I'm not a psychiatrist, but in my emergency department lifetime, I have had a lot of experience in seeing chronic illness come back and forth. Patients get into a point of great darkness, and this is where we see patients who attempt suicide. Often these patients have had many interventions in the past, and we know that some of them do recover. We know that some patients with substance abuse do recover.
When we talk about it being irremediable, how do we predict which patients are going to recover from intervention or not? I think that saying a patient has had three courses of anti-depressants does not give predictability as to whether or not this is recoverable.
With more and more science behind the use of medications that have been restricted and are not accessible by psychiatrists or therapists, we are starting to see that there is a potential for recovery for these patients. When we look at what irremediable means in mental illness, I think it's very difficult to predict and to say that this person has tried a lot of things, but their depression they cannot recover from.