Information provided in the “Ask the Doctors” column is not meant to take the place of individual consultation with a qualified health care provider. See your health care provider to discuss specific questions about your health, medication and treatment plan.

Question: How can my doctor tell if I’m likely to have a recurrence of depression if I stop my treatment?

John F. Greden, M.D.: Unfortunately, recurrences are quite common in people with clinical depression; it’s estimated that at least 75-80% of those with depression have multiple episodes. If untreated, depressive episodes tend to become closer together and harder to treat. But recurrences can be prevented.

Helpful prevention strategies include:

• Early detection and intervention

• Special attention to people at high risk

• Treating the whole illness, rather than just symptom flare-ups

• Focusing on treating to complete wellness (“better but not well” isn’t good enough)

• Emphasis on effective treatments that include medicine, psychotherapy and peer support

• Adherence to treatment plans

Your doctor can get a better idea of your risk of recurrent depression by looking at seven factors:

• More than two prior depressive episodes

• A high number of days spent feeling depressed during your lifetime (even if the number of episodes has been small)

• A strong family history of major depressive disorder

• Symptoms of depression that remain even after vigorous treatment

• A prior history of prompt relapse or recurrence after stopping treatment

• Early age of onset, prior suicidal behavior or other co-occurring psychiatric or physical illnesses

• Abnormal results on laboratory tests of stress hormones, brain imaging, sleep patterns or brain structure

The risk for recurrence appears to be higher the more variables you have. It is a good idea to discuss these variables with your doctor, and plan your future treatments keeping them in mind. Your main goal should be consistent, lasting wellness.

John F. Greden, M.D. is Senior Research Scientist and Chair of the Department of Psychiatry at the University of Michigan, and a member of DBSA’s Scientific Advisory Board.