Is Severe Depression Curable or Manageable? Setting Realistic Expectations

Apr 19, 20245 min
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Before we delve into the treatment and management of depression, I want to talk a bit about what I call ‘the burden of labeling’. Many people shy away from mental health evaluations because being diagnosed or “labeled” with depression or another mental illness can feel life-changing and daunting. This is especially true in a country like ours where mental health concerns are still shrouded in stigma and misinformation. I honor this reluctance. And I also believe there is value in identifying what you’re going through. Identifying one’s mental health concerns is the very first step in learning how to manage them. It helps us strategize management, as well as be more forgiving of ourselves when we are in the trenches. 

However, depression is not something to be self-diagnosed, though. It is important to consult with a mental health professional who can appropriately help you identify what you are experiencing. You can start by reading some of our blog posts on depression, here, here, and here

Clinical depression can be mild, moderate, or severe. This classification depends on the number and type of symptoms, and the extent to which depression interferes with one’s daily functioning and life. Once diagnosed, naturally, the question arises: is severe depression curable or manageable? Let’s look into this. 

Is Severe Depression Curable or Manageable? 

‘Cure’ means you no longer have an illness. An infection can be cured. An injury can be cured. Some physical illnesses can be cured. Management means a discomfort or disease is present, but you’ve learned ways to keep it from disrupting your life. 

Diabetes can be managed with dietary and other lifestyle changes, and medication, if necessary. Hypertension can be managed with medication and keeping stress levels low. Similarly, depression can be managed with a combination of medication, psychotherapy, and lifestyle modifications. 

For example, diabetes can be managed with dietary, lifestyle changes, and medication. Hypertension can be managed with medication and by keeping low stress levels. Similarly, depression can be managed with a combination of medication, psychotherapy, and lifestyle modifications. 

Clinical depression is often episodic in nature. This means that youone will have periods where you feel okay, your motivation, energy, appetite, sleep cycle, and hope for the future are at an optimum level, and you’re able to get through your day with ease. In other words, when the symptoms of depression are not present. At other times, you may find yourself experiencing symptoms such as feeling hopeless, tired, low on energy, changes in appetite or sleep, or loss of pleasure in activities. 

Both these periods can last for a varied amount of time. So while severe depression is not curable, it is manageable, and we can utilize symptom-free periods to learn ways to cope. For this, seeking the right treatment is important. So, you may wonder, ‘What is the best therapy to treat depression?’ Let’s break this down. 

What is The Best Therapy to Treat Depression?  

The trifecta of the management of depression includes medication, psychotherapy, and lifestyle modification. In severe cases of depression, treatments like ECT and transcranial magnetic stimulation are also recommended. The right combination depends on the individual’s history and the severity of symptoms. 

Medication

The medication for depression is prescribed by a psychiatrist, and it is common to precribe different types of antidepressants based on the client’s needs. and different types of antidepressants are commonly prescribed. In India, there is quite a bit of stigma attached to psychiatric medication. But think of it this way: depression can sometimes feel like seeing the world through smudgy glasses. Medication helps you clean the glasses so that you can see more clearly. 

Feel free to bring up any concerns you may have about medication with your healthcare provider, including side effects, dosage, or any emotional discomfort you may have about taking medication. 

Psychotherapy 

Psychotherapy provides a safe space for us to understand and make sense of our inner lives. For depression, in particular, psychotherapy can help us identify negative thought patterns we may have, strategize how we navigate triggers and episodes, and give us tools to strengthen our social support systems. Some of the treatment modalities for depression recommended by the American Psychological Association are Interpersonal Psychotherapy, CBT, and psychodynamic psychotherapy. 

Don’t hesitate to ask your therapist what is their treatment approach for depression is. If this is your you are seeking therapy for the first time seeking therapy, you may have questions about the process, timeframe, frequency of sessions, length of sessions, and so on. Feel free to ask anything that can help you gain more clarity about how psychotherapy can benefit you.   

Lifestyle Modifications 

Depression is a mood disorder that impacts us at a physical as well as a mental level. A healthy, balanced diet and regular exercise can help both prevent and ease episodes of depression. Our mental health and our sleep cycle are also closely tied. Poor mental health affects our sleep cycle, and poor sleep can sometimes exacerbate symptoms. Therefore, maintaining good sleep is an important part of lifestyle management.  Additionally, some stress management strategies can also have long-term benefits when it comes to managing depression. 

To sum it up, the best therapy to treat or manage depression is one that helps you holistically. Medications help to ease the biological aspects of depression. Psychotherapy helps with understanding our patterns and triggers whilstwhilste equipping us with helpful coping strategies. Lifestyle management helps us manage the severity and frequency of episodes. 

Setting Realistic Expectations 

An important thing to keep in mind is that our mental health journey is not linear. We go two steps forward, one back. Sometimes, we may be able to cope with low periods with more ease than before. Sometimes, we may not. It’s important to remain compassionate toward ourselves and take some time to examine and understand how depression shows up for us. 

Therapy can help you understand your patterns and triggers. With the help of your therapist, you can gain insight intoabout periods or circumstances that may make you more vulnerable to an episode. Once you understand these patterns, you can find ways to take preemptive measures. For example, some people can feel an episode coming in - maybe they find that they’re sleeping more than usual, or don’t have much appetite. Knowing what these signs are can help us get support and help before things escalate. 

Lastly, remember that while depression can sometimes feel all-consuming, it is not your entire identity. Invest in things you enjoy. This may be your loved ones, a creative pursuit or a hobby, traveling or volunteering. Having a healthy and supportive social circle can provide much-needed comfort when living with depression. Find people - even if it’s one or two - who understand what mental health and, in particular, depression is,  - and can support you through difficult periods.

References: 

Apa.org. (2022).  https://www.apa.org/depression-guideline/decision-aid-adults.pdf 

‌Cleveland Clinic. (2023). Antidepressants. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/9301-antidepressants-depression-medication 

Health (UK), N. C. C. for M. (2010). The classification of depression and depression rating scales/questionnaires. In www.ncbi.nlm.nih.gov. British Psychological Society. https://www.ncbi.nlm.nih.gov/books/NBK82926/ 

‌Herndon, J. (2018, April 4). Can You Cure Depression? How to Manage Symptoms. Healthline. https://www.healthline.com/health/can-you-cure-depression 

How to Choose the Best Type of Therapy to Treat Your Depression. (n.d.). Verywell Mind. https://www.verywellmind.com/types-of-psychotherapy-for-depression-1067407#toc-psychotherapy-for-depression 

Kietner, G.I. et al (2006). Realistic Expectations and a Disease Management Model for Depressed Patients with Persistent Symptoms. J Clin Psych 67:9.

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Prachi Gangwani
Therapist | Yoga Teacher | Author of Dear Men: Masculinity and Modern Love in #MeToo India