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An Unexpected Aspect of Remission from Depression
I recently was visited by a patient who I first met about two years ago, when she was in her late fifties. “Ariel” had chronic depression and anxiety and was referred by her therapist of nine years for consultation.
Ariel first experienced symptoms around age 16. From that point on, she was never completely free of depression. During the next 10 years, she had intermittent symptoms, but a series of tragic life events seemed to solidify her illness, leading to a persistent and severe major depressive disorder. By the time I saw her, she had failed not only long-term psychotherapy, but also 17 antidepressant trials. She was having daily suicidal ideation that was increasingly difficult for her not to act on.
Based on her history and her reluctance to try electroconvulsive therapy (ECT), I recommended transcranial magnetic stimulation. Ariel agreed, and I treated her with a course of this therapy—to which she had a dramatic and life-changing response.
Thankfully, nearly two years later, Ariel remains in remission. She wanted to see me to let me know she was doing great, working, and building her first home. She also wanted to tell me that getting used to living without depression was unexpectedly difficult.
As strange as it sounds, she said that it was like learning how to function all over again. While she was incredibly grateful to be free from the burden of the crushing symptoms, she felt like she had to get to know herself and others all over again. She wanted to know if this was normal and if I had heard similar reports from other patients.
I told her that, yes, I had heard this from others, and that I thought that it was a reflection of the way in which depression touches nearly every aspect of a person’s life, striking at the very core of what makes us the people we are.
Have you treated a patient who experienced difficulty in adjusting to live after depression? How do you help?
Chris Bojrab, MD, is the president of Indiana Health Group, the largest multidisciplinary behavioral health private practice in Indiana, established in 1987. He is a board certified psychiatrist and a Distinguished Fellow of the American Psychiatric Association who treats child, adolescent, adult, and geriatric patients. His areas of interest include psychopharmacology, sleep disorders, and gambling addiction. For more information and disclosures, visit www.chrisbojrabmd.com
The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors.
