Depression is a debilitating mood disorder. While depression can be treated very effectively, it is important to recognize that it is very possible for people to slip back into depression. When the symptoms of depression recur during or after treatment, this is known as a depression relapse. Research shows that over half of those who recover from depression experience an additional episode. Among people who have had two episodes of depression, 80% have further relapses.
It is crucial to identify the signs of depression relapse as early as possible and get help. When a person goes a long time without getting treatment, it may become more difficult for them to achieve symptom remission. Early intervention can save people from the difficulties and consequences of long term depression. These consequences, which include problems at school, with family, at work, and with drugs and alcohol, can worsen depression in the long run.
What is Clinical Depression?
Clinical depression is distinct from mere sadness. Sadness is a mood – and it is a typical part of being human. Depression, however, is a mood disorder. When a person suffers from depression, their sadness or loneliness is all-consuming. They are likely to experience both emotional and physical symptoms that alter how they think, feel, and take care of daily activities, such as working, communicating, eating, and even sleeping. For a psychiatrist to be able to make a clinical diagnosis of depression, a patient must experience symptoms for a minimum of two weeks.
What Are the Signs of Depression?
Individuals who suffer from depression are likely to have less interest in activities and interests that were once important to them, including work, family, and hobbies. Physical symptoms, such as fatigue, chronic pains and aches, changes in sleep patterns, and weight fluctuations are also common. In severe cases, suicidal ideation can occur as a life-threatening consequence of depression. However, even mild cases of depression require treatment, since the condition tends to worsen over time.
Common symptoms of a depressive episode include:
- Feelings of pessimism or hopelessness
- A recurring feeling of anxiety, sadness, or “emptiness”
- Reduced energy or fatigue
- A reduction of interest or pleasure in activities or hobbies
- Feelings of worthlessness, guilt, or helplessness
- Restlessness or difficulty sitting still
- Moving or talking at a slower pace than normal
- Problems remembering, concentrating, or making decisions
- Changes in weight (both increases and decreases)
- Changes in appetite (both increases and decreases)
- Problems getting to sleep, oversleeping, and early morning awakening
- Thinking about suicide or death, or making actual attempts at suicide
- Pains or aches, including cramps, headaches, and digestive problems, that does not have an obvious physical cause and that do not dissipate with treatment
These symptoms can make life very arduous, but depression is very treatable. Conventional approaches, such as SSRIs and talk therapy, can be very helpful at eliminating symptoms. For people with treatment-resistant depression or severe depression, alternative approaches like ketamine therapy and TMS can provide much-needed relief and tackle depression at the source.
What is Depression Relapse?
A depression relapse occurs when a person who has received treatment for depression begins to experience symptoms yet again. This flare up of depression symptoms can occur long after remission. Sometimes it occurs while a person is currently receiving treatment for depression – such as when an SSRI that was previously effective suddenly ceases to work as well. In other cases, lifestyle changes or traumatic life events can trigger a new depressive episode. The symptoms of a depression relapse are sometimes very different from previous episodes of depression, and in some circumstances the symptoms can be far more severe and life-threatening.
What Causes Depression Relapse?
The reasons why depression relapses occur are diverse and often difficult to determine. For many people, changes in their life circumstances can be a major factor. The death of a loved one, a divorce, a move, or unemployment can lead to emotional responses that ultimately cause a flare up in depression symptoms.
Some depression relapses are affected by time. When people live in areas with severe winters, seasonal changes can have an impact. Depression that is determined by the seasons is called seasonal affective disorder (SAD). Time can influence depression relapses in other ways as well, such as when an anniversary or some other triggering date causes a person to dwell on negative thoughts and emotions.
For most people, depression relapses are caused by a combination of factors. Some of the most common triggers that play a role in depression relapses include:
- Hormonal fluctuations
- When treatment (such as SSRI medications) ceases to be effective
- Changing or discontinuing a medication
- Being laid off or fired from a job
- Getting divorced
- Children leaving home (empty nest syndrome)
- Selling or buying a home
- Worsened sleep habits
- The death of a loved one
What Are the Signs of a Depression Relapse?
