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Begin to Hope

A new study reveals that even as symptoms of depression begin to dwindle, feelings of hopelessness can linger

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Depression sufferers generally experience relief from most related symptoms during the first few months following treatment and medication. Regaining a sense of hope, however, can take a bit longer according to new research from the University of Michigan Medical System, Ann Arbor.

The danger in these findings is that patients who don’t begin to feel hopeful within a few months often stop taking their medication – in spite of the fact many other symptoms, including lessened feelings of depression and body pain. For many in the study, feelings of hopefulness did not improve until several weeks, or even months, after depressive symptoms lifted, says lead author James E. Aikens, Ph.D., associate professor in the department of family medicine.

“The finding suggests that some patients may become unduly pessimistic and stop adhering to an already-helpful therapy,” Aikens says. This finding is troubling, he says, because hopelessness is a strong risk factor for suicide.

Aikens and his team studied 573 patients with depression that were administered an antidepressant, either fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft). Each person was assessed one, three, six and nine months after the treatment began.

Overall, patients’ depression responded rapidly to medication, with 68 percent of their improvement occurring by the end of the first month, and 88 percent by three months. The patients experienced the majority of their improvement in several areas during this time period, including positive emotions, work functioning and social functioning. Since hopefulness lags, physicians may want to consider cognitive-behavioral strategies, such as teaching patients to identify and challenge the pessimistic thoughts that usually accompany depression, and encouraging them to engage in activities that may improve their mood, Aikens says.

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