That 10 percent number might look disappointingly low, or encouragingly high, depending on one’s perspective. The best comparison is the portion of people who were rated as thriving who never had depression: 20 percent.
“That is, having depression cuts in half your chances of ending up in this group” at the high end of the well-being scale, Dr. Rottenberg said. He added: “But we really don’t know for sure, until we have better evidence.”
To gain that evidence, the ideal approach would be to follow a large cohort of people who had recovered from depression, over many years, to tease apart the differences between the 10 percent or so who thrived and those who did not. Such studies would be costly, the authors acknowledge, and likely would require collaboration among many large clinical centers.
Still, individuals who’ve routed what Winston Churchill called his “black dog” and built a full life have a collective knowledge that others do not. And researchers can only speculate about what that vanquishing entailed until they ask, systematically and empirically.
The answers won’t necessarily fall into a straightforward pattern. Whereas some people who thrive after depression might swear by daily pills, others may depend on weekly talk therapy. Good friends, good opportunities, and good genes are likely to play a role. And there very well may be many people who have developed idiosyncratic methods of their own, a kind of daily self-therapy or routine not found in any manual, textbook or study.
“If so, it would be exciting to find out what those are,” Dr. Rottenberg said. “You’d not only be giving people with depression some hope, by studying this group. You might also be able to give them something they could use.”
For now, said Dr. Stotland, the Chicago psychiatrist, the fact that depression can be chronic, and recurrent, hardly means that people are doomed by the diagnosis. “I’ve never told patients that,” she said. “ I tell them they’re likely to get better, and I suspect that most of my colleagues do the same.”