The symptoms of depression are not always very clear, especially in cases of depression relapse. The symptoms that occur in a relapse may be very different in nature or intensity, which can make it hard to recognize that depression is returning. For this reason, it is critical to be aware of the lesser known symptoms of depression relapse so that it can be identified in the early stages. By getting treatment as soon as possible, you can prevent a depression relapse from developing and becoming more severe.
Weight or Appetite Changes
Depression can affect a person’s desire to eat. Interestingly enough, the change can go in either direction. Some people overeat when they are depressed, while others fail to eat enough. The latter situation occurs because people with depression tend to lose motivation, which can make them less interested in making or getting food. Depression can also lead to anhedonia, which reduces pleasure, thereby making food less appealing. For people with increased appetite, eating may be a coping tool to deal with the symptoms of sadness and loneliness that characterize depression.
Altered Sleep Patterns
Just as weight and appetite levels can change in either direction when depression strikes, sleep patterns can change in both directions as well. During a depression relapse, some individuals find that they struggle to get enough sleep. This can involve waking up too early or in the middle of the night – or it can be due to insomnia. Other people with depression, however, end up sleeping far too long. They may sleep in and struggle to get out of bed in the morning, or find themselves taking one nap after another. Other sleep changes during a depression relapse include:
- Lying in bed awake for long periods of time at night
- Waking up and not feeling refreshed
- Waking up multiple times during the course of the night
- Taking too long to fall asleep
Unfortunately, impaired sleep quality can worsen depression. The result can be a self-perpetuating cycle, where both conditions worsen each other over a long period of time. Getting help for your sleep problems can be an important part of treating depression. In fact, improving sleep quality can reduce the symptoms of not only depression, but also attention deficit hyperactivity disorder (ADHD), PTSD, anxiety disorder, and other mental health disorders.
Feeling Cranky All the Time
It is normal to feel annoyed, irritable, or cranky at times. Everyone gets this way. But when a person experiences dramatic changes in the severity or frequency of these moods, it may be a sign of a depression relapse. During an episode of depression, it is more difficult to control or regulate one’s moods. This can mean that irritability more easily turns into angry outbursts. This symptom can manifest as a feeling of unexplained annoyance. Sufferers may find themselves saying hurtful things they don’t mean to people they love, engaging in road rage, or using sarcastic humor to push people away. In many ways, this crankiness is understandable. Depressed people often suffer from emotional exhaustion from dealing with their own inner turmoil – so it is understandable that dealing with other people can be overwhelming at times.
Stopping Pleasurable Activities
One of the most surefire signs that a depression relapse is occurring is when a person stops engaging in their hobbies. Individuals who were once social tend to stop going out and fraternizing with their friends when they are depressed. You may find yourself no longer doing activities that you once enjoyed. This is partly due to the low motivation and energy that characterize depression. It may feel physically hard to get yourself out of the house or even out of bed. However, the other cause is simply lack of pleasure. One symptom of depression is anhedonia, a word that means “an inability to experience pleasure.” This feeling can affect not only a person’s interest in their hobbies, but even other sources of pleasure – such as music, food, and sex.
Getting Help for Depression
At Lucid Wellness Center, we work with individuals who are experiencing depression of any severity. We specialize in helping individuals whose depression has become unmanageable through traditional means. Many people going through depression relapses have already tried treating their mood disorders using antidepressants and talk therapy.
During a relapse, they sometimes need something more. Our evidence-based alternative therapies, which include ketamine therapy and TMS therapy, are proven to help people who are suffering from even the most treatment-resistant cases of depression.
If you have discovered that your depression has returned, don’t wait and suffer any longer than you have to. Reach out to a staff member at Lucid Wellness Center today for a free and confidential consultation.