What Is a Depression Relapse and Should I Expect to Have One?

A depression relapse is the return of depression symptoms after they had significantly diminished or disappeared altogether. Relapse refers to depression returning within the first four months following an episode of major depression, while recurrence is used to define the return of depression after four months. Often, though, the term relapse is used for depression’s return at any time, even years later. Here, we’ll use the term “relapse” broadly. No matter when they happen, depression relapses are disappointing and upsetting. Are they inevitable? Read on to see if you should expect to have a depression relapse.

How Often Do Depression Relapses Occur?

Depression relapse is common, with about half of people who have recovered from depression experiencing another episode; Once you’ve had one relapse, your chances of another are greater (Burcusa & Iacono, 2007). Men and women appear to have an equal chance of having more than one episode of depression.

Numbers don’t lie. There’s a good chance that your depression might recur. Consider the whole meaning of the numbers, however. There is an equally good chance that you won’t have to deal with a return of depression symptoms. This means that while you don’t have to expect to have a depression relapse, you can be aware of your own chances so you can take action to keep depression at bay.

Why Does Depression Relapse Happen?

Some people have two or more episodes of major depression because they are either genetically vulnerable or have certain risk factors that increase their chances of developing depression again. Having a first-degree relative (a parent or sibling) that has had their own depression recur increases your chances that you will experience depression more than once. If you do have a close relative who has had more than one episode of depression, you still don’t have to expect to have your own relapse. Your chances are higher, but it’s not guaranteed.

Depression relapse can happen for reasons other than a genetic link. Risk factors include:

• The severity of your first depression—the more symptoms you had, the longer they lasted, and the more bothersome they were, the greater your chances of their return
• Stopping depression treatment, especially medication, on your own without the help of a doctor
• Having a personality trait known as neuroticism, which is characterized by strong self-doubt, a tendency to be anxious, and experience generally negative thoughts and feelings
• Experiencing multiple stressful life events
• A lack of social support
• Serious health conditions like diabetes, heart disease, and obesity
• Life-changing events such as a move, divorce, empty nest syndrome, losing a job, and others
• Loss, including the death of a loved one or failure to accomplish an important goal
• Experiencing trauma (past or present)
• Traumatic events locally, nationally, or internationally
• Hormonal fluctuations in women, especially in puberty, pregnancy and afterward, and perimenopause
• Addictive behaviors

It’s the cumulative effect of these risk factors that increases your chances of depression returning. The more these stressors pile on, the more likely the mood disorder is to recur.

You’re Not Doomed to Have a Depression Relapse

Even if your risk is high for having more than one depressive episode, you don’t have to sit back and let it come. You can be proactive and build protective factors to buffer yourself from the risk factors of depression relapse. Some ways to do that:

• Work with a therapist regularly to build coping skills, reduce negative thoughts, and address problems
• Stay connected to others. Having even one or a few social connections helps stave off depression
• Be active, doing activities you find enjoying and meaningful
• Exercise regularly
• Practice mindfulness to increase calm and reduce negative thoughts
• Get enough sleep by having a nightly routine that includes a regular bedtime, wind-down activities, and staying away from electronics at least two hours before bed
• Eat nutritious foods and avoid unhealthy ones

Depression relapses can happen, but they’re not inevitable. You don’t have to expect to have one. Minimizing your risk factors and taking steps to prevent a recurrence can help you remain mentally healthy.

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