Are Mood Disorders Reversible?

Are Mood Disorders Reversible?

An exact answer to that question cannot be given; it depends on the individual patients and on many factors. We can provide you a rough overview of the usual prognosis of the common mood disorders, the statistical figures and factors that are associated with the prognosis.

Major Depressive Disorder

Depression can occur at any age; earlier onset depression causes fewer problems and usually responds to treatments. Whereas, late onset depression is milder and chronic, it is most likely to impact life events.

A mild-moderate depressive episode can last for 4 to 30 weeks and a severe episode can last for about 6 months to 1 year (25% of severe depression episode lasts for about 1 year).

10-20% of patients with depression will have a chronic course, with symptoms lasting for about 2 years.

Majority of patients with depression is likely to get a recurrence; it is hard to say an exact value as it changes with individual person. Usually the risk of recurrence is -30% at 10 years and drops down to -60% at 20 years.

The presence of residual symptoms after remission increased the risk of recurrence. E.g. anxiety, sleeping problems, low mood, reduced sexual drive, physical symptoms such as fatigue, headache

With the modern antidepressants most of the figures mentioned above are quite less. If treatment is continued for long-term, residual symptoms are less, the risk of recurrence is less and the chronicity of the disease reduces up to 4%.

  • Good prognosis is seen in depressive patients who got the disease at early stages.
  • Poor prognosis if following factors are present
  • Elderly patients
  • Low-self confidence
  • Residual symptoms
  • Personality disorders
  • Alcohol or drug problems
  • Lack of social support
  • Bipolar Disorder

After the 1st episode of bipolar disorder 40-50% patients get another manic episode within 2 years.

50-60% patients who are on the drug lithium take control of their disease. Usually 7% of patients on lithium do not have any recurrence, 45% get some episodes of in the future, and 40% had persistent recurrence.

  • Most of the time the cycling of manic episodes and depressive episodes increase with age.
  • Patients with recurrent depression have their first manic episode after the age of 50.
  • Good prognosis is associated with the following features:
  • Later age of onset
  • Few psychotic symptoms
  • Fewer ideas of suicide
  • No alcohol or drug abuse
  • Good compliance and response to treatment
  • Good social support
  • Poor prognosis with bipolar disorder is associated with the following features:
  • Early age of onset
  • Alcohol abuse
  • Presence of concurrent psychotic features
  • Depressive symptoms in between the period of depression and mania
  • Poor employment history
  • Male sex
  • Lack of compliance in treatment
  • Cyclothymic Disorder

The disorder initiates in early childhood or in young adults. There is 15-50% risk of developing bipolar disorder in a person with cyclothymic disorder. Some people recover completely and do not get any future episodes.

Persistent Depressive Disorder

Persistent depressive disorder is not reversible most of the time, as it takes a long time to recover and even after that if treatment is stopped it recur, sometimes even with treatment the symptoms can worsen. Most of the patients need to continue the drugs and/or the psychological therapy that made them better for life long.

Seasonal affective disorder and premenstrual dystrophic disorder are temporary.

Depression related to medical illness is reversible when the disease is treated. Depression induced by substance use or medication is reversible when the substance or drug is stopped completely.

Conclusion

An exact answer to that question cannot be given; it depends on the individual patients and on many factors. Depression can occur at any age; earlier onset depression causes fewer problems and usually responds to treatments. Whereas, lase onset depression is milder and chronic. 10-20% of patients with depression will have a chronic course, with symptoms lasting for about 2 years. After the 1st episode of bipolar disorder 40-50% patients get another manic episode within 2 years. 50-60% patients who are on the drug lithium take control of their disease. Usually 7% of patients on lithium do not have any recurrence, 45% get some episodes of in the future, and 40% had persistent recurrence. There is 15-50% risk of developing bipolar disorder in a person with cyclothymic disorder. Some people recover completely and do not get any future episodes. Persistent depressive disorder is not reversible most of the time.

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