Remission in depression often feels like you’re getting back to your true self. Still, it’s a good idea to keep your eye on recovery.

Living with depression can make day-to-day functioning a challenge.

When entering into a remission status, you might start to feel less burdened by the symptoms that used to exhaust, deplete, and numb you.

These are hopeful signs that you may be on the right track to treating your depression. But remission is not quite depression recovery.

Persistence in finding the right depression treatment plan tends to pay off. Understanding what remission is and what to expect during this phase can help prepare you for a successful recovery.

Remission is a phase on the path of depression treatment that comes after a major depressive episode.

Whether you’re in traditional talk therapy, taking medication, or exploring other avenues of depression treatment, remission of depression is the goal.

You’ll typically enter the remission phase when depression symptoms have been reduced, either partially or fully.

This often means the oppressive fog that kept you lethargic, unmotivated, and feeling hopeless has lifted, at least somewhat.

It’s a good sign that your treatment plan is working for you and a reminder that major depressive disorder (MDD) is not a permanent life sentence.

When can remission begin?

There’s not a consensus among medical professionals regarding the timeframe of when remission begins.

A 2008 analysis classified remission as 3 weeks or more of reduction in depressive symptoms. Others, like the International Classification of Diseases, 10th Revision, defined “in remission” as free from depressive symptoms for several months.

Because there’s no standard timeframe for the remission of depression, talking with a healthcare professional can be beneficial. Consider asking questions about how they discern remission status and how it may affect your treatment plan.

Keep in mind that the period in remission is not the same as recovery from depression. There’s no medical consensus on how long you should be in full remission before being considered in recovery.

How remission is handled

Your doctor or therapist may recommend changing your medication once symptoms have stopped. Or, they may advise staying the course to avoid depression symptoms recurring.

Remission may mark the end of your time receiving specific clinical treatments for depression. This decision is largely up to your discretion and the clinical professional.

Consider talking with your doctor and therapist to make sure you’re on the same page about your depression treatment plan and what markers you’ll both use to determine recovery.

Partial remission

Even if residual depressive symptoms persist, your depression may still be classified as a “partial remission” status.

Partial remission is an improvement in some depressive symptoms over time, while some symptoms remain unchanged.

Full remission

Full remission is often more pronounced than partial remission because your depressive symptoms may be nearly nonexistent.

When your depressive symptoms are negligible, you’ll likely be functioning the way you were before a major depressive episode.

Still, this doesn’t mean you’ve reached recovery. Your medical team needs to see a sustained period when you remain symptom-free before changing your status to recovery.

Full remission is scored at 7 or below on the HAM-D rating scale.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), a major depressive episode is characterized as having 5 or more depressive symptoms that last for more than 2 consecutive weeks.

The symptoms must be severe enough to disrupt daily functioning at home, work, or at social events. These depressive symptoms include:

  • unrelenting sadness
  • disinterest in most activities and hobbies
  • slow movements and delayed speech responses
  • drastic changes in appetite
  • sleeping too much or too little
  • lethargy
  • intrusive feelings of worthlessness or guilt
  • mental fog
  • difficulty making decisions
  • suicidal ideation

A major depressive episode may make you feel enormously burdened and permanently altered. But speaking with a medical professional and committing to a treatment plan can help you regain your spark.

The HAM-D is one measure that can assess the severity of remission in depression. However, clinicians tend to use the DSM-5 for rating and diagnosing depression remission.

Remission in the DSM-5

According to the DSM-5, a diagnosis of full remission of depression requires you to go at least 2 months with no significant symptoms of depression.

Partial remission is classified in the DSM-5 as having some symptoms of major depression present but no longer meeting the full criteria for MDD. If most of your depression symptoms are no longer present, but it’s been less than 2 months, then you may also be diagnosed as being in partial remission.

The HAM-D rating scale

The assessment takes 21 depressive symptom-related items into account but scores only 17 of them. The resulting scores are based on the severity of those symptoms and sometimes the frequency at which the symptom is experienced.

Many HAM-D assessment items expand upon the nine characteristic depressive symptoms of a major depressive episode. HAM-D also considers questions that assess somatic symptoms, anxiety, sexual dysfunction, and denial of experiencing depression.

You’ll be assessed by the HAM-D standards through a 10- to 15-minute interview with a medical professional. When the assessment is completed every 2 weeks, it can be an effective tool for tracking your depression trajectory.

  • Scores from 8 to 13 indicate mild depression.
  • Scores of 14 to 17 indicate moderate depression.
  • Scores greater than 17 are considered severe depression.

Achieving remission after a major depressive episode is possible, even if you’ve experienced recurrent depression in the past.

Depression recovery often depends on several factors. So, don’t feel pressured to stick to one type of treatment and forgo the others. The right treatment plan for you could include a mix of approaches.

Therapy for remission of depression

You don’t have to walk through depression alone. A qualified and trusted therapist can provide insight, perspective, coping mechanisms, and a tailored treatment plan.

Therapy types for depression include:

Medication for remission of depression

A 2020 review that looked into the continuation and discontinuation of antidepressants in remission found that 80% of people who continued taking antidepressants didn’t experience recurrence.

There are many options for choosing the right antidepressant and dosage for you. You can talk with your doctor about possible side effects, desired outcomes, and any concerns you may have.

Types of antidepressants include:

  • selective serotonin reputable inhibitors (SSRIs)
  • serotonin-norepinephrine reputable inhibitors (SNRIs)
  • tricyclic antidepressants
  • monoamine oxidase inhibitors
  • noradrenergic and specific serotonergic antidepressants
  • atypical antidepressants

Lifestyle changes

Some depression symptoms can be managed with lifestyle changes.

Nutrition

Diet can play an integral part in your well-being, physically and mentally. Research from 2017 shows that nourishing your gut health with probiotics may decrease depressive symptoms and regulate cortisol levels.

Exercise

Making exercise a part of your routine has been shown to have many mental health benefits. If you stick with it, habitual exercise can even reduce depressed mood and reduce the risk of clinical depression.

Mindfulness

Depression and negative thought patterns often go hand in hand. You can put a stop to rumination by approaching your thoughts with self-compassion.

Acknowledging your experience with depression in an open and kind-hearted way can help you process those difficult feelings rather than avoid them.

Engaging in meaningful activities

Making time to regularly engage in activities that you find meaningful or enjoyable can be effective for managing depression symptoms, raising your mood, and supporting your overall well-being.

Remission can feel exciting, like you’re getting a glimpse of your old self coming back. And celebrating exactly where you are and what you’ve overcome is good.

But it’s not quite depression recovery, and recurrence of symptoms is still possible.

But experiencing the return of depressive symptoms should not spark feelings of guilt or shame.

Talking openly with your doctor and therapist can help you work together to develop an effective depression treatment plan, wherever you happen to be on the path to recovery.

Looking for a therapist but not sure where to start? Psych Central’s mental health support resource can help.