Identifying and managing triggers to prevent relapse

Recovering from depression can be one of the toughest times in your life and the last thing you would want is to go through it all over again. Unfortunately, depression is frequently a chronic disease, with people experiencing relapsing episodes.¹

There are many things that can contribute to a relapse. For example, residual symptoms which remain after your mood has improved – such as cognitive symptoms like trouble concentrating, which is common between episodes² – can increase your risk of relapse.³

When you are feeling well, there are steps you can take to maintain your positive state and reduce the risk of experiencing a relapse. Having a robust plan in place can also limit the severity or duration of depression if it ever does return.¹

One thing you can do as part of this is to familiarise yourself with triggers which might indicate the start of an episode. Some of these apply to depression in general, and some will be personal to you. Being aware of these and managing them appropriately can help to prevent a relapse.^1,4

• Not following treatment e.g. skipping therapy sessions or avoiding taking medication. It’s important to stick with your treatment as advised – even if you feel better. If you feel unhappy with your treatment plan, speak to your doctor.¹

• Residual symptoms e.g. trouble concentrating. As mentioned above, residual symptoms may persist even though you feel better, and increase your risk of relapse² (another reason why it’s important to stick with treatment even if feeling better). Look out for these, and make your doctor aware of them.

• Lack of sleep. Not getting enough sleep can have a negative impact on your mental health. If you are having difficulty sleeping, your doctor can help.⁴

• Stress or being overworked. Try to take regular breaks from work, and set boundaries about work interfering in your personal time – such as not checking emails in the evenings. Relaxation techniques can help to manage stress;⁴ mindfulness meditation has been shown to be beneficial for this and effective at preventing depression relapses.⁵

• Negative self-talk or thoughts. We all put ourselves down at times – it’s easy and common to become your own worst critic. But consistent or prevailing negative thoughts can start a negative spiral. Cognitive behavioural therapy (CBT) and other mindfulness based interventions can help you to manage these thoughts and encourage positive self-talk.^1,4 There’s also lots of helpful guides online.

• Neglecting self-care. Plan some ‘you time’ and take the time to do something you enjoy or that helps you relax. You can do this by yourself or with friends or family – whatever helps you to switch off for a while.⁴ This is not self-indulgence; it’s essential for mental wellbeing.

• Personal vulnerabilities e.g. anniversaries of difficult times. Being aware and prepared for difficult periods in your life, where possible, can help you to better control your mood and prevent your chances of a relapse.¹ The methods discussed above can help.

Try to stay aware of the triggers mentioned here, particularly residual symptoms, and be sure to voice any concerns to your doctor, who can help you manage your risk of relapse. A little proactivity can go a long way.