It the treatment of depression the goal is remission, but what does that mean?
A good way of thinking about what it means to achieve remission from depression is to imagine walking out of a dark tunnel. Walking into the light of day, out of the darkness of despair. Walking into life, and having a good shot at the pursuit of happiness.
Once depression is successfully treated it’s feels like it’s never been a problem. There are no residual, left over effects. People who achieve remission act well, look well, and feel well.
There are a number of technical definitions of remission, and numerous ways to measure depressive signs and symptoms. All of these are designed to help psychiatrists distinguish between response and remission.
In the treatment of depression response means that there is a significant reduction – a 50% reduction – in the symptoms of depression. Response is sometimes a step in the right direction, but it’s not good enough.
The standard in treating depression is to achieve remission.
In the treatment of depression remission means a a formerly badly depressed person is so symptom free that they could not be diagnosed with depression. They feel completely well.
A person in remission no longer fells the dread they once woke up with every day. They’ve decided to start doing new things. They’ve returned to feeling optimistic about the future. They’re back in touch with their happy chemicals.
A person in remission has a score on this test which is 75% reduced from their score when they were suffering from depression. We often see scores below 5 following successful treatment to remission.
A person in remission isn’t exactly cured, but they feel well. A good way of thinking about what this means is to consider that some patients with adult onset diabetes can eat properly, and lose enough weight, and exercise, and take pills. This person may put their diabetes into remission. They’re not cured exactly, but their life is vastly better because their diabetes is in remission. They may need ongoing treatment with medicines to stay in remission, but they feel well, and are not limited in their ability to enjoy life.
A person whose depression is in remission may still have a few symptoms of depression, but these symptoms are not bothersome. They have so few symptoms that it doesn’t matter!
When it comes to diagnosing depression, or to feeling clinically depressed the number of symptoms, and the severity of symptoms are both important. When depression is treated to response, people feel somewhat better, but they’re only half well.
When depression is treated to remission people feel well, and act well.
Remission is always our goal in treating depression. No other goal is acceptable for victims of depression in Augusta, Georgia.
Remission means feeling good, but STAR*D showed there’s much more to the story.
Yes, depression is often difficult to treat to remission. Depression can be resistant to drug therapies. It’s estimated that only about a third of people with major depression will achieve remission after starting antidepressants (Prozac, Effexor, Celexa, and all the others).
Magnetic stimulation compares very favorably to antidepressant medication therapy. It can be very effective when pills don’t work anywhere near well enough.
All across Georgia TMS does a lot of heavy lifting. It gives us renewed hope for depression’s victims, as we pursue our goal of stamping out depression worldwide beginning in our own backyard. In Augusta, depression treated to remission is our standard.