I am NOT a psychiatrist, but from my experience with mental issues I would doubt that such disorders will cure themselves.

I don't know specifically to what the "diagnosing" clinician was referring when s/he told your patient that s/he had an "affective disorder", so the first thing would be to get an accurate diagnosis. If the condition is a mood disorder, such as major depression, then the answer would be - it depends. Major Depressive episodes - the basis for major depressive disorder (MDD), tend to resolve after a period of time. It has been suggested that the episodes can and will resolve without treatment. However, given the connection between major depression - hopelessness - and suicide, I would be very careful about not treating it at all. There are pharmacological as well as psycho-therapeutic therapies ("talk therapy", cognitive-behavioral therapy, etc.) which, when used in tandem tend to work better than either alone. One other thing - as always, you must be very careful not to accept the diagnosis of another without doing your homework - i.e., your own assessment and evaluation of the patient. There are far too many misdiagnoses out there to simply accept someone else's assessment or evaluation. I don't know if this answered your question at all, but based on my understanding of the question, its my best answer. If I completely missed the mark, either ignore or please advise. Best, TND

I don't know specifically to what the "diagnosing" clinician was referring when s/he told your patient that s/he had an "affective disorder", so the first thing would be to get an accurate diagnosis. If the condition is a mood disorder, such as major depression, then the answer would be - it depends. Major Depressive episodes - the basis for major depressive disorder (MDD), tend to resolve after a period of time. It has been suggested that the episodes can and will resolve without treatment. However, given the connection between major depression - hopelessness - and suicide, I would be very careful about not treating it at all. There are pharmacological as well as psycho-therapeutic therapies ("talk therapy", cognitive-behavioral therapy, etc.) which, when used in tandem tend to work better than either alone. One other thing - as always, you must be very careful not to accept the diagnosis of another without doing your homework - i.e., your own assessment and evaluation of the patient. There are far too many misdiagnoses out there to simply accept someone else's assessment or evaluation. I don't know if this answered your question at all, but based on my understanding of the question, its my best answer. If I completely missed the mark, either ignore or please advise. Best, TND

Individual episodes resolve with time, with or without treatment in most people. But they tend to return.

Dear All,

Thank you for your kind input.

My personal evaluation was such that the patient has no mood disorder except for being a highly positive patient throughout his 6 years of accident episodes. If that could be defined as mood disorder, it is indeed a positive mood disorder and not other "affective" disorder - one that merits no mental decompensation totally.

A check with the psychiatrist resulted in him replying that the patient is actually not having any MDD, anxiety or the ilk issues. The reason he was referred to the psychiatric department is for the fact that he did not socialize with other patients during his prolonged stay and intermittent admissions.

What I found out was that - this man was a successful workaholic entrepreneur, great achiever but a private person. He does not engage in "small" talk but full of creative solutions to big ideas like setting up businesses from zero to highly successful ones. The accident changed his life totally but his zest for life never wane. For the lack of social engagement within the ward, he was branded as having an affective disorder. He broke his spine and most of his joints - how socially "affective" could he be?

I do not accept the diagnosis lightly because it involves character assassination of such a fine person. But I do not hold the diagnosis pen and it has been concluded and input in the NEHR and ME much to our disdain. His record has been tainted but I could not do anything further but continue observing him if he should really and affectively breakdown thereafter.

Best regards - Mariam

Dear Syed,

Thank you for your kind input.

Would you truly consider this patient as having a true affective disorder?

If it is, what category of disorder does he fit in - recurrent or otherwise?

Best Regards - Mariam

Dear Nazia,

Thank you for your kind feedback.

The patient was diagnosed by a Psychiatrist Registrar on the one off ward admission and again on outpatient basis.

There was no mention of a single or recurrent episode because the Psychiatrist only came once per admission.

The "short-term" was merely to have talk therapies and thereafter close the case. But it remains open till now because the Reg has left due rotational schedule leaving the poor patient "stranded" with a long-term affective disorder instead.

Regards - Mariam

the term "affective disorder" includes bipolar spectrum disorders and depressive disorders. very positive mood states (particularly in the face of tragedy) and compulsive work may be indicators or excellent resilience or symptoms of hypomania. 

depressive disorders fall into 3 categories:

1) a single episode that never recurs

2) periodic episodes over the life span

3) ongoing chronic depression that may or may not remit with medication and psychotherapy.

hope this helps.