1.9

Increase in average relative risk of major depression in each successively younger generation born since 1935, in Florence, Italy: 2.6

Increase in average relative risk of major depression in each successively younger generation born since 1935, in Christchurch, New Zealand: 1.3

Age at which a Parisian born before 1925 acquires a one-in-ten risk of developing major depression: 55

Age at which a Parisian born since 1955 acquires a one-in-ten risk of developing major depression: Under 25

Percentage of depression patients who recovered following 16 weeks of drug or psychotherapy and remained well during 18 months of follow-up: 24%

Rate of depression relapse for recovering patients: 33% to 50%

Two-year incidence rate of major depression in the offspring of depressed parents: 8.5%

Mean time to recovery for offspring of depressed parents exposed to a divorce in the family, in weeks: 66.7

Mean time to recovery for offspring of depressed parents not exposed to divorce, in weeks: 29

Two-year relapse rate of depressed patients treated by medication: 50%

Two-year relapse rate of depressed patients treated by cognitive therapy: 21%

Sources: Ivan W. Miller et al., Journal of Abnormal Psychology (Vol. 101, No. 4); Jim Mintz, Ph.D., et al., Archives of General Psychiatry (Vol. 49, No. 10); Cross National Collaborotive Group, JAMA (Vol 268, No. 21).


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## David Baxter PhD (Sep 25, 2006)

The other issue is that what you learn in therapy are to recognize early signs of depression so you can intervene before it becomes incapacitating, either through medication or CBT, and to use cognitive restructuring/reframing techniques to change the way you react to things to prevent the negatuive pessimistic thinking patterns that trigger depression.


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## Retired (Sep 25, 2006)

I've had the opportunity to discuss the way a couple of my friends deal with their illness.

Of course I didn't realize what she was telling me was a therapeutic technique, I guess she just figured it out on her own

She explained that although her depression is pretty well controlled with her anti depressant meds, she occasionally experiences a mild temporary relapse lasting a couple of days to a week.

She feels it coming and therefore gives her husband a heads up, and the husband is supportive so he cooperates.

My friend will "lay low" for the days of the relapse, and not get involved in activities that might be stressful of demanding.

She says she knows it's temporary and will be short lived, so she realizes there is a light at the end of the tunnel.


Does this fit the model you have described?



> recognize early signs of depression so you can intervene before it becomes incapacitating, either through medication or CBT, and to use cognitive restructuring/reframing techniques to change the way you react to things to prevent the negative pessimistic thinking patterns that trigger depression


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## David Baxter PhD (Sep 25, 2006)

Pretty much: Identify early warning signs. Identify triggers and try to avoid or minimize them. Use whatever techniques or strategies work to counter depressive thinking.

It sounds like your friend has it perfected.


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## Into The Light (Sep 25, 2006)

tsow is she on medication for life or is she still working on recovering from depression altogether?


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## ThatLady (Sep 25, 2006)

David Baxter said:


> The other issue is that what you learn in therapy are to recognize early signs of depression so you can intervene before it becomes incapacitating, either through medication or CBT, and to use cognitive restructuring/reframing techniques to change the way you react to things to prevent the negatuive pessimistic thinking patterns that trigger depression.




This has been the answer for me. I'm no longer on medications and I'm not in therapy. However, I am aware that if I'm unable to get a grip on my symptoms before they lead me into a downward spiral, I will need to get myself to a doctor with haste. I won't mess around with it, should it occur.


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## Into The Light (Dec 26, 2006)

has anyone had personal experience of symptoms returning and recognizing them fairly well on time? or does it sneak up on you?

the dsm iv manual states that one is depressed if one has a certain set of symptoms for at least 2 weeks. does this mean that once you've got those symptoms for those 2 weeks that they won't go away on their own?


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## ThatLady (Dec 26, 2006)

The first thing you need to think about is whether or not there's anything going on in your life that might be causing the symptoms. We all get down from time to time; especially, if there are stressful or upsetting events taking place in our lives.

If that's the case, the symptoms may well disappear as the stress is relieved. However, if there's no explanation for the symptoms and you're still feeling them after a couple of weeks, you probably need to see your doctor for a good check-up. That will ensure there's nothing physical causing the problem. If a physical cause is ruled out, and the symptoms persist, you may need to look into getting some therapy and, possibly, medications to get you back on track. The faster you face the issue and deal with it proactively, the more likely an expeditious end to the depression can be achieved.


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## Banned (Dec 26, 2006)

ladybug said:


> has anyone had personal experience of symptoms returning and recognizing them fairly well on time? or does it sneak up on you?



Hi ladybug,

I've gotten pretty good at recognizing when a depressive episode is coming on.  I can usually catch it early enough and be able to do something about it.  Sometimes it blindsides me and I feel "stuck".  I've been able to fight through most of them though and prevent them from becoming full-blown depressive episodes.  Something else I noticed with me is that if it's been awhile since I've been depressed, I'll do something to bring it on.  I've operated my whole life in depression and it still seems scary for me to be living outside of that world.  Every day is a victory and I've done amazingly well in the last six months, but I have to watch myself that I'm not doing anything intentionally.  My therapist and I have talked about ways I would do that and she's pretty good at keeping on top of it too.


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