Depression, recognized in the DSM-5 as major depressive disorder (MDD) and sometimes called clinical depression, is a common mental health condition. In 2016, more than 16 million adults experienced at least one major depressive episode.
While depression can be treated, and symptoms can be alleviated, depression cannot be “cured.” Instead, remission is the goal. There’s no universally accepted definition of remission, as it varies for each person. People may still have symptoms or impaired functioning with remission.
Depression also has a high risk of recurrence. At least 50 percent of individuals who’ve experienced one episode of depression have one or more depressive episodes. Individuals who’ve had at least two episodes may have at least one more depressive episode.
As with any chronic condition, even though it may recur, there are treatments available to reduce the severity of your symptoms, manage your condition, and give you support.
Why depression happens again
While not everyone who experiences a depressive episode goes on to have another one, many individuals do have another episode. It’s not always known what causes this. Further, there isn’t one known cause of depression in general. It’s thought that a variety of things are involved, including biological, genetic, environmental, and emotional factors.
If you have a recurrence, that doesn’t mean you’re weak or that you did anything wrong. Sometimes depression can be triggered by stressors like losing a job, a serious illness, the loss of a loved one, or substance use. Other times, a recurrence can happen because the medication you were taking isn’t the best one for you, or because it’s time to try a new therapy.
Talk with your treatment team about your risk of recurrence, and what to do if this happens. This can help alleviate any anxiety you might have about possible recurrences. Knowing there’s a backup plan, should you need it, can be reassuring.
The warning signs
Depression can manifest in different ways for different people. Some people may sleep too much, while others might have difficulty sleeping. Keeping a log of your specific symptoms can be helpful, especially when discussing treatment options with your doctor.
That being said, there are some common signs and symptoms of depression, which includes:
- lack of energy or increased fatigue
- changes in weight or appetite
- feeling restless or agitated
- moving or talking slower than usual
- loss of interest or pleasure in activities or things that were previously enjoyable
- trouble concentrating or making decisions
- sleep disturbances, such as waking early in the morning, oversleeping, or not being able to sleep
- feelings of guilt or hopelessness
- feeling sadness or empty
- physical aches or pains, or digestive issues that aren’t helped by treatment, or might not have any clear cause
- thoughts of death or suicide
To be classified as depression, symptoms need to be present most of the day, nearly every day, for at least two weeks. You don’t need to have all — or even most — of these symptoms to be diagnosed with depression. If you think you or someone you care about is living with depression, it’s important to speak with a healthcare professional.
If you’ve experienced a depressive episode before, you might be able to recognize the symptoms of a recurrence. Sometimes, the symptoms of a recurrence can be as simple as not being able to sleep or having trouble concentrating.
If you think you might be at risk of having another depressive episode and are worried, talk with your treatment team — your doctor or therapist — about things to watch out for. They’re familiar with your situation and your personal risk factors, and their feedback can be very helpful.
It can be hard to self-evaluate, especially if your thought processes are being affected by depression, so having outside feedback about symptoms to watch for can make a big difference.
How to prevent a recurrence
Treating your depression can help reduce the risk of another recurrence. Treatment commonly includes a combination of some form of talk therapy, as well as medication.
Sometimes people experience a recurrence of depression during their treatment, and that’s okay. Your treatment team can reevaluate your treatment plan and see if it needs to be changed or tweaked.
Follow treatments prescribed by your doctor
Sticking to your treatment plan can help reduce the risk of recurrence. This can include:
- attending psychotherapy regularly
- completing any assignments given
- taking medications as prescribed
- avoiding drugs or alcohol, which can cause depressive symptoms and interfere with medications
If you’re currently on a medication for depression and it’s not working, you may need to work with your doctor to change medications. Sometimes it takes trying several different medications to find the one that’s best for you. As with many medications, there can be side effects, which typically go away after a few weeks.
It’s important to never stop an antidepressant abruptly, since this can cause an increase in symptoms and possibly trigger a recurrence.
Self-care can also help with preventing depression symptoms and recurrences. Adequate rest and sleep can impact the health of both your body and mind. A healthy diet with essential vitamins and minerals is also important for general health, and regular exercise can increase feel-good chemicals in the brain.
If you’re having difficulty sleeping or need assistance with a meal plan or exercise routine, talk with your doctor about these things. They might be able to assist with relaxation techniques for sleep, or if need be, prescribe something to help. They can also provide you with recommendations for a nutritionist or exercise plan.
You don’t have to do this alone. Depression is an illness and isn’t something you can fight with willpower alone. Talk with your doctor and have a support team in place.
Although recurrence is common, it doesn’t mean this is permanent. There may be no technical “cure” for depression, but with assistance and treatment, depression — even recurrent depression — is treatable.