Recurrent Depressive Disorder

Key points

• Episodes can affect interest, energy, sleep, appetite, concentration, movement, self-worth and thoughts about death.
• Assessment should review previous elevated mood, substances, medicines and physical illness because these can change diagnosis and treatment.
• Psychological therapy, social support and medicines may reduce current symptoms and relapse risk; follow-up matters when treatment changes.

Catalogue matches are not a diagnosis and do not indicate a suitable antidepressant or mood stabiliser.

What distinguishes a recurrent episode?

Clinicians assess symptom number, persistence and effect on daily life, then compare with previous episodes and recovery. A history of mania or hypomania points toward bipolar disorder rather than recurrent unipolar depression.

How is recurrence addressed?

Care may include structured psychological therapy and an antidepressant. Lithium has specialist roles in selected recurrent mood illness and requires blood-level, kidney and thyroid monitoring; it is not a routine catalogue choice.

When to seek urgent care

Seek urgent help for suicidal intent, a plan or access to means, inability to eat or drink, severe self-neglect, psychotic symptoms, extreme agitation or immediate danger.

Further reading

• Depressive disorder (depression) - World Health Organization (WHO)
• Mindful Mood Balance Effective for Treating Residual Depressive Symptoms and Suicidal Ideation - National Institute of Mental Health (NIMH)