Depression is a widespread mental health concern that affects an individual’s ability to function on a daily basis. If you’ve experienced depression in the past, you may be worried about the potential for relapse.
While treatment for depression such as therapy or medication has been shown effective, research has also shown that about one-third of individuals who discontinue treatment will relapse within one year.
What Is a Relapse?
The definition of relapse in relation to depression is a recurrence of symptoms after remission has been achieved (a period of return to original functioning, generally 16 to 20 weeks long).2
While it is possible that those who relapse will experience the same symptoms they did during their first depressive episode, it is also possible that the symptoms that they experience will be entirely different the next time.
Signs of a Depression Relapse
For this reason, it is important to consider the various potential signs or symptoms of a depression relapse. Below is a complete list of the potential signs to watch for and the sections that follow include detailed descriptions of these signs and symptoms to help you determine if they are impacting you.
Loss of interest or pleasure
Weight gain or loss
Aches and pains
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Feeling down, sad, or having low mood is one of the hallmark signs of both depression and depression relapse. This includes feeling tearful, feeling hopeless, feeling gloomy, crying, feeling empty, or feeling miserable. These feelings are normal responses to obvious causes such as losing a job, losing a loved one, or going through a breakup or divorce.
However, if your feelings of low mood have no obvious cause and last for a period of longer than two weeks and are present every day, then you may be experiencing a depression relapse.
This is especially true if your low mood or feelings of sadness interfere with your daily life. For example, perhaps you struggle to go to work because of crying spells or you feel hopeless that things will ever get better for you. These are signs that low mood may indicate a depression relapse.
Do you find yourself getting annoyed more easily than before? Are you snapping at people or finding that you easily fly off the handle or get angry? If so, you may be experiencing irritability as a symptom of a depression relapse.
If irritability is a problem for you, it is likely that you have a low tolerance for stressful situations. This means that you tend to react with annoyance or anger when faced with small inconveniences. In other words, anything can set you off and cause you to end up arguing with others.
If you feel angry and frustrated a lot of the time, and little things make you very upset, then irritability may be a problem for you and could be a sign of a depression relapse.
Loss of Interest or Pleasure
Another hallmark sign of a depression relapse is the loss of interest in things that you used to find enjoyable. This might include attraction to your partner, sex with your partner, hobbies, seeing friends, or anything that you used to enjoy.
If you are noticing that things you once enjoyed have started to feel like a burden, then you may be experiencing loss of interest or pleasure related to a depression relapse. If your favorite activities feel like too much effort and not worth it, this could be a sign that you are relapsing.
Most people with depression experience something known as brain fog. Brain fog refers to the slowing down of cognitive processes (i.e., thinking). This means that you may have trouble thinking and feel as though your thoughts are slowed down.
Brain fog can also mean that you have problems with concentration, decision-making, problem-solving, and memory. Brain fog can interfere with your life in many different ways, such as making it harder to do your job or to hold a conversation in a social situation.
How is your sleep? Sleep is another aspect of your health that can be easily impacted during a depression relapse. If you notice changes in your sleep, such as trouble falling asleep, waking through the night, not feeling rested, or sleeping too much, then you could be experiencing a depressive relapse.
Some people with depression find that as soon as their head hits the pillow, they start to ruminate (think obsessively) about their day and the things that went wrong or that are causing them stress. This in turn can make it harder to feel asleep and lead to insomnia.
It may also make fatigue worse and make it harder to get out of bed in the morning. If you are experiencing any of these issues, this could be an indication of a depression relapse.
Why It May Be Hard to Sleep If You’re Depressed
Have you been able to keep up with your social obligations? Some people who have a depression relapse may experience social withdrawal as one of the main signs of relapse. If you have been avoiding social situations or feel isolated or alone when you do attend, then you may be having a depression relapse.
Social withdrawal can have a negative effect on your relationships, which in turn may worsen your depression. If making conversation feels like too much effort, leaving the house feels like an impossible feat, or you simply hang out in your room much more than would be considered acceptable behavior, then you may be having social issues.
This sign can be related to loss of pleasure since you don’t experience any pleasure from being around other people. In combination, these issues may point to a depression relapse.
