Medical Q&As

Depression - fear of relapse?

I am a 25-year-old female with a history of severe depression. In February 1999, after the dose of my antidepressant was increased I went into remission and have been symptom free for 4 years. However, I am under a great deal of stress at the moment with assignments and studying. The old feelings are returning which I always dreaded. I don't feel too bad at the moment, just a bit down and am not sleeping but am worried depression will take over again. Should I go to my doctor again?

Relapse is a common feature of depression. Most major relapses occur within the first year of diagnosis and tend to be associated with short courses of treatment. Modern evidence suggests that depression needs to be treated for a minimum of three months and most people with major bouts of depression need to be treated for a year or longer. Clearly you complied with your treatment and have been very well since 1999. You indicate that you are currently experiencing some increased stress in your life, which could be responsible for your current feelings. Given the fact that your previous episode of depression was severe it is very understandable that you would be apprehensive about the possibility of relapse. However, your current feelings could be transient and may simply be related to your current workload. I would suggest that you return to your doctor and discuss your current feelings and workload. If this is a relapse of depression it would be better for that matter to be addressed now rather than waiting until you are more disabled by the condition. It is also possible that your current difficulty is simply fear of relapse in which case a consultation with your doctor could be very reassuring for you and dispel some of your current fears. On a positive note, it is very encouraging that you have been symptom free for four years. If this were indeed a relapse of depression I would predict, on the basis of your progress since 1999, that early intervention should alleviate your current symptoms speedily.