Depression is a highly treatable disorder. However, many sufferers experience a recurrence or relapse of symptoms over time.
Relapse and Recurrence
A relapse is an episode of major depression within six months after responding positively to treatment. A recurrence, in contrast, is another depressive episode that occurs more than six months after the first. Both are common. In fact, mental health experts consider major depressive disorder a chronic condition with frequent relapses and recurrences. Individuals with major depression are more likely to experience a relapse or recurrence than those with mild depression.
The earlier you seek treatment for depression after the onset of symptoms, the more effective treatment is and the less likely you are to have a recurrence. Some patients don't respond well to initial treatment and it takes several tries to find an effective therapy. However, the more treatment strategies required, the lower your odds of beating depression. Patients who become completely symptom free following treatment (versus those who only have a partial improvement) have a better chance of staying in remission.
What Triggers Relapse?
Certain triggers increase the likelihood of depression relapse or recurrence, including friction within personal relationships, feeling overwhelmed with too much to do, feeling like others are judging or criticizing you, ending a relationship, and physical illness.
Furthermore, individuals who first become depressed after age 60 or have depressive risk factors, such as personal or family history, co-existing mental health conditions, and lingering symptoms after initial treatment are at greater risk for additional depressive episodes.
Preventing and Managing Relapses
The goal of depression treatment is to eliminate symptoms so you can resume a normal quality of life and avoid future depressive episodes. You should not stop treatment without consulting your physician and if your treatment is not helping (after giving it sufficient time to take effect), tell your physician so she can try a different therapy. Every patient responds differently to different therapies and you need to find one that's right for you.
Patients with more serious forms of depression may need to remain on long-term maintenance treatment with antidepressant medications, psychotherapy, or both. Cognitive behavioral therapy and interpersonal psychotherapy after initial treatment with antidepressants helps many patients prevent future depressive episodes, especially adolescents. Practicing mindfulness-based cognitive therapy also helps prevent relapse in patients who are in remission.
You and your physician should monitor your symptoms and be alert for the onset of a relapse or recurrence so you can begin treatment immediately.
Sources:
ScienceDaily.com. "Mindfulness-Based Therapy Helps Prevent Depression Relapse." Web. 9 December 2010.
http://www.sciencedaily.com/releases/2010/12/101206161734.htm
ScienceDaily.com. "Psychotherapy Prevents Relapse Of Depression In Many Women." Web. 3 May 2007.
http://www.sciencedaily.com/releases/2007/05/070501075050.htm
Nirenberg, Andrew A. M.D., Petersen, Timothy J., Ph.D., and Alpert, Jonathan E. M.D. "Prevention of Relapse and Recurrence in Depression: The Role of Long-Term Pharmacotherapy and Psychotherapy." Journal of Clinical Psychiatry 64 [suppl 15] (2003): 13-17. Web.
http://www.psychiatrist.com/pcc/pccpdf/v05s09/v64s1504.pdf
National Institute of Mental Health. "Depression Relapse Less Likely Among Teens Who Receive CBT After Medication Therapy." Science Update. Web. 5 December 2008.
http://www.nimh.nih.gov/science-news/2008/depression-relapse-less-likely-among-teens-who-receive-cbt-after-medication-therapy.shtml
National Institute of Mental Health. "Depression Patients' Brain Circuitry Makes Them Vulnerable to Relapse." Science Update. Web. 1 August 2008.
http://www.nimh.nih.gov/science-news/2008/depression-patients-brain-circuitry-makes-them-vulnerable-to-relapse.shtml
National Institute of Mental Health. "Odds of Beating Depression Diminish as Additional Treatment Strategies are Needed." Science Update. Web. 1 November 2006.
http://www.nimh.nih.gov/science-news/2006/odds-of-beating-depression-diminish-as-additional-treatment-strategies-are-needed.shtml
