"[The suicidal thoughts] came back several times — when I was struggling with depression, my bipolar disorder," she tells Dr. Phil.
Though Lovato says that she's "in a really good place today," her story brings up an important point about depression recovery and mental health recovery in general: It's not a straightforward process, and relapses do happen.
Simon A. Rego, PsyD, director of the cognitive behavioural therapy training program at Montefiore Medical Centre and member of the Anxiety and Depression Association of America, says that a relapse in mental health recovery is when a disorder or mental illness recurs after having been treated.
"We try to treat psychological disorders with what we call total remission, which is the absence of symptoms of the disorder," Dr. Rego says. "Sometimes we get to partial remission, meaning there’s significant improvement but there still may be a few symptoms remaining, maybe with lesser intensity."
Even after full treatment, however, symptoms of depression can come back. In fact, according to the American Psychiatric Association, at least half of people who have had a major depressive episode are at risk for more episodes down the road. And for those who've experienced two major episodes, 80% are likely to experience an additional episode.
At least half of people who have had a major depressive episode are at risk for more episodes down the road.
Dr. Rego says it's unclear exactly why this might happen, though different people have different struggles with depression and depression recovery. Some might experience situations that trigger their symptoms, and some might relapse after not following a treatment program as closely as they should have. Plus, life events and changes like a move, a new job, or family emergencies can all make someone more susceptible to relapse if they've been on a recovery routine.
He also says that treating someone for a relapse wouldn't be all that different from treating the initial depressive episode.
"Whatever was successful the previous time, we would start with that and hope it would create a similar response," he says. "But this time we would do a bit more to pursue their progress towards formal relapse prevention, with more extensive recommendations such as booster sessions where you check in with your therapist."
Other than formal treatment with a therapist, Dr. Rego says that it's also important to reach out to your support system if you're relapsing, and to try to remember what you did in the past to get through a depressive episode.
"You did something right the first time, so if you return to the things you were doing before, you can get similar results," he says.
Most of all, remember that relapses are common, and they don't have to be the end of the world. Recovery is not a linear process, and running into a bump (or a few bumps) in the road doesn't render all your progress obsolete.
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