“Depression is like many other common medical conditions, such as high blood pressure or diabetes,” said William R. Marchand, M.D., a clinical associate professor of psychiatry at the University of Utah School of Medicine and author of the book Depression and Bipolar Disorder: Your Guide to Recovery. It’s highly treatable, and effective interventions are available. But there’s a risk that symptoms will return.
According to Dr. Marchand, the risk of recurrence — “relapse after full remission” — for a person who’s had one episode of depression is 50 percent. For a person with two episodes, the risk is about 70 percent. For someone with three episodes or more, the risk rises to around 90 percent.
That’s why having a prevention plan is critical, he said. “Depression is often a chronic illness, but with a good prevention plan in place, it is often possible to prevent recurrences entirely or limit the severity and duration if depression does return.”
A prevention plan must include maintenance treatment, which is “treatment that is continued after symptoms are in remission to prevent recurrence.” This includes medication, psychotherapy or both, Marchand said. (If you’re currently receiving or have received treatment, make sure you have a prevention plan.)
It’s also important to understand what might trigger a possible relapse, and how you can prevent or minimize the influence of those triggers. Below, you’ll find three common triggers for depression, along with information on navigating a relapse.
Trigger: Not Following Treatment
“The biggest issue regarding relapse has to do with children and adults not following through on their treatment plan,” said Deborah Serani, Psy.D, a clinical psychologist and author of the book Living with Depression. This includes anything from skipping therapy sessions to missing doses of your medication to ending therapy too soon, she said.
If you don’t want to take your medication because of side effects (or other reasons), talk to your prescribing physician about these issues. They may reduce your dose, prescribe a different medication or recommend another strategy to minimize side effects and respond to your concerns. Similarly, if you’re dissatisfied with your therapy sessions (or you’re having a hard time getting to your appointments because of logistics), speak up.
Depression, like other chronic illnesses, requires “commitment and management. [Y]ou have to learn to live with it every day but not allow it to define you,” Serani said. How? Focus on celebrating your strengths. “While your life may involve psychotherapy, medication and the need for a protective structure that keeps your illness at bay, also realize that you have passions, desires, gifts and talents that require just as much attention.”