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Is it normal for depression to come and go?


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I recently had an assessment with the mental health team and will most probably be switching medications within the next few weeks, although the psychiatrist is yet to say what to. The background: I have been on the SSRI sertraline for over a year, and while it has helped, especially in the beginning, it has not stopped me from having periods of significant depression. For much of the past 2 months, I have been really low in mood, not eating, exhausted, plagued by horrible thoughts, feeling hopeless, lacking in motivation, tearful, unable to concentrate on or find interest or enjoyment in anything, with nightmares, urges to self-harm and thoughts of suicide. However, without yet having changed medication ... in the past week or so, it seems I have begun to come out of it myself.

This is the way it frequently goes. My phases of depression can last anywhere from a few days to several months, but usually 1-3 months. This has been happening for a whole rough eight years. The depression will come on for seemingly no reason, and eventually, also lift for seemingly no reason. This happened before I was on any medications at all, as well as when I was consistently on one medication. I'm lost as to why this happens and have yet to find any answers.

My question is, is it normal for depression to happen like this -- does anyone else here experience it that way? Or is it more common for depression to persist until medication is added or changed? I sometimes doubt myself because my depressive phases will come to an end eventually even without medical intervention, but at the same, the symptoms are real and sometimes quite severe, and I have at other times seen doctors/psychiatrists who have verified that it is depression.

The possibility of bipolar disorder was brought up after fluoxetine caused me to develop symptoms of mania a few years ago, but I don't think that I have it (those symptoms stopped when I stopped the medication.) While my mood certainly does cycle, it seems to be more between varying degrees of depression, anxiety, and 'normal.' I do have periods of increased energy and sleeplessness, but I feel those are more anxiety related. I have also experienced phases of euphoria in the past, and the sense of connection to other entities & to another world, but I was able to act relatively 'normal' and so feel it was more a spiritual thing than symptoms of mental illness. I have experienced phases of hallucinations also but again, although they are very real to me, am able to be careful and recognise when they are not to others so that I am able to act 'normal' around them, and they are very rarely distressing.

I am wondering if I should even be changing the medication, now that it seems my depression is lifting by itself again. However, it's also clear that my current meds aren't stopping it from recurring. Should I change it in the hope that a different medication might keep it at bay more effectively?

If you made it through all that, thank you so much. I would be really grateful for any thoughts or input at all, as the whole situation has me pretty confused.

Edited by capulin
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Standup, thank you so much for your kind and helpful reply. All that you have said makes a lot of sense and is reassuring to read. I will definitely try to keep an open mind in terms of treatment options.

Thank you for the luck – I am wishing the same to you in your own treatment – and for taking the time to write such a thoughtful response. It helps a lot.

Edited by capulin
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