Experiencing a major depressive episode is not necessarily a standalone experience in that one can experience recurring episodes in the future. Recent research has examined the risks of recurring depressive episodes, and the findings are important in highlighting what can be done to reduce the risk.
It’s important to note that a clinically diagnosed depressive episode, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013), is one that lasts two weeks or longer and bears multiple symptoms, often including depressed mood most of the day and significantly diminished interest or pleasure in all, or almost all, activities most of the day, among other symptoms.
Consideration of the research
Recent research on the risks for a relapse of another recurring depressive episode involved a meta-analysis of 44 studies involving 2,081 participants with a history of major depressive disorder and 2,285 healthy controls (Wen, Fischer, Watson, and Yoon, 2023). Specifically, the research found that people who have recovered from a major depressive episode, when compared with individuals who have never experienced one, tend to spend more time processing negative information and less time processing positive information, putting them at risk for a relapse.
What types of negative information were focused on in the research?
In some cases, participants were shown happy, sad, or neutral faces, and participants who previously had major depressive disorder spent more time processing negative emotional stimuli over positive stimuli compared with controls. In nonclinical terms, the participants were more likely to get mentally stuck when focused on negative stimuli, “living in” the feelings that the stimuli generated instead of briefly processing the information and moving on.
Ways to reduce the risk of relapse of a depressive episode
Maintaining recovery after depression depends partly on making a conscious daily effort to focus on positives as opposed to negatives. Individuals recovering from depression can employ many different coping skills that reinforce positive, hopeful thinking. Consider the list below as they apply to viewing life and one’s circumstances from a positive framework.
Write about your best possible future.
Because depression often involves the depressed individual feeling overwhelmed by the negative present circumstances, thoughts, and feelings, directing attention to a positive future can help to provide a distraction from the present and provide hope for a different and better future. One study showed that imagining and writing about your best possible future increases positive emotions (Sheldon & Lyubomirsky, 2006). Consider employing this technique and write about how you imagine your better future and the activities you picture yourself engaging in as you feel better.
Putting pen to paper
Other written exercises may help reduce the risk of a recurring episode. Research suggests that thinking of and listing three good things daily can contribute to increased short-term and longer-term happiness (Seligman, Steen, Park, & Peterson, 2005).
Similarly, individuals may benefit from writing a daily gratitude list, which lists things for which a person is grateful. There is no fixed or correct way one writes such a list; it can be written in a notes app on one’s phone, on a piece of scratch paper, or in a personal journal. Items on the list can range from the simple (“I’m grateful to have woken up in my comfortable bed” to the complex (“I’m grateful my friend and I worked out our disagreement and are now comfortable around each other again”).
The point of gratitude lists is that individuals often get so caught up managing the immediacies of daily life that they often forget what matters most for healthy functioning, which is to appreciate what we already have rather than focus on what we want. This daily practice can help train an individual to remember that positives exist, especially when current circumstances feel overwhelmingly negative.
Using positive self-talk or mantras
You can recite many statements internally or out loud to reinforce a positive approach to immediate circumstances. This list is infinite, but some examples include: “I don’t like this, but I will do what I have to do to get through it;” “I can choose to take any negative thought and recite one positive thought immediately afterward; “This moment is temporary so that it won’t last forever;” “Feelings aren’t facts, and I might feel a little better soon.” It’s important to note that such self-talk statements reinforce a sense of personal control over your circumstances, especially at a time when one may feel they have little to none.
Conclusion
It’s crucial that an individual who has suffered a depressive episode must accept a balance between two different factors: a physiologically-driven depressive experience and the cognitive and emotional components over which one has little more control. For many, a depressive episode may not be warded off completely by voluntary coping techniques, as outlined here. Still, such techniques may reduce the intensity of the physiological drive toward another episode or, in some cases, prevent it from developing into a full-blown, diagnosable episode.
