Fear of Relapse Into Depression: 6 Tips to Manage and Overcome it

Depressive disorder is one of the most common, considered one of the most disabling and emotionally painful. Likewise, its relapse rate is high, thus generating fear of relapse.

There are factors that are unmodifiable and are linked to a greater risk of presenting the pathology again. But there are other variables that are modifiable and that the subject can take into account to reduce the probability of relapse into this psychopathology.

In this article we will talk about the fear of relapse into depression and we will see several tips to reduce the risk of relapse and to manage that fear.

Characteristics of the fear of relapse into depression

Depression is the most prevalent affectation within mood disorders, accounting for a percentage close to 90% of those affected with this type of psychopathology. The World Health Organization considers it the most common mental disorder, affecting 300 million people around the world. It is also one of the most disabling disorders and the one that generates the most costs and suffering.

This affectation of mood is especially present in women, occurring in them 1.5 to 3 times more than in men. It is also observed more in urban environments than in rural ones.

The age range most likely to develop this alteration is between 18 and 29 years old, although no individual is exempt; Childhood cases have also been observed, and there is a high rate of elderly individuals who show it. For this reason the average age of appearance is 35 years.

Once a person has experienced the symptoms of depression, it is easy for them, even having turned the page, to fear relapse into this psychopathology. That’s why, The fear of relapse into depression can be a psychological problem in itself, and even a reason to attend psychological therapy even if you no longer suffer from a depressive disorder. And in all this, the fact that the probabilities of relapse are not low has a lot to do with it.

Although suffering from a certain fear of relapse is natural, if certain circumstances occur it can paralyze us and cause what is known in psychology as a self-fulfilling prophecy. Therefore, as we will see later, the ideal is not to let yourself be carried away by fear and use that emotion as a motivating force to maintain habits that promote good mental health in us. If we don’t, the fear of relapse into depression may lead us into a vicious cycle of pessimism and increase the chances of us suffering from a mental disorder.

Are there reasons to worry?

The course of depression is highly variable and will depend on different factors such as comorbidity with other disorders, treatment adherence, among others. Although the majority of subjects recover before 2 years, some approximately 15% tend to become chronic, thus prolonging the alteration for more than 2 years.

Let’s see what periods are linked to the different courses of this disorder. Bearing in mind that to diagnose depression, the fifth edition of the Diagnostic Manual of the American Psychiatric Association considers that criteria must be met for at least two weeks, it is assessed that the subject is in partial remission of the depressive episode if the criteria are not met but Less than 2 months have passed, and in total remission if symptoms do not appear for at least the previous 2 months or longer.

On the other hand, An individual is considered to have recovered when they maintain their remission (that is, they do not show symptoms) for more than 6 months in a row and has managed to return to its normal, previous functioning. Now, the two negative events that can happen, meaning that the subject shows symptoms again, are relapse and recurrence.

The main difference is that, in the case of relapse, symptoms reappear during the remission period; That is, before the end of 6 months, it is then considered the same episode. On the other hand, in recurrence the symptoms appear again after the subject has recovered; Therefore, it represents the appearance of a new depressive episode.

The duration of the episodes is also variable; It is estimated that if no type of intervention is performed, the average time of the first episode can last 6 to 9 months. Depression is linked to a high recurrence, with relapses being quite common. For example, It is estimated that 30% of subjects show symptoms again during the first year after recovery, especially during the first months. In general terms, between 50% and 85% present recurrence.

Thus, it is estimated that having a first episode represents a 60% risk of having a second, having 2 episodes represents a 70% risk of having another episode, and presenting 3 episodes has a 90% risk of developing a fourth. The average number of episodes that an individual can show is 4 to 5 throughout their life.

Have been observed a series of factors that are related to the increased probability of recurrence or relapse. These are: having a history of previous chronicity, that is, having had an episode lasting more than 2 years; show greater severity of the first episode; have a poor response to acute treatment, show no improvement or take a long time to show improvement; earlier onset of the disorder; being older now; a short time (at most months) has passed since the last episode; there are chronic psychosocial stressors that impact the subject; and display untreated cognitive distortions.

How to reduce discomfort and the risk of relapse?

Now that we know the characteristic course of the depressive disorder, we know that the frequency of relapse is high and that We should not feel bad for being afraid, since it is normal. But it is important to keep in mind that each case is different and that there are strategies or techniques that we can use to increase the recovery period and reduce relapses.

Likewise, In the case of relapse, this fact does not mean failure, all is not lost. It is possible to intervene again and recover again.

Below we will see some tips that may be useful to you, try and choose the ones that best suit you to manage the fear of relapses in depression by developing routines to maintain good mental health. If you do not see improvement or notice that the situation is beyond you, the most recommended option is to go to a professional.

1. Play sports

Exercising is one of the main tips given to improve both physical and mental health. Practicing sports is linked to an increase in endorphins, which are a type of neurotransmitters that act mainly by reducing the sensation of pain and, consequently, increasing the well-being of the subject.

Likewise, sport also motivates you and makes you move, to avoid staying in bed or doing nothing, which are behaviors that facilitate relapse. On the other hand, sport also keeps our mind occupied for a period of time, helping us to distract ourselves and disconnect.

2. Maintain social relationships

People are social beings and as such we need to relate to them. Isolation is a behavior that tends to be linked to depression. In this way, we will avoid losing contact with our friends or family. Meeting other people will help you disconnect, leave the house, make plans, you will have the opportunity to express yourself and vent, but without talking about it all the time, since doing it excessively is not good either and we will not be able to distract ourselves. Ultimately, it helps us feel supported.

3. Do activities that you like

As we have already seen, Depression tends to generate in the subject greater reluctance to do things. Characteristic symptoms are anhedonia (loss of sensation of pleasure) or avolition (decreased motivation). Therefore, it will be important that you stay active to avoid relapse into these states, plan activities that you like, that help you distract yourself and have fun.

It is recommended to plan them in advance, that they be activities that are carried out at a specific time and maybe they need a reservation; This way you will be less likely to back out. In the same way, if we meet someone to do the activity, we are committed, we are also less likely to not attend.

• You may be interested: “Personal Development: 5 reasons for self-reflection”

4. Establish healthy routines

Another risk factor or variable that is related to a greater propensity to relapse is leading a disorganized and unhealthy life: not meeting basic needs or doing so in an inappropriate way. To be mentally well, it is essential that we are also physically well, that we eat a varied diet that provides us with all the necessary nutrients and that we rest and sleep for at least 7 hours in a row.

To make it easier for you to organize, it is recommended that you plan a routine and write it down so that it is easier to follow and comply with it.

• Related article: “How to generate new healthy habits?”

5. Live in the present

The past is something that happened, and as such we cannot erase it and it is not good to deny it either. We will simply accept it, but trying not to remain anchored in the events we have already experienced. We will try to live in the present and focus on being well now. Your “I” of the present is the one who must control and direct your life, do not let memories of the past prevent you from doing so. In this sense, Mindfulness, which is based on placing consciousness in the here and now, has proven effective to prevent relapses into depression.

6. Don’t blame yourself for not always being 100%

It is normal to have better days than others and feel bad sometimes. So don’t blame yourself for having bad days, the important thing is that you are aware of it and act to improve, you can’t get carried away by this bad feeling. In the face of negative or stressful events it is natural not to feel good, allow yourself to feel that way so that you can later gain strength and get back on track.