“Once a person has been diagnosed and treated for depression,
is it likely to return?”
Depression is a common mental illness with serious personal and public health repercussions. Recurrence prevention would be ideal, thus researchers have started to uncover the risk factors associated with recurrence. At least half of patients diagnosed with major depressive disorder who are treated and recover are likely to have a repeat episode in the future. It could happen right away or it could take a long time. It could be caused by a life event or not. A psychiatrist may recommend long-term treatment after repeated episodes of major depression.
According to one meta analysis, the suicide risk among persons suffering from depression is almost twenty times higher than the overall population. In addition, a research of over 3000 teenagers and young adults found that 90% of those with recurrent depression reported “very much” impairment, restricting work productivity, and social connections, and 40% sought professional help as a result. Because depression has such a repetitive pattern, as well as the major influence it has on so many aspects of life, there has been a lot of effort put into determining the causes of depression so that preventive measures can be undertaken.
Depression relapse or recurrence
According to the American Psychiatric Association, depression can recur in two ways after the initial episode.
- A relapse of depression occurs when symptoms begin to recur or worsen after a period of recovery. Within two months of discontinuing therapy for a previous episode, relapse is most likely to occur.
- When symptoms of depression recur months or years after a person has recovered from the last episode. This is most common during the first six months. A recurrence affects about 20% of people, however this number might climb when depression becomes severe.
50-80 % of individuals will experience at least one more episode of depression throughout their lifetime (APA). The risks of depression recurring after two or three previous episodes are substantially higher.
Some depression-like disorders relapse on a regular basis. These are:
- Seasonal Affective Disorder (SAD): is a prevalent disorder that occurs throughout the winter months.
- Premenstrual Dysphoric Syndrome (PDS): is a severe variant of premenstrual syndrome.
Depression can recur
It is natural to be concerned when symptoms of depression reappear after a period of time. Early detection of red flags, on the other hand, may help to avoid a more severe episode from occurring. Many individuals who suffer from depression may experience a relapse or recurrence at some point. It normally happens within 5 years, according to a study; although it might happen weeks, months, or even years after the first episode. About half of the persons who experience their first episode of depression will recover completely. Depression can strike the other half of the population at any moment during their lives.
The warning indicators for individuals who have repeated episodes of depression may be different each time. Doctors and experts are baffled as to why some people relapse while others do not.
Early Signs of a Depression Relapse
During preceding episodes of depression, a person can usually recognise the same fundamental warning signs of depressions, but symptoms can vary with a relapse. The following are some of the most common depression warning signs:
- Depressed mood: Feeling depressed or worried.
- Loss of interest in activities: Hobbies, sex, and other interests that the individual normally likes are less enjoyable.
- Social withdrawal: Avoiding social events and losing communication with friends are two of the most common symptoms of depression.
- Fatigue: Daily tasks like washing the dishes and getting dressed may become more difficult and time consuming.
- Agitation: Restlessness and pacing about.
- Sleep patterns change: Excessive sleeping or insomnia are two major signs that sleep patterns have changed.
- Changes in appetite: Weight gain or weight loss may be evident as a result of this.
- Increased irritability: Becoming more easily irritated than usual.
- Feelings of worthlessness and guilt: Reminiscing on the past.
- Concentration and memory problems: Thoughts and words will feel slower.
- Physical aches and pains: Headaches, stomach-aches, or muscle pain that cannot be explained.
- Suicidal thoughts or suicidal attempts: This could be an indication of a severe depressive episode.
Triggers
When people with a history of depression are exposed to specific triggers, they are more likely to develop a depressive episode than those who have never had a depressive episode. Relapse or recurrence of depression is frequently triggered by the following factors:
- Stressful life situations like family conflict, relationship problems, and mourning, that can occur during or after recovery.
- Incomplete recovery: Depression is most likely to recur if the individual does not receive complete treatment for major symptoms of a previous episode.
- Early treatment termination: Depression is not easily cured; continuing treatment for six months or more after feeling better can lessen the risk of relapse.
- Medical conditions such as diabetes, obesity, and heart disease can all increase the chance of depression in the future.
Preventing a Relapse
These preventive measures can help avoid relapsing into another depressive episode:
- Continuation of treatment: Maintaining a given medication’s course can dramatically minimise the chance of recurrence, especially during the critical first six months of treatment.
- Therapies based on mindfulness: Mindfulness can aid in the understanding of negative thought patterns and the development of strategies for dealing with them. According to one study, practising mindfulness three times a week can cut depression relapse by up to 50% in a year.
- Educating relatives and friends: Informing friends and family about the warning signs to look for may aid in the early detection of an episode.
- Prepare for a relapse: Making a plan ahead of time can help an individual react promptly if warning indicators occur. This is something that a professional can assist with.
Coping with a Relapse
When troubling symptoms reappear during treatment, it is possible that the current treatment is not working properly. A doctor may suggest a change in treatment method or increase the prescription dosage. Treatments and strategies that may be beneficial include:
- Talk therapies: Interpersonal therapy (IPT), Cognitive Behavioral Therapy (CBT), or both may help to lessen the incidence of recurrent depression.
- Medications: Antidepressants or mood stabilizers can help some individuals. Following a doctor’s instructions for taking these medication can help in preventing a relapse.
- Exercise: Staying active has been shown to antidepressant properties. It releases endorphins, which can help a person feel better. A 2015 survey of studies suggested that exercise could be as beneficial as antidepressants or psychotherapies in mild to moderate depression.
- Electroconvulsive therapy: A doctor may recommend electroconvulsive therapy (ECT) in various instances. However, the use of ECT is debatable, as some doctors consider that the advantages do not justify the risk of brain damage.
Depression can have a significant influence on a person’s life, yet up to 70% of people who seek therapy find that their symptoms improve significantly. When the previous episode was more severe, the likelihood of depression recurring is increased. Other problems, such as anxiety disorder, personality disorder, or substance abuse, can also make a person more vulnerable and susceptible to recurrence. Individuals with depression can improve their long-term outlook by taking steps to prevent or treat each new episode that reappears.
Sources:
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2169519/