How have you been feeling about yourself? Feeling worthless or unworthy is another sign of a depression relapse. If you feel as though you have low self-esteem, that you’re not deserving or worthy of better things in life, or that you generally are overly critical of yourself, then feelings of worthlessness may indicate a depression relapse.
This issue can also be related to feelings of guilt, a focus on your flaws or failures instead of positive achievements, and an overly strong internal critic. If you are constantly blaming yourself for something bad that happened, it could be that your inner critic and self-loathing are a sign of a bigger problem including a depression relapse.
Weight Gain or Loss
Has your weight changed by 5% (up or down) in the past month? Sudden changes in weight, such as losing weight or gaining weight, may indicate a depression relapse. Other signs may be losing interest in foods you once enjoyed or a lack of effort to eat healthily or get regular exercise.
People who struggle with weight gain or loss due to depression relapse may also engage in binge eating or other disordered eating patterns. If you notice that your eating habits or weight have changed, this could be a sign that your depression is coming back.
Are you tired just thinking about getting out of bed, doing the dishes, or paying the bills? When you are experiencing fatigue, it can make everything seem much harder to accomplish.
For example, a chore like folding the laundry becomes an insurmountable task that you just can’t seem to check off your to-do list. If you find yourself dragging through the day, then fatigue may be a sign that your depression is coming back.
Aches and Pains
Depression is not only experienced in the mind. Some people also notice that they have more aches and pains when experiencing signs of depression. These aches and pains can take various forms and move around the body. Below are some of the types of pains that you may experience if you are experiencing a depression relapse:
Limb pain (e.g., legs or arms)
Finally, having suicidal thoughts is a strong sign that you may have severe depression. If this is the case, it means that your depression has returned. In the case of severe depression, you likely have also lost interest in things you used to enjoy. You may also feel hopeless about your position in the world. All of these are indications of a depression relapse.
Causes of Depression Relapse
If you are experiencing a depression relapse, you might be wondering why your depression has returned. It’s true that depression can return at any time, even if you are taking medication or receiving therapy. It can also return without any obvious outside trigger or stressor.
However, sometimes depression relapse follows an external event. Below are some potential triggers or causes of a depression relapse.
Experiencing the death of a loved one or other significant loss
Going through a stressful life event (e.g., being laid off from your job, going through a divorce, having your first child, studying for final exams at college)
Hormonal changes related to your life stage (e.g., puberty, pregnancy, menopause)
Failure to use coping strategies or discontinuing their use (e.g., journaling, getting regular exercise, managing negative thoughts)
Changes in the medication that you are taking
Sleep disturbances (e.g., starting a new job that requires a change to your sleep schedule)
If you are concerned that you may be experiencing a depression relapse, it’s important to know that all of the treatment strategies that help for depression will also help for a relapse. Below are some of the options that you may want to consider in consultation with your doctor.
Talk therapy (e.g., cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), psychoanalytic therapy)
Medication (e.g., selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs))
Combination of medication with talk therapy
If you took medication before or are currently taking medication, your doctor may suggest changing medications or changing the dose of your medication.
The 9 Best Online Therapy Programs We’ve tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.
Beyond seeking help from a professional, there are a number of coping strategies that you can use on your own to manage your symptoms of a depression relapse. These may also help to prevent you from experiencing another depression relapse in the future, or at least make it easier for you to manage symptoms until you can receive professional help.
Reach Out to Family or Friends
If you feel that you are slipping back into a state of depression, reach out to a family member or friend to let them know how you are feeling. Depression can make you want to narrow your social connections, which can make the symptoms of depression worse. Therefore, finding someone you can confide in and who will check up on you can make a difference.
Practice Self Care
Self care is the act of taking care of your physical and mental health. There are a number of different things you can do to take care of yourself that will help to improve your physical and mental state if you are experiencing a depression relapse.
Get regular exercise: Walking outside, stretching, doing yoga, high-intensity interval training (HIIT) are all great examples.
Stick to a regular sleep schedule: Try to go to bed and wake up at the same time each day.
Use a light therapy lamp: UV light lamps help to mimic the sun, and are especially helpful if you have seasonal depression or live somewhere without a lot of sunlight during the winter.
Take a vitamin D supplement: Just like the UV lamp, vitamin D can help to alleviate depression symptoms related to lack of sunlight.
