When the Light Returns, but Energy Is Still Missing

The worst symptoms may have eased, even though you do not yet feel fully recovered.

After a long Danish winter come the first bright mornings. Yet the ground can still be cold, and the trees do not grow leaves overnight.

Recovery after depression can be much the same.

Some depressive episodes gradually improve without formal treatment, especially milder ones. But there is no way to predict who will improve on their own, how long depression will last, or whether it may become worse. Persistent or severe symptoms — and especially suicidal thoughts — should therefore not simply be left to pass. [1]

The hopelessness and darkest thoughts may have diminished, even though sleep, energy and concentration have not yet returned.

Getting better often happens in stages

In psychiatry, we distinguish between different levels of improvement: [2]

  • Treatment response: Symptoms have clearly decreased.
  • Remission: Symptoms have diminished to the point that the person no longer meets the criteria for a current depressive episode.
  • Functional recovery: The person can once again function satisfactorily in daily life, relationships and working life.

These stages do not always occur at the same time. Someone may feel less depressed but still become exhausted quickly or find it difficult to keep track of things. [2]

When something still remains

After depression, fatigue, poor sleep, difficulties concentrating, lack of initiative, anxiety or a reduced capacity to feel pleasure may persist. These are often called residual symptoms — symptoms that remain after the most severe phase has passed. [3]

It can resemble a house after an autumn storm: the roof has been repaired, but some rooms still need time to dry. The most severe depression may be over, while body and mind still need time and follow-up care.

“I feel better, but I still do not feel like myself”

Many people will recognise this statement — and it deserves to be taken seriously.

It is important to examine whether depressive symptoms, sleep disturbances, medication side effects, anxiety, physical illness or ongoing stressors are still present.

Saying that you do not yet feel well is not a sign of ingratitude. It is valuable information that can help identify the next step.

Recovery is not a straight line

Danish weather can change in a single day. Recovery, too, can move forwards and backwards. One bad day is not automatically a relapse, but persistent or severe symptoms should be assessed. [2] [3]

The return of the light matters. But our eyes, bodies and minds may still need time to adjust to it.

References

1. Whiteford HA, Harris MG, McKeon G, et al. Estimating remission from untreated major depression: a systematic review and meta-analysis. Psychological Medicine. 2013;43(8):1569–1585. doi:10.1017/S0033291712001717.

2. Greer TL, Kurian BT, Trivedi MH. Defining and measuring functional recovery from depression. CNS Drugs. 2010;24(4):267–284. doi:10.2165/11530230-000000000-00000.

3. Iovieno N, van Nieuwenhuizen A, Clain A, Baer L, Nierenberg AA. Residual symptoms after remission of major depressive disorder with fluoxetine and risk of relapse. Depression and Anxiety. 2011;28(2):137–144. doi:10.1002/da.20768.

This article provides general information and does not replace individual medical assessment. In an emergency, seek immediate medical help.