Centre intégré universitaire de santé et de services sociaux de l’Ouest-de-l’Île-de-Montréal
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Ask the expert
Development and process

Once you are diagnosed with clinical depression, are you more at risk for a lifelong illness and long-term management?

I like to say no for that one even though depression not a single episode like when you have a virus and it’s gone. If it’s your personality, or if it’s the way you see things, if you’re really hard on yourself, then you tend to have that with you. Circumstances may change, and from time to time, they get difficult; so, if you really understand why you get down on yourself and make some fundamental changes, then you’re protected against it. If, on the other hand, you ride it out but nothing really changes, then you’re more vulnerable. So, researchers tend to show that it does become more likely, but I think it’s because our experiences keep affecting our confidence, and, if your confidence gets destroyed every time you have a conflict, then you’re more likely to react badly in the future.

Having said that, I do fundamentally believe that, if you really take the time to understand what is going on, then you can make changes. Cognitive behavioural therapy (CBT) involves having the patients question their attitudes and perceptions, become aware of their prejudices, and how they affect their own experiences. Having said that, for people who tend to keep getting depressed over and over again, there are what we call “acceptance” or “mindfulness” treatments. The old adage says: “change what you can and accept what you can’t change”. Obviously, the goal of therapy normally is to change the way we see things and thus change our circumstances, but we also sometimes need to just accept who we are and our circumstances. People with recurrent symptoms really need to learn to let go; if you can let go, then you tend to be more protected from depression.

-Camillo Zacchia, Ph.D., Mini-Psych School 2009

Is it possible for depression or anxiety to disappear and then resurface later in life?

Yes. Even without treatment you can get better with time, but people can have relapses. It also depends on the number of traumas you have experienced, because a lot of people will go through different difficult life events. We can’t prevent people from going through them, but we try to support them and help them cope better with different stressors, because that’s life. And life can also be very fun, which is a message I also try and give my patients.
- Johanne Renaud, MD, Mini-Psych School 2010

If depression is a chronic disease, does this mean that you never completely recover?

Studies seem to show that each depressive episode can change the brain, which increases the risk of future episodes. But generally there is a precipitating factor. People who are depressed should therefore undergo psychotherapy to learn adaptation techniques to better manage the events in their lives. Our hope is that these techniques will prevent the person from experiencing another episode of depression. I think that psychotherapy is very important for changing how we see the world. Learning "protective" strategies and adopting an optimistic attitude won't help you succeed at everything in life, but you will be in a position to better react to difficult situations.
- Johanne Renaud, MD, Mini-Psych School 2010

In the case of special needs adolescents who have dyspraxia or a mild intellectual disability, how would depression appear?

For teens with learning disorders, dyspraxia or other types of disorders, you need to make sure that they are in the best supportive environment. Because if they are not in the right setting or with the right people, over time they may become overwhelmed and can become more depressed. In all cases, if you can eliminate the stressors or difficulties, the person will improve.

In the case of mental disability, you can’t expect the best performance, but you can expect the best performance compared to peers with the same impairments, and the environment has to be adapted to the teenager’s capacities. It can also happen that young teenagers with autistic spectrum disorders get bullied a lot at school, which can lead to sadness and even self-harm.

Depression can occur even in someone with traits of pervasive developmental disorder, as the person may be in a difficult environment or have a family history of depression. In this case, treatment for depression is indeed indicated.
-Johanne Renaud, MD, Mini-Psych School 2012

What is the cause of post-partum disorder or depression and can someone completely recover from it?

After giving birth, you can have what is known as the “baby blues.” For some women, the blues can develop into something stronger that lasts more than a month or two. We need to screen very closely for anyone with difficulty adjusting, especially if this person has gone through depression before. Postpartum depression and psychosis, which is even more difficult, can have an effect not only on your mood but also on your relationship with your child. More than ever, OBG departments are very sensitive to these issues.
- Johanne Renaud, MD, Mini-Psych School 2010

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