Maintain a routine: Try to do very basic things to feel like you are in a routine, such as showering, brushing your teeth, and getting dressed every day.
Adhere to Therapy Recommendations
If you were already in therapy for depression, it’s likely that you received some homework and/or recommendations on how to move forward after the last session. Reflect back on your time in therapy and what you learned.
Are there strategies you could start using again? Are there workbooks or tracking logs that your therapist gave to you? Anything that was helpful to you in the past will likely be helpful to you again as you face a depression relapse.
Adhere to Medication Plan
If you were prescribed antidepressant medication as part of your treatment plan, it is very important that you adhere to the medication schedule that you were prescribed. Do not abruptly stop taking medication if you do not like how it is making you feel.
Instead, schedule an appointment with your doctor to discuss your medication and possible changes that you could make. Abruptly stopping your medication could lead to withdrawal effects; instead, follow the advice of your doctor before stopping or changing any medication.
Track Your Mood
If you have experienced depression in the past, it is important to become aware of your moods and how they shift and change each day. One way to do this is by using a mood tracker.
A mood tracker is generally a one-page worksheet that spans a month and allows you to shade boxes that correspond to how you are feeling each day. Some mood trackers also allow you to rate your mood from 1 to 10 or to add in details about what was happening each day. There are also mood trackers that span an entire year.
The benefit of tracking your mood by using a mood tracker is twofold.
First, you will become more aware of how you are feeling and begin to see patterns according to the time of month, time of year, and relation to things going on in your life.
Second, a mood tracker can alert you to a problematic shift in mood that doesn’t resolve itself.
Since a diagnosis of depression requires that a feeling of low mood every day for at least two weeks, this is one thing to look for when tracking your mood using a mood tracker.
Develop a Journaling Habit
If you are facing a depression relapse, one way to help manage your symptoms is to develop a journaling habit or expressive writing habit.
Journaling or expressive writing can be helpful to manage your mental health because it allows for the expression of and exploration of emotions, similar to what you would be doing in a therapy session. The difference is that you will be doing self-exploration rather than exploration with the aid of a therapist.
If you are interested in starting a journaling habit to cope with a depression relapse, the best way to start is with a time block set aside for free-writing in your journal. Choose a time of day when you will be relaxed and not likely to be interrupted.
Use a blank journal, and begin writing about whatever comes to mind, good or bad. Be curious about what you write and try to “get to the bottom” of your feelings. If you are feeling sad or down, ask yourself what’s going on in your life or what might have caused you to feel that way.
Journaling can also be a way to catch negative thought patterns and reframe them in a more realistic tone. For example, if you write in your journal, “everything is terrible and I will always feel awful,” you could examine that thought for negative distortions.
Black and white thinking is one type of thought distortion found often in people with depression symptoms, and is present in this thought. Then, you could practice rewriting the thought in a more realistic way, such as “things are bad sometimes, but I know that I won’t feel awful forever.”
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Find a Support Group
If you are truly struggling with a depression relapse and feel you need more support, consider looking for a support group specifically aimed at those living with recurrent depression. While going to therapy, taking medication, and using self-help strategies can help to alleviate your depressive symptoms, having the social support of others who have gone through the same things as you can help you to feel less alone.
A Word From Verywell
If you are struggling with symptoms of a depression relapse it can feel hard to know what steps to take. If you were previously in treatment or are still receiving treatment (therapy or medication), often the best first step is to reach out to your current treatment provider.
It may be necessary to restart medication, resume therapy, or make plans for a new treatment regime. Recurrent depression is completely normal, so there is no shame in reaching out for help a second time.
Once you have reached out to a professional for help, you’ll also want to make sure you are doing everything possible to ensure the success of your treatment plan. However, depression can make it hard to do the smallest of tasks.
For this reason, you may want to enlist the help of a family member, friend, or support group member to check in with you and help you stay on track. Knowing that someone is there to support you could mean the difference between effectively managing the return of depression and slipping further into your symptoms.
While depression can feel insurmountable when it happens, try to remind yourself that you made it through once before and you can do it again. The benefit of having been through a previous depressive episode is that you’ve seen the other side and know that it’s possible to feel good again