The gulf separating patient and care-provider accounts for at least some of the reason why a majority of people who suffer a depressive episode, will suffer another within five years. Psychiatry calls this “recurrent depression,” and in cases when treatment is tried steadily, but episodes keep returning nonetheless, it’s called “refractory depression.”

These are both clinical phrases which indicate — essentially — that providers have thrown up their hands.

That depression recurs so often, is — all by itself — an indictment of the mental-health system. What is inexcusable is that this recurrence isn’t often addressed. Little research goes into discovering why depression recurs. Those who have recurrent episodes, are frequently labeled “trouble patients,” and sometimes are treated with disdain. Or else, they’re given high doses of multiple medications, in the hope that one or more of them might finally “take” and begin working.

The mental health industry is loath to mention the rate at which depression recurs, as I pointed out for good reason — it exemplifies better than anything else the system’s inadequacy. Also, many theorize, this knowledge might discourage potential patients from seeking help.

At this point, however, the situation is so bad, that I cannot see much benefit to keeping a lid on this information. Those who seek help, will. Those who won’t, won’t. Keeping this knowledge quiet, however, doesn’t serve anyone, since it discourages investigation into the causes and psychopathology of mood disorders.

It’s high time psychiatry finally seized the bull of recurrent depression by the horns, and did something about it … something more substantive and useful than just labeling patients as “troublesome” or “non-compliant” or anything else. Recurrent depression, as a phenomenon, isn’t going to go away by itself.

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