Finishing Treatment for Depression

By Howard Levy, M.D

Nobody likes taking medication or getting ongoing treatment for the rest of their life. So, if you have been taking advantage of home remedies, medications, and/or counseling for depression, when is it safe to stop treatment?

The answer, of course, depends on many things. Some people just have such severe depression that they can never completely stop treatment. And some people are so strongly predisposed to mood disorders that they periodically need to resume treatment multiple times over their lives. There is no shame in being one of these people. In fact, it takes a lot of courage to admit to yourself and others that you have a problem and that it needs to be treated. The reward for such bravery is escape from the dark clouds of depression that so often make life almost unbearable.

Many other people, however, can successfully stop at least some of their depression treatment program. Here are some guidelines to help maximize your likelihood of success.

Be patient. Depression rarely comes on suddenly. Rather, it slowly sneaks in and gradually robs us of our vitality. Once a pattern of depression becomes established, it can be very hard to change. The same idea works in reverse: Happiness and improved mood can also become self-renewing, and help to keep depression at bay. As counseling, medications, and lifestyle changes begin to kick in, they are initially just treating the symptoms of depression. Actually curing the underlying mood disorder takes much longer. Therefore, my standard advice is to continue full antidepressant treatment until you have felt completely back to normal for a minimum of 3 months.

Pick the right season. It is well known that our moods tend to be brighter when the days are longer and the weather is warmer. So don't try to stop or reduce your depression treatment during the gloomy, dark, and cold winter months. Instead, target the spring or early summer, when you're more likely to be able to get outside and enjoy some healthy fresh air, sun light, and exercise.

One step at a time. Even if your mood is flying high on a magic carpet (or on a therapeutic regimen of counseling and medication), don't suddenly stop your meds or your therapy sessions—that's like pulling the rug out from under yourself and you might crash land. A gradual tapering down of medication doses will allow your body and brain to adjust to the chemical changes that come with less medicine.

And if it turns out that your depression gets worse and it was too soon to try to stop the medication, it will be easier to get back to normal if you just need to increase the dose a little bit. If counseling has been part of your regimen, it can be very helpful to continue those sessions while decreasing the medication dose, to help you work through any bumps on the road to less medicine.

Maintain a healthy lifestyle. Many people with depression do successfully taper off of their medication and no longer need counseling. But the basic lifestyle approaches to boosting your mood are worth pursuing forever. Continue applying the new coping skills you've learned. Keep everything in perspective, so the little things are less likely to get you down next time. And always look for more opportunities to laugh, exercise, get some sunlight, and interact with friends and relatives.