What Does It Mean to Relapse With Depression?

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A depressive relapse is a common occurrence. Although antidepressants can provide relief to many people and even stop depression symptoms altogether, they do not tackle the root cause of the issue or provide a permanent cure.

A relapse, also called depression recurrence, is defined as a period in which symptoms return months or even years after an individual has recovered from the last episode. It is most common within the first six months of being depression-free.

Relapsing doesn’t mean that your treatment plan has failed or that you haven’t been committed enough to recovery, it is a normal part of living with and overcoming depression.

Understanding the Language: Types of Depression

There are various types of depression, and understanding the terminology helps to make sense of what you or a loved one might be experiencing.

Major Depression

Major depression is a mood disorder that causes symptoms that interrupt daily functioning, making normal tasks like work, school, or hobbies more difficult. Although depression might only occur once during your life, some people often have multiple depressive episodes. A major depressive episode lasts at least two weeks but can continue for up to a year. An average new episode will not last longer than three months.

Persistent Depression

Persistent depression differs from major depression in the severity of symptoms but most significantly in the period that it affects people. Individuals with persistent depression experience symptoms for at least two years, so instead of recurring episodes of depression symptoms, they experience regular and persistent symptoms. If you are not experiencing any relief from depression symptoms, and they have occurred for over two years, you may have persistent depressive disorder (PDD).

Depressive Episode

An episode of depression is a period of depression that lasts for at least two weeks. During this time period, a person will typically experience a low or depressed mood and energy, loss of interest in activities, as well as any other symptoms of depression such as irritability and hopelessness. Depression relapse is a common part of major depressive disorder. After the first depressive episode, around 60% of people will experience relapse, and after two previous depressive episodes, this rises to 70%. This likelihood of relapse increases steadily with each episode a person has.

What Are Depressive Symptoms?

Recognizing depression relapse can sometimes take time, as symptoms may differ from a previous episode or take effect gradually. The core symptoms of depression include:

  • Sleep disturbances
  • Suicidal thoughts
  • Change in eating habits including losing weight or weight gain
  • Decreased interest or pleasure in activities
  • Fatigue or loss of energy nearly every day
  • Feelings of hopelessness, worthlessness, or excessive guilt
  • Struggle to concentrate or make decisions

Warning Signs of Depression Relapse

If you know that a loved one has a mental health condition, it is good to be aware of the signs that they might be struggling. Recurrent depression can be difficult to deal with as individuals can sometimes oscillate between states. Recurrence of depression might cause:

  • Social withdrawal and change to social life
  • Persistent negative thought patterns or general negativity
  • Sleep disturbance and not getting enough sleep
  • Physical aches
  • Struggle with daily life tasks
  • Substance use

If someone you care about is experiencing any of these symptoms with no obvious cause, it might be a depression relapse. Whether you know they experience moderate depression, severe depression, or you know there are certain risk factors for depression in their life, it is always good to check-in. If you are worried that a loved one is having suicidal thoughts, there are suicide prevention networks set up to provide support and resources.

Other disorders may present depression-like symptoms and return sporadically or regularly. These include:

Seasonal affective disorder (SAD) – most often affecting people during winter months, SAD causes depression-like symptoms, including lack of energy, changes in sleep patterns and irritability.

Premenstrual dysphoric syndrome (PDS) – experienced by a small percentage of those who menstruate, PDS is a severe form of premenstrual syndrome impacted by hormonal changes. It causes behavioural symptoms such as binge eating and problems sleeping as well as mental and emotional symptoms, including irritability, feeling anxious, depression, anger and, in extreme cases, suicide.

What Causes a Depression Relapse?

Depression relapse is a normal part of depression, which the vast majority of people with the disorder experience. There are, however, certain factors and life events that may increase the likelihood of relapse occurring. Factors associated with an increased risk of relapse and recurrence in depression include:

  • Grief or a significant loss
  • Comorbid anxiety or co-occurrence of other mental disorders
  • Stressful life events such as a change of job or divorce

Behavioural Changes for Preventing Relapse

There are a range of changes to routine and daily life that may help to prevent relapse. Exercise can help with depression, and changing the amount of physical activity in your daily routine can make a big difference to mood and well-being. Something as simple as a daily walk can greatly improve mental well-being. Other changes such as reducing social media use, eating a healthy and well-balanced diet, reducing screen time before bed and trying to stick to a healthy sleeping pattern can all help avoid depression relapse. It is really important to reach out for help if you do feel your symptoms return and feel like you are struggling.

Treatment for Depression Relapse

There are a wide range of treatment approaches for managing depression, though the right treatment plan for one person may be wrong for another. It is possible to experience relapse while receiving treatment – about half of people do after the first episode – and it isn’t necessarily a sign that professional help isn’t working for you. From antidepressants to a variety of different therapeutic modalities, it might just take time to find what works.

Antidepressant medication, such as mood stabilizers, can treat the symptoms of depression, but they do not always address the cause. Counselling or psychotherapy can help you get to the root cause, identify unhelpful patterns of behaviour and thinking, and enable you to create healthier ways of managing symptoms. The most common antidepressants are selective serotonin reuptake inhibitors (SSRIs), although there is a wide range of others.

Psychotherapy therapy is seen as a way to identify some of the potential causes of depression. Therapy can also help to address negative thoughts and prevent relapse.

Common types of therapy for people who struggle with mental health issues and have experienced depression include:

  • Interpersonal therapy
  • Cognitive behavioural therapy
  • Mindfulness-based cognitive therapy
  • Dialectical behavioural therapy
  • Psychodynamic therapy
  • Group therapy

Electroconvulsive therapy is a much rarer form of treatment used if individuals are in a state of serious distress and no other approaches have worked.

Peer-reviewed studies show that a combination of treatment approaches, with therapy in addition to medication, is the best method for relapse prevention. Depression treatment can be incredibly effective, but it often requires dedication and commitment.

Recovery at The Wave Clinic

At The Wave Clinic, we understand how challenging it can be to struggle with depression relapse. Our carefully designed treatment plans are individualised, so we ensure they are tailored to your unique needs. We offer a wide range of clinical treatment options to help young people better manage their symptoms and deal with relapse. We also provide young people with a chance to grow and learn through fun activities, educational opportunities, and team-building exercises. There is a strong sense of community and the stability to heal through clinical and experiential treatment. Contact ustoday to learn more.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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