What could cause remission of major depressive disorder (MDD), anxiety disorders, and negative self-perceptions?

From the Guidelines

Waking up without depression, anxiety, or negative thoughts is most likely to result from a combination of cognitive behavioral therapy (CBT) and lifestyle changes, as evidenced by the American College of Physicians' clinical practice guideline 1. This approach typically includes professional mental health treatment such as CBT to restructure negative thought patterns, along with possible medication like SSRIs (such as sertraline 50-200mg daily, escitalopram 10-20mg daily, or fluoxetine 20-80mg daily) which may take 4-6 weeks to reach full effectiveness, as shown in a comparative benefits and harms study 1. Some key points to consider include:

• Regular physical exercise (30 minutes of moderate activity 5 times weekly) has been shown to have similar response rates to SGAs in network meta-analysis 1
• Consistent sleep habits (7-9 hours nightly), healthy nutrition, stress management techniques like meditation or deep breathing, and strong social connections all contribute significantly to mental wellness
• Addressing underlying medical conditions, reducing alcohol and substance use, and practicing mindfulness and gratitude can further support recovery
• These approaches work by regulating neurotransmitters like serotonin and dopamine, reducing inflammation, strengthening neural pathways for positive thinking, and providing the biological foundation for emotional stability Improvement typically occurs gradually rather than overnight, with consistent effort yielding cumulative benefits over time, as recommended by the American College of Physicians' clinical practice guideline 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Potential Causes of Waking Up Without Depression, Anxiety, or Negative Thoughts

• Combination of selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT) has been shown to be effective in reducing symptoms of depression and anxiety in adolescents and youth 2, 3, 4
• SSRIs, such as fluoxetine, sertraline, and citalopram, have been found to be effective in treating depression, with few side effects compared to traditional antidepressants 5
• The combination of fluoxetine with CBT has been shown to offer the most favorable tradeoff between benefit and risk for adolescents with major depressive disorder 4
• Remission from depression has been associated with a greater reduction in symptoms of anxiety, attention-deficit/hyperactivity disorder (ADHD), and disruptive behavior disorder (DBD) 3

Factors Influencing Response to Treatment

• Patient characteristics, such as age, severity of symptoms, and presence of comorbid disorders, can influence response to treatment 2, 3
• The additive benefit of CBT over SSRI monotherapy may not be statistically significant until week 12 of treatment 2
• The fastest response to SSRI+CBT was found in patients who were younger, with milder baseline anxiety/depression symptoms and depressive disorders 2

Limitations and Future Directions

• Further research is needed to understand the heterogeneity of treatment response and to develop more tailored and adaptive interventions based on patient characteristics 2, 3
• The development of new antidepressant therapies, such as sertraline salts and functional derivatives of fluoxetine and citalopram, may offer promising results in delivering antidepressant activity and overcoming anorexigenic side-effects 5