Depression Relapse

Estimated reading time: 27 minute(s)

Depression is a widespread psychiatric illness that continues to affect millions of people across the world. The mental health disorder primarily affects a person’s ability to function daily but is fortunately manageable with medication and therapy. People who have successfully overcome depression can sometimes worry about re-experiencing this condition even after completing the required treatment. Known as a depression relapse, this comeback is quite common, with 40 to 60 percent of people re-experiencing the depressive symptoms after seeking treatment at least once in their lifetime. [1]

Learning about depression relapse, its causes, symptoms, and potential treatment modalities is essential to ensure prolonged and continued recovery with minimal disruption in daily life.

Relapsing into Depression: What are the Causes?

If you feel like your depressive symptoms are coming back despite seeking treatment, multiple causes can be behind it. A relapse is possible even in people receiving therapy or taking medication. It may also sometimes appear without any apparent external stressors or triggers.

Following are some common triggers of depression relapse in the majority of people:

• Experiencing the death of a loved one
• Failure to use the learned coping strategies or discontinuing their use in daily life, such as regular exercise, journaling, etc.
• Sleep disturbances
• Changes in the antidepressant medications
• Hormonal changes secondary to an ongoing life stage, such as during pregnancy, menopause, or puberty
• Undergoing a stressful life event, such as getting fired from a job, having a child, studying for exams, or going through a divorce or breakup

Remember that the causes mentioned above can vary from one person to another. What leads to a relapse in one person may not cause any problems in the other.

Common Signs of a Depression Relapse

The signs of a depression relapse may sometimes differ from those you encountered during your past depressive episodes. These differences can also be based on ethnicity, cultural background, and age. [2]

Following are the symptoms to watch out for to detect a depression recurrence in time:

• Sleep changes: A depression relapse can make people struggle to sleep, mainly because they fix their minds on whatever happened during the day or anything that makes them feel unhappy. On the other hand, some people may use sleep as a coping mechanism to escape their depressive thoughts and fail to leave bed for most of the day.
• Irritability: A depression relapse can make people feel annoyed more quickly than usual. Such people may snap at loved ones more frequently or get anger outbursts more quickly.
• Loss of attraction to your partner: While losing interest in a partner can have various causes, depression can sometimes trigger it.
• Loss of your interests: Recurring depression can make a person lose interest in activities they previously used to enjoy.
• Poor concentration: Many people with depression recurrence experience brain fog that interferes with their attention. This means they have a slowed-down process and face difficulties in making decisions.
• Feeling down, teary, or hopeless: Everyone has a bad day occasionally, and feeling teary or low because of such days is expected. However, experiencing prolonged tearfulness and hopelessness may indicate that your depression is returning.
• Social withdrawal: People with recurring depression may completely isolate themselves from all social activities and suddenly withdraw from family and friends without any reason.
• Feelings of worthlessness: Depression can significantly harm self-esteem, manifesting itself in the form of worthless feelings. It may become challenging to get rid of these feelings, and in some cases, it may become self-hatred.
• Weight changes: Depression makes a person lose interest in food, sometimes to the extent that they stop eating and lose weight. In others, the mental health issue may lead to overeating and consequent weight gain. In short, any changes in the body weight with no alternative explanation may signify underlying depression.
• Fatigue: As a telltale sign of depression, fatigue can make people so exhausted that even getting through the routine may become impossible.

Treating Depression Recurrence Professionally

If you feel like you are experiencing a depression relapse, remember that treatment is possible. In general, all treatment strategies that manage depressive episodes will help with a relapse, too. Below are some options to consider after consultation with a doctor.

Talk Therapy

This may include interpersonal therapy (IPT), cognitive behavioral therapy (CBT), and psychoanalytic therapy.

Medications

The standard medications for depression include selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs).

Combinational Therapy

This involves the right balance between medications and talk therapy to benefit a patient best.

How to Stop Depression Relapse: Coping Tips to Remember

In addition to seeking professional help, as mentioned above, there are some coping strategies to help get past the depression relapse while managing the condition in the best possible way. These tips can help a person deal with an active relapse and avoid it in the future.

