Feeling down from time to time is natural. Still, when sadness lingers, you may begin to wonder if something more is going on.

You’ve lived with depression before – could you be experiencing it again?

Everyone goes through ups and downs during life. Some days are good ones, and some days you can’t wait to get home and hide under the covers.

But when you’ve successfully overcome depression, you might always wonder if those “bad days” are the start of something more serious.

While depression is one of the most treatable mental health conditions, the chances of relapse after your first major depressive episode are not uncommon.

In fact, people who have had a major depressive episode have a 60% chance of having another. If you’ve had two bouts of depression, those chances increase to about 70%. Three or more episodes of depression and that number jumps to about 90%.

But you don’t have to live every day wondering when depression will strike.

Understanding what might trigger a relapse and knowing what to do if it happens will help you navigate having depression.

Worrying about a relapse can make it difficult to know when you are having a healthy emotional response. If you’re constantly on the lookout for depression symptoms, it can be easy to assume every negative feeling will lead down that road.

Relapse symptoms of depression are the same as those associated with major depressive disorder but recur once previous depression symptoms have been in remission for at least several months.

The symptoms you experience during a relapse may be different every time. These include:

  • depressed mood
  • significant loss of interest in activities or pleasure
  • weight loss or weight gain unrelated to dieting; changes in appetite
  • difficulty concentrating, thinking, or trouble with decision-making
  • feelings of guilt or worthlessness
  • significant loss of interest in activities or pleasure
  • changes in sleep habits
  • increased fatigue or energy loss
  • slowed speech and movements that are visible to others
  • increased restlessness
  • irritability
  • physical aches and pains
  • thoughts of death or suicide or attempts of suicide

These symptoms are usually present throughout the day, nearly every day, for at least 2 weeks. If symptoms go ignored or untreated, they can cause problems at work, home, and school.

Knowing what symptoms to watch for is only one part of recognizing a depression relapse. Understanding your triggers, or those things, moments, and events in life that may cause a relapse, are also important.

Triggers can be different for everyone. For you, isolation may be a significant factor. Maybe you’ve noticed that you’d rather lie on the couch than be as active as you once were. Or maybe you may have a new family crisis you’re facing.

In some cases, there may not even be an obvious trigger. One day you may simply realize you don’t feel like yourself.

Here are some common relapse triggers.

Family changes

Divorce, death of a loved one, or children becoming independent can all be stressful family changes.

Sometimes, the addition of household members can put a strain on day-to-day life. Having an elderly family member move in for caretaking, for example, may be very emotionally and physically demanding.

Hormonal shifts

Puberty, pregnancy, and menopause can be some of the most stressful life-changing moments.

Not only do these phases represent significant hormonal changes in the body, the stigma around them can wear on you mentally.

Professional or financial stress

The loss of a job or inability to pay bills are stresses many people know. Job changes, supervisor critiques, and new responsibilities may contribute to the stress you feel every day.

Medical issues

Many chronic illnesses increase stress on the body and mind, including diabetes, obesity, and heart disease. These conditions require lifestyle changes that can be difficult to adjust to.

Even injuries can be a potential relapse trigger when you go from being active to needing prolonged recovery or to adjust to a complete routine change.

Sleep disturbances

Sleep is a critical function of the human body, and sleep disturbances over time can cause stress levels to elevate.

You may have a new pet, a new baby in the house, or maybe your neighbors are disrupting your sleep.

Incomplete recovery

Complete treatment of your first depressive episode is key to prevent relapse. A 2020 study suggests that not completing treatment between episodes may make a relapse of depression more likely.

Stopping depression treatment early

Just because you feel better after 3 weeks of treatment doesn’t mean you should stop your treatment. The longer you invest in your treatment, the better chances you have of avoiding a relapse.

Not knowing personal triggers

If you are unaware of your personal triggers, recognizing depression relapse might be a challenge.

Try to keep track of what, when, and who causes you to experience symptoms. Being mindful of dates, like holidays, where stress is naturally higher for families and individuals, can be helpful.

Negative self-focus

You don’t need to have depression to experience poor self-esteem. Still, constantly putting yourself down may contribute to chronic feelings of low self-worth associated with depression.

Sometimes, depression relapse happens no matter what you do. Your mood may have been down for days, even though you’ve taken care to watch for triggers and keep up with treatments.

When depression relapse occurs, recognizing it and quickly seeking treatment can make a big difference in how much the episode impacts your daily life.

If you think you may be experiencing relapse symptoms, try to begin treatment immediately. Consider reaching out to your mental health professional to get a plan in place.

Treatment options for relapse are the same as for your first experience with depression and may include:

  • restarting medications, such as antidepressants
  • restarting or adjusting schedules of interpersonal therapy
  • restarting or adjusting schedules of cognitive behavioral therapy
  • electroconvulsive therapy
  • being mindful of getting enough sleep
  • focusing on a healthy diet
  • getting enough exercise

Since the symptoms you experience during a depression relapse can be different every time, the types and frequency of treatment options may change.

Being proactive about depression relapse can help keep you from living in a state of constant worry. While you may not be able to prevent every episode, you can still give yourself the best chance possible to avoid relapse.

Here are some steps you can try.

Keep a journal

Tracking your daily routines and feelings is a great way to identify patterns. You may be able to pick out triggering events, or you may discover certain times during the day when you’re feeling down.

Keeping a journal would allow you to be mindful of symptoms and can help you catch them early.

Mark the calendar

Similar to keeping a journal, marking on the calendar when you feel down may help identify dates that are particularly stressful.

Maybe you feel your worst on Mondays heading back to work, or maybe the holidays are particularly stressful.

Have friends and family look out for you

It can be easy to get swept up in emotions and not realize how long you’ve been feeling a certain way. Family and friends may be able to see changes in your behaviors before you do and help you catch symptoms before they progress.

Home therapies

Self-care is important for overall mental health, and home therapies such as breathing techniques and meditation may help you be more aware of your symptoms.

A 2015 systematic review found mindfulness-based cognitive therapy decreased the risk of relapse for people who have had three or more previous depressive episodes.

Keep a sleep routine

Sleep problems, such as insomnia, can increase your risk of depression. Sleep is closely linked with overall health, so creating a sleep routine can benefit you physically and mentally, not solely in relapse prevention.

Eat a healthy diet

Having depression may make you crave unhealthy food options, but how you eat before relapse matters.

Recent research published in the International Journal of Environmental Research and Public Health found that eating a more healthy diet may help lower the risk of relapse.

In fact, women who improved their eating habits – cutting out trans fat and eating more fruits and vegetables — had a 65% lower chance of relapse than women who did not.

Exercise regularly

The benefits of exercise on depression are well documented. You will likely sleep better, have a more regulated appetite, feel a mood boost, and negate some of the negative effects of other chronic health issues.

A 2020 review found that 3 exercise sessions a week for 12–24 weeks resulted in a medium to a large reduction in the severity of depression for study participants.

Keep up with your treatment

If you received treatment for previous episodes of depression, sticking to the plan your doctor has in place may make a big difference in relapse prevention.

Remember: Just because you’re feeling better doesn’t mean you should stop any therapies early.

Depression relapse affects more than half of people diagnosed with major depressive disorder.

During a relapse, you may experience multiple depression symptoms, and those symptoms can be different with every relapse event.

Recognizing your triggers, maintaining current treatments, and being proactive about relapse prevention can all help make the thought of an episode less intimidating.

If a relapse does occur, you’ll have plans in place to come through it with success.