The objective of this article is not to delve into the broad topic of depression nor to focus on its treatment as we have done in other articles, but rather to convey to the reader a personal experience that, as a doctor, I have accumulated over many years. of exercise; This is the anguish that many patients express when the symptoms of their major depression They take time to disappear even if treatment has been instituted (especially during the first weeks), making them impatient and repetitive when expressing their desire for improvement.
In these situations, the depressed person feels such a need to cure himself (not only improve but do it quickly and completely) that he loses objectivity when asked about his evolution (“I’m the same as I was at the beginning” “this doesn’t improve anything”), he shows pessimistic regarding his evolution and not recognizing the signs of improvement that he may be showing, such as, for example, recovering his appetite somewhat, being able to shower and get dressed after several days (or weeks) of pajamas and abandonment, or tackling small tasks that he previously had to do. were impossible (preparing breakfast, reading a little…), data that are perceived by the patient’s environment but not enjoyed by him if he persists in the obstinacy of wanting to “be completely well” from the beginning.
These complaints (which are typical of the beginning of the depressive process) should not be confused with the late residual symptoms that appear in at least 20% of patients and can occur in up to 74% of depressions; The persistence of these symptoms beyond 3 months from the start of taking the antidepressant should be considered as an attenuated form of chronic depression with a tendency to relapse.
Residual symptoms are more common when there is a history of previous depression. Similarly, the persistence of residual symptoms indicates a risk of new depression up to twelve times greater than in patients who fully recover and do not present them.
The five most common residual symptoms are decreased pleasure or interest (the most common); sad mood (the second most common); sleep disorders; asthenia; physical discomfort and/or chronic pain (they are the most resistant to treatment).
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However, these are not the symptoms to be treated in this presentation aimed only at exposing the situation of distressing rush to be cured that appears in some major depressions, especially in anxious patients and exclusively in the first weeks of the depressive process. We will therefore leave the issue of residual symptoms in the pipeline as a pending subject to be addressed in a new article.
How long does it take for some improvement to appear in major depression?
Once depression is diagnosed, it is common for the patient to feel disconcerted, frustrated, and to experience feelings of worthlessness as they are unable to cope with their occupations. All of this is usually associated with a feeling of doom and an urgent demand for solutions made desperately to the doctor in charge of treating the process.
This situation is experienced with anguish by the patient (also by his family and even by the health professional) and complaints are frequent because depression has come over him at a moment. especially inappropriate (“something must be done as soon as possible” “now I can’t afford to be like this”), circumstances that encourage victimhood (“why precisely me” “I don’t deserve this” “why now”) and making demands of urgency to the psychiatrist to obtain an immediate cure.
In this phase of Rage and impatience (which not all depressed people go through) a lot of stress is generated and there is a great risk of abandoning the medication, since antidepressants take between 2 and 4 weeks to act and the patient believes that they are not having an effect. These are conflictive weeks in which it is very important that both the psychiatrist and the psychotherapist offer support to the patient and listen to them with empathy, although without succumbing to their impatient demands.
The health professional must inform the patient that their depression has a course, times and stages for which there are no shortcuts, stages that must be faced with patience until the medication adjusts and takes effect.
Finish reading the full article in Clotilde Sarrió’s specialized blog.