Can Mental Illness Be Cured?


– Can mental disorders be cured? That’s what I’m talking about today. I’m Dr. Tracey Marks, a psychiatrist, and I make mental health education videos. I’ve been asked this
question several times, and the answer is no. Here’s the explanation. Most disorders, both mental and physical, are managed, but not cured. In medicine, we think of a cure as a total reversal of an illness to the point where
there’s no evidence of it, and it does not return. The closest we get to this
scenario is fixing a broken limb, or treating a vitamin deficiency by giving a vitamin supplement, but even things like high
blood pressure are not cured. Let’s say you develop high blood pressure because you’re overweight. Then you lose weight, and your blood pressure returns to normal. Did you cure the depression? You resolved it at the moment, but you’re still at risk for later developing high blood pressure because not everyone
who becomes overweight gets an elevated blood pressure. Some people are more susceptible to elevations in blood pressure as a response to weight gain or diet, and if that’s you, it could
happen again at a later point. Let’s look at the main mental illnesses that tend to come and go
over the course of your life, and then I’ll talk about how
they tend to look over time. The main illnesses are major
depression, bipolar disorder, anxiety disorders, attention
deficit hyperactivity disorder, and schizophrenia. The mood disorders, like major depression
and bipolar disorder, are recurring illnesses where you have episodes that last a while and then they resolve. Some people can have chronic symptoms, but the classic picture is
that you have discrete episodes that resolve and then return. You have periods in between with either very few
symptoms or no symptoms, and when your symptoms go
away we call it remission. When your symptoms return,
we call it a relapse, so both depression and bipolar disorder are relapsing and remitting illnesses. The symptoms from these
illnesses can remit on their own even if you don’t take medication, but most times you need to take medication to treat the symptoms. When you take medication
and the symptoms go away, you’re in remission. If you stop taking the medication you can remain in remission for
weeks, months, or even years until your symptoms return. There are people with
depression who have an episode and never seem to have a
return of their depression. We still wouldn’t say
that that person is cured. They’ve just remained in remission. Why does this distinction matter? In practice, an episode
that’s in lifetime remission looks the same as one that’s cured. The difference, really, is
in how you think about it. If you think about it
as being in remission, you have some level of expectation that there’s a possibility
that it could happen again, so you could be prepared
if there is a next time. With the mood disorders, if
you have future episodes, they can become worse over time, and we refer to this
as the kindling effect. We think of kindling,
as in building a fire, and the more material you put on the fire the stronger the fire becomes, so repeated episodes, especially ones that go left untreated, can return and become
longer or harder to treat. Now, this doesn’t mean that
you have to live in fear. It just means to be aware of when you start to have
a return of your symptoms so that you can jump on it
quickly and extinguish the fire to resolve the symptoms
earlier rather than later. Anxiety disorders tend to
behave a little bit differently. Rather than being episodic, they tend to come and go
in intensity over time. It’s kind of like a wave
that crests and then recedes, so there can be periods of your life where your anxiety can feel unmanageable, and you may seek treatment for it, and then there can be periods of time where it’s not that bad. The usual is that you don’t become
completely free of anxiety. It’s just that your
symptoms are manageable, so you may have pops of
feeling tense during the day that go away for, if you were to go on a walk
or watch a movie with friends, and you’re able to bring
yourself down from that anxiety, and it’s not causing
much problems for you, but then you might have some
stressors that come along, like moving, or changing jobs, or some other life transition, and your anxiety ramps up and becomes more problematic for you. You might start losing
sleep or drinking more to bring yourself down from the anxiety. Attention deficit hyperactivity disorder tends to look a little
different from anxiety over the course of your life. Generally, symptoms can
improve or nearly resolve once you become an adult, but not resolve to the point
of being completely absent. Residual ADHD symptoms can look like being a slow reader, or being disorganized
and losing things a lot, or not being a good listener. There can be little things here and there that don’t really cause
much dysfunction for you, but if you become stressed
because you’re going through a difficult period in your life, your ADH symptoms may
become more prominent. It still may never get to the level where you feel like you
need to see a psychiatrist, but you may just have
trouble getting things done, or struggling with dealing
with whatever that stress is, but then once the stress passes, you’re back to your usual functional self with a few issues here and there. That’s one way that ADHD can
progress over your lifetime, but there are people whose ADHD symptoms don’t improve a lot as
they become an adult. They’re just as symptomatic as an adult as they were when they were a child, but what can happen is that
over time you learn to adapt, and to recognize your weaknesses
such that you avoid things that you know that you’re not good at, and you spend more time doing
things that you can do well, and that’s the ideal scenario
in the adult with ADHD. Schizophrenia tends to look
more like a series of plateaus. A person can start out
with somewhat mild symptoms that don’t always look like schizophrenia, and then at some point in their life the symptoms fully manifest. I did a video explaining schizophrenia, and I’ll put a link in the description and in the corner of this video so that you can watch
that video after this one, but the usual course with
schizophrenia is that once the symptoms fully manifest, a person can remain at that
level of illness severity for a while, and that can be years, and then at some point there’s a decline, and the symptoms increase. You may get more medication added, but that seems to be your new baseline, and this is especially the case
for the cognitive symptoms, so instead of having this
gradual deterioration, which some people can have, there’s this stepwise downward trend. The good news about this pattern is that the interval in between the steps can be very long, like years, so someone who develops
the disorder at 25, and then lives until they’re 75, may have three or four steps downward. I hope this helps you understand the outlook of mental disorders
and how they’re not cured, but the symptoms are treated in a way that they can be
completely absent or minimal. For more information on mental
health and self-improvement, subscribe to my channel. I publish new videos every Wednesday. See you next time.

