One of the characteristics of Depressive Disease is its cyclical nature, that is, its tendency to reappear periodically. The period following the recovery of of Depressive Disorder represents the moment of greatest risk for the appearance of relapse.

The persistence or reappearance of psychological and/or social factors is an important factor-causing relapse. E. S. Paykel from England has concluded from his extensive research that whenever negative psychosocial factors occur, the person is prone to develop of Depressive Disease. In vulnerable individual negative psychosocial factors precipitate episodes of of Depressive disease.

Dr. Manilal Gada in his study found that

1. accidental or untimely death of near relative
2. serious illness of a near relative
3. failures in business, in relationships, in love affairs etc.
4. quarrel with near ones
5. loss of prestige,

has resulted in recurrence of Depressive disease. In addition, other events acting as precipitating factors have been mentioned earlier.

Furthermore, the length of the treatment has an influence on the frequency of relapses. The stoppage of the medication during the 4 months period following recovery leads to the reappearance of Depressive Disease in about half of all the cases. If the treatment is continued for a longer period even though the patient is better, the incidence of relapse reduces.

SYMPTOMS

Usually the symptoms of the relapse are similar to what symptoms were in earlier episodes. Some new symptoms may occur and some symptoms may not be present.

TREATMENT

Each repeated episode of of Depressive Disorder is treated as a fresh episode. The patient is prescribed the same medicines with which he had shown improvement earlier. Research has shown that same medication is useful. It is very important to understand that the drug treatment will have to be continued for a longer period than on the previous episode.

Once the recovery of of Depressive Disease has occurred (the patient has no active symptoms) in order to avoid relapses, it is advisable to continue medication for 9 to 12 months.

Through psychotherapy and counseling an attempt is made to change certain attitudes of patients and relatives. With this, the effect of psychological stress is minimized thus minimizing chances of recurrences.