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While feeling sad or overcome with grief every once in a while is a normal part of life, major depression is much more than a passing feeling of hopelessness.
Major depressive disorder, or simply depression, is one of the most common mental illnesses affecting adults today.
An estimated 21 million adults in the U.S. experienced a major depressive episode in 2020, according to the National Institute of Mental Health (NIMH).
A mental illness like depression can affect your mental health, as well as your physical health — depression symptoms can range from weight change to a consistently sad or hopeless mood.
A wide variety of factors, from genetics to environment, can cause depression. There are also several different ways to treat depression, from medications like SSRIs to lifestyle changes and more.
But is there a way to prevent depression? And can a depression relapse happen after you start to feel better?
Below we talk about the causes of depression and if there are ways to prevent depression.
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Depression, or a depressive disorder, is a mood disorder defined as having a depressed mood or loss of interest or pleasure in daily activities for two weeks or longer.
A depressive disorder is a severe mental illness that shouldn’t be confused with everyday, short-term feelings of sadness.
Common depression symptoms are:
Persistent feelings of sadness, anxiety, hopelessness and/or an “empty” mood
Change in appetite, either loss of appetite or increased appetite
Weight gain or loss
Loss of interest in normally pleasurable activities
Lack of energy or fatigue
Irritability or frustrated outbursts over minor issues
Oversleeping
Insomnia, including difficulty falling asleep and/or staying asleep
Physical symptoms, including pain, digestive problems, headaches, joint and/or muscle pain
Difficulty focusing, making decisions and recalling information
Noticeably slower speech and movement
Recurrent thoughts of death, suicidal thoughts and suicide attempts
There are many types of depression, including:
Persistent depressive disorder (dysthymia). Dysthymia is a type of depressive disorder that lasts two years or more. It typically involves mild feelings of sadness or hopelessness with other depression symptoms.
Seasonal affective disorder (SAD). This form of depression is a mood disorder that occurs with seasonal changes, mostly in the fall and winter. SAD affects an estimated 10 million American adults, and women are four times more likely to be diagnosed.
Postpartum depression. Feelings of sadness, fatigue and mood changes are common in women after giving birth. If they only last for a few weeks, they’re known as the “baby blues,” but mood shifts lasting more than two weeks could indicate postpartum depression.
Psychotic depression. Major depressive disorder with psychotic features is depression that involves hallucinations, paranoia, or delusions. This form of depression often coincides with psychosis, which is a loss of touch with reality.
Bipolar disorder. Those with bipolar disorder may experience episodes of depression along with episodes of mania (high or euphoric moods). Bipolar disorder is typically treated with different forms of medication and therapy than other forms of depression.
While many believe brain chemicals play a role in depression, there is not an exact known cause, nor is there one single cause. A variety of factors can contribute to a mood disorder like depression, including:
Genetics. Depression is more likely to occur in those with a family history of depression. According to a 2014 study, women with a family history are three times more likely to develop depression.
Brain chemistry changes. Changes in neurotransmitters, or brain chemicals involved in transmitting information between brain cells, could cause depression. While the exact chemicals involved are uncertain, research suggests serotonin, which regulates mood, may play an important role.
Trauma or abuse. Abuse or trauma from any point in your life can put you at a higher risk for depression. A study found that over 75 percent of 349 adults with chronic depression had a history of trauma from their childhood.
Chronic conditions. Chronic conditions may affect people’s mood and lead to depression. These illnesses or conditions can include diabetes, chronic pain, cancer or illnesses that aren’t life-threatening but negatively impact the quality of life.
Other mental health conditions. Many mental health conditions have been linked to depression, including post-traumatic stress disorder, anxiety disorders and obsessive-compulsive disorder.
Major life changes. Depression can develop after a sudden change in your life, such as ending a relationship, losing your job, being diagnosed with a medical condition, losing a close friend or loved one or other events, planned or unplanned.
Our guide on the most common causes of depression goes into more detail about all the different risk factors of this common mental illness.
While the exact cause of depression is unknown, you may still be wondering how to prevent depression, or if it’s even possible.
Or if you previously had depression and found your mood and mental health improving, you might worry about having a depression relapse.
A review of randomized controlled trials has suggested that up to 38 percent of future major depressive episodes could be prevented.
