When will winter (or depression) end?

The “official” start of spring is only two weeks away, but here in northern New England, it’s still winter. Parts of Vermont got almost 30 inches of snow yesterday and, here in New Hampshire, the mountainous snow banks in shopping mall parking lots will probably take another month to melt. The long winter and late spring of northern New England were hard to get used to when I moved here from the mid-Atlantic 22 years ago.

I was used to a long, slow, gradual spring. Here nothing much happens until the snow finally melts in late April. Then, all of sudden, everything seems to blossom at once. 

During a discussion with one of my TMS patients today, what struck me is how most people with depression expect their recovery to be like the New England springtime--overnight and all at once. In fact, it’s a lot more like springtime in the mid-Atlantic. 

In the same way that daffodils are followed by forsythia, which are followed by dogwood, sleep often improves before appetite, which may improve before energy level, motivation, or sex drive. 

All of these basic physical symptoms of depression usually improve before there is any subjective improvement in mood. 

This is why it’s not uncommon for someone else, rather than the patient, to notice the first signs of improvement--a brief smile perhaps--like the first crocuses--or a slight change in posture--like the first cherry blossoms. 

Different types of plants, animals, and insects emerge from hibernation at different times, each according to its own schedule. In much the same way, different symptoms of depression improve at different rates. And some people do get better more quickly than others.

It’s important to remember that, no matter how brutal or how long, winter always ends and snow always melts. And no matter how brutal or how long, depression can always be treated.