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Preventing relapse and recurrence

Even when depression (or another mental illness) is diagnosed and treated successfully, it can still return over time. According to reports, about 50% of people will experience a relapse after having one episode of depression and that percentage increases after each additional episode. This can be discouraging news when you’re at the early stages of facing depression. However, there are steps you can take to reduce the impact of a relapse or recurrence or even prevent them altogether.

It is important to view a mental illness as a condition that requires ongoing care and attention over a lifetime – not as a single episode to be addressed and forgotten. Then you can you prepare to do what it takes to get well and stay well over time. Committing to ongoing effort is the best strategy for ensuring that you stay well. In addition, learning what tends to trigger your symptoms and recognizing them early can often help to prevent symptoms from worsening. 

Managing setbacks

Experiencing a setback when you’ve managed to stay healthy can be extremely frustrating and alarming. However, relapses can be a great opportunity for self-exploration and personal growth. You may ask yourself a few of these questions during and after a setback: What have I learned from this? How would I deal with this differently next time? Relapse or recurrence may indicate that you need to have your medications adjusted, use a different approach to therapy, or adjust your lifestyle habits. Take the opportunity to learn about what tools and management strategies are working well for you or not.

Learn the 5 R's

Response

Response takes place when symptoms improve relative to baseline (the point just before starting treatment). The reduction in symptoms is taken to indicate that treatment is having an effect. Getting to a response level can be relatively easy, moderate, or difficult based on a patient’s particular situation.  

Remission

Partial remission occurs when someone experiences significant symptom improvement but still has some degree of symptoms. Full remission is a period of time (often 2 months or longer) when someone is symptom free and returns to a healthy state of functioning.

Recovery

Recovery occurs when someone is symptom-free for 6-12  months following a long period of remission.

Relapse

Relapse is a return of symptoms during the remission period, but before a recovery has taken place.

Recurrence

Recurrence refers to a new episode that takes place during a recovery phase.

References

Beshai, S., Dobson, K. S., Bockting, C. L., & Quigley, L. (2011). Relapse and recurrence prevention in depression: current research and future prospects. Clinical Psychology Review, 31(8), 1349-1360.

Richards, D. (2011). Prevalence and clinical course of depression: a review. Clinical psychology review, 31(7), 1117-1125.