Reach Out to Family or Friends

If you feel like slipping back into a state of depression, consider contacting a friend or family member and letting them know about your feelings. Depression can make anyone cut back on their social connections, worsening symptoms. Find someone to confide in and make a difference in controlling the recurrence.

Practice Self Care

Consider taking care of your physical and mental health during a depression recurrence to make the experience less challenging. Following are some tips to consider in this regard:

• Get regular exercise: Consider doing yoga, stretching, high-intensity interval training, or even brisk walking.
• Maintain a routine: Fix time for basic things in a routine day, such as brushing teeth, showering, or dressing up daily.
• Use light therapy: Invest in a UV lamp to get enough light and regulate your mood. This is particularly helpful in people with seasonal depression.
• Fix a regular sleep schedule: Try going to bed and waking up simultaneously daily.
• Pop a vitamin D supplement: Vitamin D can help manage depression due to a lack of sunlight.

Adhere to Therapy Recommendations

For people who have received treatment for depression, most rehabs provide specific recommendations or aftercare tips on how to move forward. Reflecting on these recommendations and remembering what therapy taught is an excellent way to cope with a relapse. Check for any strategies you can use to get past this difficult time. If this is not the first time you have relapsed, think about all the things that helped you overcome depression the last time and consider using them again.

Adhere to the Medication Plan

People taking antidepressants to manage depression must adhere to their schedule precisely as prescribed. Avoid abruptly stopping any medication or changing its dose because you do not like how it makes you feel. If you have any concerns about an antidepressant, consider scheduling an appointment with the doctor and discuss any changes that can be made.

Go For Mood Tracking

For someone who has battled depression, getting aware of their moods and any shifts in them every day is essential. A mood tracker is the most efficient way to record these shifts. It usually involves a one-page-long worksheet that can be maintained for one month according to a person’s current mood. For more extended coverage, year-long mood tracking sheets are also available.

Mood tracking has various benefits, such as they can tell an expert more about a person’s mood shifts in terms of time and emotions to find and address a pattern. Moreover, a mood tracker also alerts them about a potential mood shift that may not be resolved independently.

Start Journaling

Expressive writing or journaling is an excellent way to manage mental health as it allows a person to explore their emotions, just like in therapy. [3] The difference is that journaling enables a person to explore themselves emotionally instead of with a therapist’s support. The technique is also an excellent way to find a negative thought pattern so that it can be reframed in a more positive tone.

Find a Support Group

People struggling with depression relapse often require additional support. Looking for a suitable support group that deals explicitly with recurrent depression can help people find the support they need and make friends who truly understand their struggles. A feeling that there is someone who understands and relates to you creates a significant difference in terms of depression relapse recovery.

FAQs

What does relapse mean in depression?

A depression relapse occurs when the depressive symptoms start worsening or reappear after resolution following a treatment program. Relapse generally hits a person within the first two months of completing treatment for a previous episode.

Can alcohol cause depression relapse?

Experts believe that depression can not only trigger depression but also make the pre-existing one much worse. Its relapsing potential is attributed to the alcohol’s direct effects on certain brain parts that regulate emotions, impulsiveness, perceptions, inhibitions, and self-control.

Can depression come and go?

Depression may come and go in many people, but therapy and treatment can help reduce its symptoms. The condition can also recur, sometimes due to the same problems that led to its development in the first place. However, this varies from one person to another, with some remaining symptom-free for months following treatment and others requiring constant ongoing care to keep depression under control.

References

1 Nuggerud-Galeas S, Sáez-Benito Suescun L, Berenguer Torrijo N, Sáez-Benito Suescun A, Aguilar-Latorre A, Magallón Botaya R, Oliván Blázquez B. Analysis of depressive episodes, their recurrence and pharmacologic treatment in primary care patients: A retrospective descriptive study. Plos one. 2020 May 21;15(5):e0233454.

2 Bailey RK, Mokonogho J, Kumar A. Racial and ethnic differences in depression: current perspectives. Neuropsychiatric disease and treatment. 2019 Feb 22:603-9.

3 Sohal M, Singh P, Dhillon BS, Gill HS. Efficacy of journaling in managing mental illness: a systematic review and meta-analysis. Family medicine and community health. 2022;10(1).