AS@W
AS@W Antidepressant Skills Workbook: Heling You Deal With Depression
The road ahead: reducing the risk of relapse
Winding road sign

Major depressive episodes end. It often doesn’t feel as though they will, but they do. Unfortunately, many people go on to have another episode months, years, or decades later.

Is there anything you can do to reduce the risk of relapse? Yes. You may or may not be able to eliminate the possibility of having another episode. But you can make episodes less likely, less severe, and less frequent.

Keep up your efforts

When you feel terrible, it’s obvious that you need to make your mental health a real priority. When you feel better, it can be tempting to forget all about taking care of yourself. If you feel “good enough”, you may want to stop working away at activity increase, realistic thinking, and problem-solving.

Think about the strategies you have been using to cope. Are there some that you will need to keep up over the long term, even after you feel better?

What strategies do I need to keep up?

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Plan ahead for stress

We all have difficult times in our lives – some of us more than others. For the person who has recently recovered from depression, stressful times may be a risk factor for relapse. The solution is not to avoid all possibility of stress (which none of us can do), but to plan ahead to manage the stress effectively.

Some stressful events can be predicted. Perhaps you know that on a certain date you will go back to work. Perhaps Christmas is always stressful for you, and December is coming. Perhaps a stressful family gathering is scheduled. Perhaps you are expecting a baby, whose birth will bring many demands. You can plan ahead for these events to make them less difficult.

Here are some strategies:

When possible, introduce the stress gradually. If, for example, you are returning to work soon, you might check to see if you could go back part-time at first.

Lighten up on ongoing responsibilities. If you are taking a night school course, for example, give yourself permission to eat out more often or have a slightly less tidy home.

Keep up your self-care. How do you keep yourself balanced? Don’t give these things up when you need them the most. If a weekly lunch with a close friend is important to you, keep doing it. If exercise helps a lot, do everything you can to keep exercising during stressful times.

Create a Mood Emergency Action Plan

If you plan ahead for a relapse, you may be able to get help faster than last time. As a result, the depression may not become as severe, last as long, or be as difficult to recover from. By planning a course of effective action ahead of time, you may not be as anxious, and you may actually reduce the possibility of a return of the depression.

If you were to become depressed again, what are some of the things that you could do to help yourself and get better as quickly as possible?

Here are some areas to think about:

Increase rewarding activities. Use the steps in the section called “Reactivating Your Life”.

Reduce your obligations. How could you plan ahead to scale back the demands on your energy in the event of
depression? For example, perhaps you could get an agreement in advance to reduce your work hours or to get help with
childcare from a family member.

Get professional help. Consider giving permission to a few friends or family members to tell you (or perhaps your
doctor) when they notice your mood seems to be sliding.

Get support. Who could help you and what kinds of help would you need? Perhaps you need someone to talk to, or
maybe you would prefer practical help – like assistance with grocery shopping.

Manage your lifestyle. A mood decline is no time to stop exercising, or getting out of the house, or eating
properly, or keeping a good sleep schedule. What are the lifestyle factors that help your mood the most?

Take some time to think about how you could get to work early in a depressive episode to prevent it from
getting worse. What would have helped this time? Use the list above as a starting point and make up a clear
plan of action.