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How do I know if I am 100% recovered from depression and anxiety?

Mental Health Psychiatry
I was diagnosed with depression and anxiety some years back. My doctor gave me the "all clear", and I tapered off my antidepressants and other meds. It's been some time but very occasionally I still feel anxious for no reason. I kind of expected everything to be OK after stopping my meds. Does this mean I am not 100% recovered? Is it possible to get back to what I was like before?
DOCTOR’S ANSWER (1)

I must admit that this is a challenging question to answer as there are many possible perspectives that one can adopt when talking about recovery from anxiety or depression. Is it just freedom from symptoms alone or should other factors be considered as well?

To the clinician, ‘In full remission’ means that there are no longer any symptoms or signs of the disorder present, but it is still clinically relevant to note the disorder. ‘Recovered’ means that the disorder would no longer be noted. The differentiation of in full remission and recovered requires consideration of many factors, including the characteristic course of the disorder, the length of time since the last period of disturbance, and the total duration of the disturbance. However, the differentiation is not absolute.

To complicate matters further, there are many different subtypes of anxiety and depression and the characteristic course of these subtypes may not be well delineated or fully understood at this point of time.

For the purpose of insurance coverage, usually if the individual is not taking psychiatric medications for at least two years, and still remains well, and is able to hold on to a job, he is usually considered ‘well’ . All this will be considered when calculating the insurance premium. Other features that may be noted will be the number of episodes of illness and whether the individual was suicidal or psychotic in the past.  Another point to note is that the criteria may be different for different insurance companies.

While there is no universally accepted definition of recovery, one definition, often referred to as the “recovery model” argues for the importance of building the resilience of people with mental health problems and supporting their identity and self-esteem. It is a strength-based approach that does not focus solely on symptoms and which emphasises resilience and control over life’s challenges.  This model aims to help people with mental health problems move forward, set new goals, and take part in relationships and activities that are meaningful.

Recovery does not necessarily mean cure. In my clinical practice, many patients have an episode of anxiety or depression in their 20s and 30s. They remain well after that and do not require psychiatric attention for many years. However, once they hit their 60s or 70s, and when they start to develop physical ailments like cancer, heart disease or stroke, the symptoms of anxiety and depression start to manifest. Ultimately, for conditions like anxiety and depression, external stressors, life’s challenges and one’s personality and social support system, all play a part.

201 views 5 Feb 2019
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