So while there’s no 100 percent sure way to prevent depression entirely, there are ways to prevent future depressive episodes or depression relapse. Keep reading to learn what depression relapse is and how to prevent it in the future.
While a treatment plan can help manage the symptoms of depression, treatment doesn’t mean depression will be cured.
Depression symptoms can relapse, or come back after going away for up to eight weeks — when depression symptoms come back after you don’t experience them for over eight weeks, that’s called a recurrence. Like any other condition, once you have depression, you’re more likely to experience it again.
And that’s true even after you’ve treated your depression. At least 50 percent of people who recovered from a depressive episode experienced another episode in their life, according to one study.
Depression relapse symptoms may be different from previous depression symptoms. It’s important to keep an eye on all symptoms you experience so you can get treatment as soon as possible.
A depression relapse can happen anytime, even if you’re on medication or following a treatment plan prescribed by a mental health professional. Many of the same causes of depression can also cause a relapse, including the loss of a loved one, stressful life events, ruminating on negative thoughts and more.
Fortunately, there are ways to prevent depression relapse, many of which are similar to treatment plans for depression and can be incorporated into daily life.
Regular exercise is not only one of the best things you can do for your physical health but it can also provide mental health benefits and is considered a natural way to prevent depression.
Exercise can help with many depression symptoms by:
Having a calming effect on the central nervous system
Boosting mood with the release of endorphins
Reducing inflammatory chemicals in your immune system, which can make depression worse
Regular physical exercise can also improve cardiovascular health and prevent cardiovascular disease, such as heart disease, which has a strong connection to depression.
Doing any physical activity is a good start in preventing depression relapse. Be sure to speak with a healthcare professional before starting a new exercise routine.
Psychotherapy has been proven to be effective in both treating depression and preventing depression. Cognitive behavioral therapy (CBT) is an especially effective method of therapy for depression and involves changing patterns of thinking and learning coping strategies for difficult situations.
Studies have shown that CBT can significantly lessen the risk for future depressive episodes.
If you’re in therapy when you experience a depression relapse, your therapist may introduce new coping strategies.
Staying connected with friends and family is beneficial for your mental health and for preventing depression triggers.
A study of over 3,000 young adults and adolescents found that 90 percent of those with recurring depression reported limited social interactions. Multiple other studies have also shown that social support can be an effective way to prevent future episodes of depression.
Regularly connect with friends and family, even when your lives get busy. You can also attend social events and try new hobbies to meet new people and build new relationships.
While medications such as antidepressants are typically the first line of treatment for depression, many cause side effects or have adverse interactions with other medications.
Because there is no “best” medication for depression, be sure to let your doctor know if your depression worsens while taking an antidepressant such as Prozac® or sertraline.
Other medications, like beta-blockers and hormonal birth control, are sometimes thought to cause depression, although no link has been fully proven.
Make sure to carefully read your prescription labels and let your healthcare provider know about any other drugs you’re taking before starting a new medication. You should also let them know of any new or persisting side effects.
Getting plenty of good, quality sleep is necessary for both mental and physical health. People with insomnia have a 10 times greater risk of developing depression than those who get a good night’s sleep.
To improve your sleep, you can reduce screen time before bed, meditate, avoid caffeine in the afternoon and go to sleep at the same time every night.
While some depression triggers are unforeseeable, you can plan for the known ones to preemptively cope.
Unavoidable depression triggers could be the anniversary of something traumatic, like a death anniversary or divorce.
You can plan for these triggers by asking someone to check in with you, as well as reminding yourself that you’ll get through it. You can also talk to your therapist for tips on managing the trigger or event ahead of time.
If you’ve experienced a depressive episode before, you’re likely to experience another. Maintaining your current plan of treatment is one of the best ways to prevent depression in the future.
Continue taking any prescription medications, regularly see your therapist or schedule “maintenance” visits every so often and consistently practice any coping strategies you learned in therapy.
You can talk to a licensed healthcare provider to find the right treatment plan for you and your depression symptoms.
While depression prevention is not fully possible, there are ways to prevent depressive episodes in the future.
A regular exercise routine, getting enough sleep and spending time with people you love are all good starts to improving depression symptoms.
Make sure to take medications as prescribed and pay attention to symptoms of depression, as well as medication side effects. You can also continue talking to or find a therapist to work on coping strategies for depression.
Depression relapse is preventable with the right treatment plan, and you deserve to find treatment for your depression.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.