Treatment phases

The treatment of depression is divided into three phases:

• Acute treatment
• Maintenance treatment
• Long Term treatment
  

What is acute treatment?
The period between the start of treatment and the suppression of the symptoms of depression is known as acute treatment:

• If you respond to the medication you should feel the symptoms decrease during this time period
• Acute treatment will typically last from two to three months

It is important to remember that your symptoms may improve gradually over 2 to 12 weeks. So we would urge you not to discontinue treatment just because you don't notice any effects after a week. Please be patient with your treatment.

Often your friends and family will notice the effects of the treatment before you do yourself, so be sure to listen to them.

The treatment has its greatest impact after four to six weeks. At this stage you may notice a positive difference in how you feel.

What is maintenance treatment?
Maintenance therapy is defined as taking your antidepressant consistently for at least six months after your depression symptoms have disappeared.

After a good response to acute treatment you will feel completely well. Your mood, energy and interest in the people around you has returned. You will be able to resume work and other activities. You return to living life the way you used to.

It's now important that you don't experience a relapse. i.e. that the depression recurs. The best way of avoiding that is to continue your treatment unchanged and this is called maintenance treatment.

What is long-term treatment?
Fortunately future episode of depression may be avoided through long-term treatment. This may allow you to:

• Lead a normal life
• Attend to the needs of your family, education and employment

The purpose of long-term treatment is for you to avoid future depressive episodes.
If you have had several bouts of depression already, long-term treatment is especially important. The more depressive episodes you have had, the more likely it is you will have another.

Long-term treatment may last for the rest of your life, especially for very severe depression, which may be life-threatening.

Preventive treatment
After your maintenance treatment you and your doctor must decide whether or not you need to continue with preventive treatment.

Why have long-term treatment?

• If you've had one bout of depression, there is roughly a 50% risk of having another at a later date. In this case long-term treatment should last for a year after the acute phase.
• If you've had three or four bouts of depression, unfortunately the risk of having another is very high (90%). In this case long-term treatment should last for at least five years.
• This treatment should involve the same medication and dose that was effective during your acute treatment.

Can be permanent
The goal of preventive treatment is to avoid new depressive episodes. If you have had several depressive episodes, preventive treatment is especially important, as the more depressions you have had, the easier it is to develop a new one.

Preventive treatment is long - in some cases lifelong. You may see this as something negative but try to think of the benefits to you and discuss this with your doctor if you need to. The good thing is that treatment is available and that you may be able to avoid ever having another episode of depression.