We know most of my friends are still medicated and, the other day, I was concerned when I read an article claiming that most depressive people on daily maintenance medication will have seven major episodes over the arc of their lives. The demarcation between depressive events was notched as major changes in medication. Some of my young friends have had only a couple of events. Some of my older friends are deeper into their modes of seven.
I know the psychiatric community doesn’t like to label disease or suggest that everyone who is majorly depressive will have seven episodes, but it seems like seven is the average. Some people will have fewer medication changes while others will fall beyond the seven.
I also understand doctors don’t want a young person, facing their first round of medication, to be overwhelmed with the notion that there may be more than two changes. Withdrawal symptoms can be prolonged and punishing. Sometimes it takes up to six weeks to even test to see if a new medication is working or not. If not, you start the step-down and ramp-up process all over again.
It must be beneficial, though, on some level, for all patients to realize no medication is a permanent cure-all. People change, brains change, physiologies change, and there’s no shame in stopping one medication to try another — or two or three until the right fit is found. Keeping patients in the dark about the spectrum of their depression doesn’t really help them anticipate that things may change in the future and that is not necessarily a bad thing.
There is no shame in being medicated. Brain chemistry is a tricksy thing to try to divine, and doctors can be just as in the dark as their patients when it comes to predicting the how and what of what will and will not work in particular bodily circumstances.
One must never give up trying to win the dark fight over depression — if you’re on the first level, or passing the seventh — there is always something new and untried waiting to be exampled within, and that’s why it is always important to keep the lines of mood and thoughts open between patient and doctor and friends — even against the overwhelming world spinning around that sometimes feels heavier, and darker, than it ever really should be.