Thriving After Major Depression

Worth Living Ambassador Frankie Samah

Hi I’m Frankie and I’m from Wales, UK.  I am a psychology teacher and postgraduate education psychologist. I am a women’s right activist, working with women’s aid to raising awareness and to break the silence. I am a mental health advocate and writer. I believe in counteracting the stigma around mental health and we should begin with the ideology. Instagram- Frankie Samah

Thriving After Major Depression

New research released in 2018, suggests epidemiological literature indicates that the orthodox view of depression as being chronic, recurrent,  and lifelong is hugely overstated.  Depression is a serious medical illness that negatively affects how we feel. However, too much emphasis is placed on it being a lifetime illness, and new research suggests we can recover and thrive after depression.

More and more people with mental health conditions are now told that their prognosis is gloomy.  This is somewhat ironic that psychopathology research spreads epidemiological gloom when in fact biographies of leading researchers reveal trajectories that go from severe disorder to productive living.

Elyn Saks tells us in her book The Center Cannot Hold: My Journey through Madness- her story of hearing voices as a teenager and harming herself repeatedly to becoming an accomplished lawyer and now a pioneering psychiatrist in the area of mental health law.

Kay Redfield Jamison’s book An Unquiet Mind tells us of her story of episodes of bipolar disorder to gaining control over her illness and now is a leading researcher in the field of bipolar disorder.

Marsha Linehan, who is a researcher in borderline-personality-disorder research, revealed how she had psychiatric hospitalization for two years in her youth.

There is a somewhat gloomy outlook predominantly for people with a diagnosis of depression which is noted over and over again especially in journals that are aimed at practitioners.  Here are a few examples-

  • “Depression is a chronic, recurrent, and often familial illness that frequently first occurs in childhood or adolescence.” (Brent and Birmaher, 2002, p. 667, in the New England Journal of Medicine).
  • “Depression is a chronic and recurrent condition, with each experienced depressive episode increasing the risk of future episodes (Solomon et al., 2000).” (Hitchcock et al., 2016, p. 92, in the Journal of Behavior Therapy and Experimental Psychiatry).
  • “During the last decade, researchers and clinicians have become increasingly aware that major depression, which was once thought to consist of discrete episodes of illness followed by full recovery, is both chronic and recurrent in many patients.” (Keller, 1994, p. 205, in European Neuropharmacology).

According to the World Health Organisation, depression is now the foremost source of disability worldwide.

However, there is hope. A team of psychologists led by Jonathan Rottenberg at the University of South Florida proposed there is a significant subset of people who recover and thrive after depression, yet research into this area is rare. Therefore, they propose a definition for “high functioning after depression” (HFAD) arguing that the advice given to people with depression need not be so gloomy, and layout key areas for future research.

Rottenberg cites 3 studies and they find that an average of 40-50% of people who experience an episode of depression don’t go on to suffer another episode.

It may be somewhat irresponsible for me to suggest everyone who has had a diagnosis of depression can never experience it again, that’s not what I am saying.  It’s more with proper care, well-being, and treatment,  people with depression can experience a full life. A further reason High Functioning After Depression needs to be further researched is that it is part of the truth, which  practitioners, patients, public, and everyone are owed.

For me, it opens new questions to be explored- Are people who are HFAD more likely to have sought help? If so, what type of support did they receive? Are there more HFAD’s in a specific region/country/area? (One of the studies cited was conducted in Sweden- is depression better treated there?) Can we adopt these strategies? Does depression itself play a role in triggering the long-term improvement seen in HFAD? (Something similar has been proposed for trauma). Can we apply what is learnt about HFAD to enhance clinical interventions?

The one thing I am sure of is the more people who speak out about their own experience with mental health, the stigma attached to it will slowly disappear. A growing number of celebrities testify to the possibility of renewal after psychopathology, to name a few- Lady Gaga, my daughter’s hero- Dwayne Johnson, Adele, Miley Cyrus, and Demi Lovato.

I cannot tell you the number of people who have told me they don’t want to go to the doctor’s and be labelled with ‘depression’, as it would affect their future or other just as outdated views.  If we have correct medical care and we look after ourselves, there is a high chance that depression won’t be recurring.  Far from signalling a lifetime prison sentence, the onset of depression can herald a delimited period of suffering, after which we can emerge as highly functioning, successful members of the community, who are  loved and are  love.  Let’s start 2019 with a new narrative.

If you are feeling that you may be experiencing mental health issues, please consult medical care.



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