How to Reduce Your Risk of Depression Relapse

Major depressive disorder is often a chronic condition rather than a one-time occurrence. Research indicates that many individuals who experience improvement through treatment may find their symptoms worsening again before reaching a prolonged remission, a process known as relapse.

According to Kimber Shelton, PhD, a licensed counseling psychologist, relapse is a common part of the recovery process. Data shows that approximately 70 percent of people who achieve partial remission of major depressive disorder will relapse, typically within the first four months.

Common Triggers of Depression Relapse

Relapse triggers are personal and can evolve over time, but several common factors are frequently linked to the return of depressive symptoms.

• Medication Changes: Altering dosages or stopping treatment altogether can lead to relapse. A change in medication can disrupt the balance of endorphins, serotonin, and dopamine, which are chemicals involved in general well-being, pain relief, and mood.
• Life Events and Trauma: Stressful events such as the loss of a job, the death of a loved one, caregiving responsibilities, or natural disasters can trigger episodes. Traumatic events, including abuse, or vicarious trauma experienced by emergency responders and healthcare workers, also contribute.
• Medical Diagnoses: New diagnoses of serious chronic illnesses, such as cancer, diabetes, multiple sclerosis, arthritis, Parkinson’s disease, and heart disease, increase the risk. In some cases, the disease activity of an inflammatory condition itself can cause depression.
• Postpartum Factors: Giving birth can trigger a relapse. One study of nearly 450,000 births found that 19.1 percent of new mothers developed postpartum depression.
• Seasonal Changes: Seasonal affective disorder (SAD) typically occurs during fall and winter months due to shorter daylight and colder weather, though some experience it in the summer.
• Significant Dates: Anniversaries of major life events, such as a divorce, or holidays like birthdays and Mother’s Day can trigger symptoms by reminding individuals of traumatic childhood experiences or the death of a loved one.

Race-based trauma is also a significant factor. A study of over 1,600 Black women ages 23 to 34 in Detroit found that 65 percent reported experiencing racism, and nearly 37 percent had high depressive symptoms. The research noted that frequent racism experienced before age 20 was linked to an increased risk of high depressive symptoms in adulthood.

Strategies for Reducing Relapse Risk

While there is no guaranteed way to prevent a relapse, there are proactive steps to lower the probability of recurrence and reduce the impact of triggers.

Manish Sapra, MD, executive director of behavioral health services at Northwell Health, emphasizes that while treatment reduces the probability of relapse, the condition requires active daily work.

Key strategies for risk reduction include:

• Identifying Triggers: Tracking triggers in a journal and setting boundaries with behaviors or people that pose risks can help maintain wellness.
• Maintaining Routines: Prioritizing regular exercise and adequate sleep each night can lower the impact of triggers. Dr. Sapra suggests incorporating activities that bring joy, such as book clubs or dance classes, even within a structured schedule.
• Building Support Networks: Participation in social groups and leaning on friends and family can protect against relapse and relieve current symptoms.
• Optimizing Treatment: If a current treatment plan is not working, patients are encouraged to change therapists, doctors, or medications. Dr. Sapra notes that mental health care is a personal service, and finding a compatible approach is essential.

Managing Medication and Professional Support

Careful management of medication is critical. It is generally recommended to give an antidepressant up to eight weeks to work before requesting a change in medication. Stopping treatment entirely can lead to a higher risk of relapse; one study found that depression relapse within one year occurred more frequently among those who slowly stopped antidepressants than those who continued treatment.

Early intervention is key when symptoms begin to return. Seeking help from a mental health professional as soon as worsening symptoms appear can prevent the accumulation of shame, guilt, and hopelessness, making recovery easier.

Relapse is a part of recovery. When you have this mindset, you’re less likely to feel hopeless when you feel depressed at another point in your life

Kimber Shelton, PhD