Asked by Ally, Washington
“I am 26 years old and have had four major depressive episodes. I did not seek treatment until the last (and worst) episode and have since been taking two different antidepressants.
My question is this: Will I ever get off these meds?
To be honest, my last episode was so bad that I am not too keen on the idea of going without. However, I am aware that the more episodes of depression a person has makes the person that much more likely to have another one and that the severity of the depression gets progressively worse with each episode. I shudder to think what a worse episode would be but at the same time do not want to take medications that I do not need.
Mental Health ExpertEmory University Medical School
Expert answer
Dear Ally, let me start by applauding your very accurate understanding of depression, terrible illness that it is. Your question is an interesting one because, of course, you could get off the medications any time you like simply by ceasing to take them. But what you mean, of course, is whether you will ever be able to stop taking the medications and not have to worry about falling back into another depressive episode.
This brings up a very important point about psychiatric disorders: Anything is possible. So anytime someone asks a question that starts with some variation of “Is it possible …?” the answer is always, “Yes.” Why? Because all psychiatric illnesses are probabilistic, not deterministic. Probabilistic means that although some things are a lot more common than others, nothing is certain and nothing is impossible.
I sometimes resort to physics as a metaphor to explain this idea. Isaac Newton used mathematics to paint the universe as an absolutely rigid machine in which causes always led to results in a predictable manner. In his view of the universe, if you knew what every particle in the universe was doing at this second, you’d be able to predict all future events flawlessly out to the end of time.
This way of thinking about things works very well for many practical things like firing cannon balls, sending rockets to the moon or building bridges, but it turns out that when you look really closely at matter, it only approximates the certainty that Newton described. This realization has become enshrined in a theory called quantum mechanics, which — in essence — says that no final certainties exist in the physical world, only various degrees of likelihood.
For example, although most of us think of atoms like little solar systems with the nucleus being like the sun and electrons swirling around it like planets, the physical reality is much weirder. In fact, an electron only tends to stay close to the atom of which it is a part. The further away you go from the atom the less likelihood there is for finding one of its electrons, but the chance isn’t zero, and it is possible that you might find an atom’s electron on the other side of the universe. It’s not impossible, just so unlikely that it might as well be impossible.
To get the rest of this article you will need to go to: http://www.cnn.com/2009/HEALTH/expert.q.a/12/08/
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