Depression is a relapsing condition and it may at some point return. However, many of our patients have remained depression free for up to five years (and counting). Only a minority have begun to re-experience some depressive symptoms.
If meds have been tapered and a patient begins to relapse, then the options are to restart or increase medications or give a series of booster TMS sessions, often one to five in number if intervention occurs early.
One key element is to notify us quickly before the momentum has led to deep depression. Close monitoring and follow up is necessary. We continue to monitor each patient for 12 months after treatment and longer, if requested.
If depression lifts, as it often does over just several weeks’ time, this can have a number of benefits. Patients often state, “I have myself back”. Family and friends may be very excited things are better.
Psychotherapists often report the patient finally has enough energy to meaningfully participate in therapy, learn new skills, develop insight, or complete therapeutic homework.
This same change can be disorienting. As the ability to feel returns, so does the ability to pay attention to uncompleted life issues.
Many patients report some intensification of sadness and anxiety in the 4th to 5th week of treatment as they realize all they have lost while depressed or what monumental tasks face them.
One patient told us, ”When I was depressed I simply could not care. Now that I am better I have to face the fact that I have not filed taxes in 3 years, don’t have a job, have a mountain of bills, and two children at home who need me. I am overwhelmed.” Patients often struggle to differentiate this return of feeling from worsening depression.
Others struggle to find meaning in life without their constant despair or suicidal thoughts as a central organizing part of their daily life experience. Some fear abandonment by loved ones if they get better. All of these issues must be addressed.
Both our group sessions and your therapeutic skills are needed to help patients transition into a new life as someone with lowered depressive symptoms. While exciting, recovery is never completely easy.