About three-quarters of people with depression live in fear of recurrence, Canadian researchers report. 

“Many of our patients talk about depression in a very cyclical sense, with key moments or dates throughout the year that would scare them because they were associated with periods when they suffered from acute depression,” says lead author Stephanie Gumuchian, a PhD candidate in the department of psychology at Concordia University, Montreal.

Thirty people (83 per cent female; 37 per cent white) aged on average 27.7 years with major depression in remission participated in semi-structured interviews. Of these, 73 per cent reported fear of depression recurrence (FoDR).

Twenty-three per cent experienced FoDR weekly and 30 per cent monthly. FoDR usually lasted a few minutes (43 per cent) or hours (23 per cent) but 17 per cent said that it could persist for days. Most respondents associated FoDR with increased anxiety and negative mood changes (57 and 47 per cent respectively). Symptoms similar to those experienced previously, reminders of past episodes and life events (e.g. stress, feeling alone and unsupported) could trigger FoDR. 

Thirty-seven per cent of the patients in the study described a “snowball effect” – FoDR meant they became hypervigilant to symptom changes, which increased their anxiety and feelings of being overwhelmed. 

However, 40 per cent said FoDR led them to proactively try to address the early signs warning of a recurrence. Thirty per cent said that FoDR resulted in positive changes and personal growth, such as increased confidence and awareness of their mental health needs. 

“They would do everything in their power to address their fears. They would reconnect with their mental health providers or their friends, visit their families and use coping strategies that they knew had been effective in previous depressive episodes,” Gumuchian says. 

“Eventually we hope that we can use our FoDR questionnaire in a clinical setting, so that it can give us a clear sense of people’s fears early on, or in a primary care setting where a physician can screen for these fears.”
“Ideally, it could be used to identify the individuals who may be most at risk of future recurrence.”