Depression is an ongoing battle for many people. Knowing what can trigger a depressive episode can help you minimize or avoid a relapse.
Major depression is a complex and challenging condition: Even when your symptoms are under control, you can potentially slide back into despair. However, knowing what might trigger a downward spiral can help you stop one from happening.
Depression relapse or recurrence is common, although these two terms aren’t the same thing. First, it’s helpful to know how recovery is defined: It’s when you’ve been free of depression symptoms (in remission) for at least four months. In clinical terms, a relapse is when depression returns after you’ve reached remission but before you’ve reached recovery. A recurrence is a new episode of depression after a recovery.
Whether it’s a relapse or a recurrence, about half of people who’ve had one episode of major depression go on to have another, says Deborah Serani, PsyD, a psychologist in Smithtown, New York, and author of the book Living with Depression.
If you’ve had two bouts of depression, you’re 80 percent more likely to have another, Dr. Serani says. If you’ve had three depressive episodes, you have a 90 percent chance that symptoms will return again, she says.
7 Possible Depression Relapse Triggers
While there are certain events that can be stressful for many people, that doesn’t mean that all of these factors will trigger an episode in a person with depression. “Triggers are usually very personal things,” Serani says. “For example, things that are stressors for one person may not necessarily be difficult for others.” The reason a trigger sets off a depressive episode is that it overwhelms a person’s ability to cope effectively, she says.
Potential depression triggers include:
- Quitting treatment. Most people whose depression returns have strayed from treatment, Serani says. “They begin to feel better and stop taking their medications or quit psychotherapy.” As a result, they don’t reach full remission and depression symptoms slowly return, pushing them into another episode, she says. Keeping a healthy sleep schedule, exercising regularly, eating well, and avoiding alcohol, drugs, and toxic people are all part of effective depression treatment, Serani says. “Maintaining a healthy consistency with your life can dramatically lower your chance for depression relapse.”
- Death of a loved one. About 1 in 5 people develop major depression after a loved one passes, according to the American Cancer Society. “Grief is expected after a loss, but if symptoms of mourning go on for a long time, normal grief may turn into a depressive disorder,” Serani says. “If a person is still struggling with depression months after a death, they may need professional help to address prolonged grief and major depression.”
- Divorce. If you’ve already had depression, getting divorced significantly raises your risk for another episode, according to a 2014 study published in the journal Clinical Psychological Science. Researchers found that nearly 60 percent of divorced adults with a history of depression experienced another depressive episode. Only 10 percent of divorcees without a history of past depression experienced it.
- An empty nest. Although “empty nest syndrome” isn’t a clinical diagnosis, it’s common for parents to feel sad when a child leaves for college or moves out of the house, according to the Mayo Clinic. But such a change might trigger depression in some people. Get help if these feelings last a long time or interfere with your work or social life.
- Traumatic events. Frightening events like terrorist attacks and natural disasters can bring on a relapse or recurrence, Serani says. Anniversaries of such events can be triggers, too. A study published in The British Journal of Psychiatry in February 2016 found that people involved in attacks, disasters, and military deployment are at a much greater risk for depression.
- Hormone changes. Hormonal changes unique to women can trigger depression, according to the U.S. Department of Health and Human Services. Hormones affect the brain chemistry that controls emotions and mood. Women are more vulnerable to depression at puberty, during and after pregnancy, and at perimenopause (when a woman starts to experience menopause symptoms but hasn’t reached full menopause). Having a depressive disorder before you become pregnant puts you at the greatest risk for post-partum depression, Serani says.
- Addictive behaviors. It may not be a surprise that alcohol and gambling can create a potentially-addictive temporary escape, but even too much TV can be a depression trigger too, Serani says. Binge-watching — viewing many TV episodes in a row — can bring on the common depression triggers of stress and anxiety, according to a 2015 survey presented at the American Public Health Association annual meeting in Chicago. “When a person stops binge-watching, it can lead to a sudden shift in neurochemistry and a psychological feeling of loss, just like those who stop taking drugs or alcohol,” Serani says.
Ways to Minimize Depression Triggers
Some depression triggers can be avoided, but others can’t. “A person has to learn how to move through the event or the experience as best as possible,” Serani says. If you’re starting to feel stressed or overwhelmed by something in your life, Serani suggests taking these steps:
- Get through it with positive talk. Tell yourself, “This is temporary,” “I’ll feel better soon,” or “I’m just experiencing a bad moment, I’m not stuck in a bad life.”
- Nurture yourself. “It’s essential to feed your senses when triggers loom in your life,” Serani says. “Listen to music, or savor a cup of tea, soup, or coffee.” You might stimulate your sense of smell with soothing peppermint, florals, or woodsy scents with aromatherapy, candles, or a walk outside. Taking a warm bath can also be soothing.
- Reach out to others. “It’s easy to want to be alone when stress hits, but isolating yourself from people can worsen depression triggers,” Serani says. “Let others know you’re struggling and talk about it openly as much as you can.” Consider joining a depression support group to be able to talk to other people who also understand what it’s like to live with depression.
If you suspect you’re experiencing a new bout of depression, don’t hesitate to contact your doctor or therapist. Remember that depression relapse is common and nothing to be ashamed of.
Last Updated: 4/21/2016