For many people with depression, emerging from the fog of the illness can be an uncertain, hope-filled reprieve. On the other side of things, you may feel hopeful, excited, sexy, powerful and ambitious again. But what happens when those feelings start to fade again? If you’re feeling the symptoms coming on again, could you be in the early stages of a depression relapse?
Relapsing in depression is the kind of bad news no one wants — the moment you realize you may be heading into it again is the moment everything can feel most hopeless.
Luckily, there are plenty of steps that you can take to cut off that relapse before it occurs. In order to prevent depression from taking hold again, however, you do need to act fast, and part of acting fast is knowing what signs to look for that a relapse is upon you.
Understanding how to spot a depression relapse before it takes hold requires knowledge. Let’s start from the beginning.
Depression or major depressive disorder is a mood disorder in which you feel depressed for a regular, recurring period of time, at a level of intensity that impacts your quality of life. What characterizes a “depressed” feeling? Low, down, sad or hopeless thoughts.
These thoughts and feelings can lead to anxiety, exhaustion, insomnia and many other problems if they go untreated, and the resulting issues can affect your relationships, your job, your love life, your libido and, well, pretty much everything in your life.
At least two weeks of these daily symptoms are required for a depression diagnosis, though depending on the form of depression that you have, it may differ.
Clinical depression, seasonal affective disorder (SAD), major depression and persistent depressive disorder all affect you differently, at different times, to different degrees.
A relapse, then, is simply when the depression and the symptoms that you experienced in previous episodes (and maybe some new ones) start to return for a second time.
We probably don’t want more episodes of depression than we’ve already had, and most of us would prefer the symptoms of depression never get a reboot. And yet, it can happen.
The signs of a depression relapse, simply, are the signs of depression itself. The good news is that there’s no “super depression” that comes when you’ve beaten back the first round of the disorder.
The bad news, of course, is that many of your familiar symptoms could be returning. You might be able to recognize your own particular stages of depression. Noticing those symptoms might be easier the second time around, but it can still be difficult to see what’s going on until you reach a level of severe depression with depression symptoms strong enough to affect your daily life.
If you’re trying to identify what to look for, you don’t necessarily need to identify a depressive episode to see signals that your risk of relapse is increasing. Here are some signs that depression relapse is starting:
Depressive symptoms can vary a lot, but as far as your emotions go, negativity is what you’re looking for an increase of. This includes feelings of irritability, guilt, worthlessness and hopelessness.
Feeling less enthusiastic about hobbies? Care less about TV shows you used to like? It might not be bad writing or boredom that’s driving you away. Depression can make you lose interest, experience less pleasure and become more pessimistic about your everyday life.
Losing your appetite? Dropping pounds? Doing the opposite? Any of it could signal a change in mood associated with depression.
Having trouble sitting still, tossing and turning more in bed and increased levels of anxiety and distress can all be signs that your depression is returning.
Unexplained headaches, aches and pains when you haven’t been to the gym, extra cramps, diarrhea and nausea can all be caused by a lot of things, but if you’re seeing an unexplained increase in these areas, it may be more mental than physical.
Unfortunately, the causes for depression relapse are largely similar to the causes of depression the first time.
Those causes can be biological, genetic, psychological or environmental, meaning you can get depression from your parents; from changes in your body health; or from the apartment, office, city or surroundings in your life; or even from things that affect your mental health, like stress, sadness or grief.
Even the pros don’t fully understand what causes depression — experts understand that genetics, biology, trauma, illness and some other factors can all increase your risk of recurrence of depression, but the reality is that it can be a combination of those factors you might not suspect.
Either way, you’re not responsible for any of the things on that list.
A depression relapse is not your fault, and that’s an important thing to accept quickly if you’re experiencing a relapse. From the relationships that define our life to the jobs that come and go, there are things we don’t have control over.
Changes to those things and the burden of new illnesses, grief and other hindrances to your mental health can cause depression to return.
If you’re feeling guilty, you can drop it. If you’re feeling responsible, you can skip it. This isn’t about consequences, nor is it about responsibility. You are not responsible for your illness happening.
What you are responsible for, though, is how you handle the signs of relapse once you spot them. Watching the oncoming depression train get closer and closer without action is not okay — when you see it getting bigger, you need to step off the tracks and into a conversation with a professional.
Realistically, relapse is not an uncommon concern. There’s not a lot you can do to stop depression from coming again, and sometimes that just means accepting that you’ll have to do battle again.
Research shows that between five and 10 percent of patients who maintain their medication when on antidepressants relapse each year.
Some research has shown that relapse and recurrent depression are a genetic problem, but other variables like gender, marital status, the severity of the first bout with depression, the presence of other disorders and socio-economic status could all play a part.
Proactive mental healthcare is the best strategy for handling depression before and during its possible return. What that means for you may differ, and ultimately it will be a decision you make with the support of a mental health professional.
Continuing to take your medications as directed and maintaining maintenance therapy can both help with your mental health generally, but they may not ultimately prevent a relapse of depression.
If and when it comes back, you’re going to need to seek treatment as close to the onset of depression as you can.
Whether you’re here because stressful life events have rattled your mental health or, after months or years without an episode of depression, you feel a depressed mood returning, the most important next step is seeking care and professional treatment.
Depression is something that people want to be rid of once and for all, but even if you’ve done everything right, you may be unable to prevent a depressive relapse. When depression does return, the best steps for you to take are going to be familiar — starting with professionals.
Get in touch with a healthcare provider, share your symptoms, and start the treatment dialogue.
If you’re ready to do that today, our online therapy for depression is available to help you without so much as a shower first. In the meantime, we have more resources available if you have questions that need answers.
If this isn’t your first rodeo, you already know what you need to do: get up in the treatment saddle and ride this out. You’ve done it before — you’re already a pro.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.
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