38 comments

  1. A bit sad to hear this, however have grown to trust what you say and to focus on the beneficial things such as management of anxiety. Thanks!

  2. thanks doctor tracy for this informative video. depression is reccuring illnessses. i have a question . do antidepressants resist depression to relapse after remission if somone stay on his Medicfation after remission. i heard from psychiatrist that taking Medication resist depression to return or come back after remission

  3. Thank you for the clarification. I always thought when I felt better that meant I was cured and I would stop taking my meds. I would have an episode and it would be worse than the last because I didn't stay on treatment. I didn't get it then but I get it now. I'm not cured just because I start to feel good.

  4. So true. I'm on a cocktail of meds for my bipolar disorder type 1 with rapid cycling,my PTSD,and my blood pressure. My meds make me feel human. I have been doing so much better…I went years without meds,and I regret it. Latuda and other meds have made my life better. I mentally got to a point where my emotions took control of everything and every choice. Now I think with more logic. My emotional rollercoaster ruled my life for a good chunk of it. I am thankful for your videos.

  5. I’m nearly 40. I have anxiety disorder with panic attacks and sensory processing issues – very painful and unbearable. Lexapro did not suit me, especially jaw clenching, restlessness and sleeping problem. I’m on sertraline, sodium valproate and olanazapine now. I take valium on occasional basis. They are working, but I hope they will eliminate all the symptoms as much as possible.

    I’d like to ask you to upload a video on sensory processing disorder in adult. There’s little information on adults with SPD on the Internet, unfortunately.

  6. Dear Dr. Marks
    I love your channel and I watch each and every video you post. They're so helpful! 💛 If I could request a topic for the new video, that would be Medication Resistance and Tolerance Build-up /or something along the lines/. I recently got prescribed Zoloft to help with my anxiety and depression, and it works pretty great. However, I'm afraid I might build up tolerance to it someday. I would love to learn more about this, especially if you can give stories or examples from your own practise.
    Much love, Rory 💛

  7. Precise. Clear. Exact. Perfect articulation. Not one irrelevant syllable. No ambiguity. I quite literally understood all of what you intended that I should all the way from the beginning of the video to the end of it. You know how to make maximal use of your natural abilities. Your video presentations are the best that I've seen. Thank you for filling in more of those gaps in my knowledge and understanding. My best to you Dr. Marks.

  8. Long time ago I was told by a psychiatrist,
    "Think of it like this, Its like a forest fire you just manage the fire" …great advice…

  9. Really well done video, thank you for sharing this information! I’m really wondering how this applies in the case of PTSD?

  10. What percentage of people recover completely from MDD episode without any residual symptom?? Star*d study show only 50-60%. What's your experience in practice?I haven't seen one. Can u plz share recovery stories of patients who got out of severe depression?

  11. Where are you from? I went to a lot of doctors in my country and they gave me different names to my problem like deficit of attencion and others but i do not know what is my problem in real. Some people speaks to me things like you are crazy. I would like you Speak to me my problem. Sorry for my english, i am learning yet.

  12. Hi Dr. Marks, thank you so much for the great videos you put out! For mental health disorders that are properly managed, what do the later years of life look like for us? Bipolar 1 in my case. I have heard that mania and depression can be much worse and that there can be major problems from a lifetime of taking medication.

  13. 1.what is the best profession for people who suffering from anxiety disorder?? 2.will you tell any most successful people in studies with anxiety disorder is this possible 3.Getting good job helps the person free from anxiety disorder??? 4.How to avoid this anxiety genes with next generation??? Pls make a video mam if ur free thank u

  14. its really break my heart, im suffering from depression anxiety and bipolar. i was okay 2 months ago after i get threatment then something bad happen again and it triggers me. i want to see my psychologist but my parents are not supportive about it. they really want their kid to be sane without doctor needed but the one who make me crazy is them

  15. Hi Dr Tracy,
    Thankyou for your videos they're helping me during a difficult time
    I am currently starting treatment for major depression/possible bipolar 2 disorder and I was wondering if it would be possible to persue and a career in psychology/psychiatry with this illness. Going through these trouble times has resparked an old love of psychology, psychiatry and helping others through life's difficulties, but I was worried that there would be issues with me treating people if I myself had a diagnosed mental illness.

  16. Dr.Tracey Marks.Please do a video on the fear of developing scizophrenia or psychosis(pure OCD).Why people with this disorder can not actually develop psychosis?

  17. Why are people who can develope some sort of psychosis or scizophrenia not able to have this fear? Let's say they haven't unlocked the illness yet. Is it possible for them to think about the fact they may develop it at some point? What if I fear it now and actually start developing it later in life?

  18. Hi Dr. Tracey Marks, thank you a lot for your videos,
    i'm medical student, and you helped me a lot to understand psychiatric disorders more and more.
    I want to ask you about Bipolar disorder, does it associate with violence or self-harm or not? it's associated or it's symptom or there is even any relation between them or not…?

  19. My depression was due to Gut imbalance…more i healed my Gut more the depression went, is there but much more less , so i think the answer is what created it the first time.

  20. Dr. Tracy i just found your channel, and grateful for the helpful videos, can you make a video on how to cope with living with a relative with schizophrenia/ mental disorders who is constantly relapsing because of unavailability of finding proper treatment and baker acting/ refusal to live in assisted living or seeking counseling options have been exhausted. Thanks!

  21. Hi Dr tracy, I have a question… I’m seeing a psychiatrist and she is also a therapist , ¿it’s it a good idea to see a therapist beside my psychiatrist? She is already giving me therapy but it’s it okay if I have another therapist that is not a psychiatrist?

  22. Hi Dr Marks— can you do a video about the link between PCOS/hormonal imbalance and depression/anxiety? It’s so common but often isn’t addressed by psychiatrists in my experience. Thank you!

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