Why Does Depression Return?
"Return of depression is usually triggered by a change in social rhythms," says Dr. Kennedy. "This could be anything that causes a disruption in normal social routines, such as an illness or the loss of asocial support system."
Changes that can trigger a depressive episode include:
- Life-altering events.
- the loss of a job,
- the end of a valued relationship,
- Cheating by spouse
- ill treatment by children
- suffocating environment in work place ( like denying rightful promotions for years)
- comparing or expecting too much from life
- over demanding family
- serious illness in a family or self
- constant injustice
- or any other new and stressful situation.
- "A common example would be when a spouse becomes ill and the person with a history of depression must become a caregiver," notes Kennedy.
- Other medical conditions. Being diagnosed with a serious medical condition may cause depression in some people. The onset of a major illness may introduce new medications and symptoms that could trigger a depressive episode. "Studies show that one-fourth of people will suffer a depressive episode after a heart attack. A stroke or a fractured hip may decrease independence and increase isolation, which also could lead to a return of depression," says Kennedy.
- The illness itself. It’s not always possible to pinpoint a trigger for a depressive episode. "Just like many other diseases, depression may get worse or come back even if you are doing everything right,” Kennedy says. “This is more common in older people, who may undergo changes in their brain that make depression more likely."
- Antidepressants are not working. "We often say that depression is treatable, but we should add that it is not always easy to treat,” says Kennedy. “About half of all people with depression don't improve on the first antidepressant medication.” Your medications may also become less effective over time. “The medication must then be changed, or a second antidepressant must be added," Kennedy says.
Avoiding the Return of Depression
With these steps for self-care, you can be more in control of your depression:
- Recognize the symptoms of a depression relapse. Learn your depression triggers and symptoms so you can tell your doctor about them. "Studies show that the best predictor of a return of depression is a change in sleep patterns,” says Kennedy. “Each person should be aware of their own warning signs. Sometimes a family member may be the first person to pick up on these symptoms." Other symptoms to watch out for include loss of interest in sex, loss of appetite, irritability, and negative thinking.
- Stick to your treatment. The most important thing you can do is follow your treatment plan. That means keeping all your doctor appointments and taking your medications as prescribed. "If antidepressants are part of your treatment plan, never stop taking them on your own," says Kennedy. "Antidepressants are not like pain medications. They take a long time to work completely, and starting to feel better does not mean that you are well yet. Patients who have had two or more depressive episodes may need to stay on antidepressants indefinitely."
- Maintain a healthy lifestyle. This includes learning how to deal with stress, developing a good support system, getting regular and adequate sleep, and exercising. "Regular exercise affects the brain in the same way as medication does. In fact, for mild depression, exercise often works as well as antidepressants,” says Kennedy. It’s also important to eat a healthy diet and limit alcohol consumption. “Studies show that two or more drinks of alcohol a day decrease the rate of recovery from depression by half," warns Kennedy.
Depression is a very treatable disease, but you need to be aware of the possibility of a relapse. "It’s important to treat all cases of depression aggressively and to continue treatment long enough to allow for maximum recovery," says Kennedy.
You can help avoid a return of depression by working closely with your caregivers and medical team, avoiding known triggers of depression, recognizing the early symptoms of relapse, and maintaining a healthy, active lifestyle.
