Recurrent Depressive Disorder is a type of clinical depression.
Instead of experiencing a single short- or long-term episode of depression, a person with this condition goes through repeated depressive episodes, with periods in between when the depression subsides and the individual lives a normal life without distressing emotions. These episodes can be mild, moderate, or severe, depending on the number of symptoms and the degree to which they impact the person’s life.

What is Recurrent Depressive Disorder?

Recurrent depressive disorder is characterized by the occurrence of at least two depressive episodes separated by several months.
All symptoms correspond to those of general depression: low mood (sadness, irritability, a sense of emptiness) and the inability to feel pleasure or joy (anhedonia).
Other symptoms typically include difficulty concentrating, excessive guilt or low self-esteem, hopelessness about the future, thoughts of death or suicide, disturbed sleep, changes in appetite or weight, and a sense of exhaustion or lack of energy.

In cases of recurrent depression, it is especially important to determine whether there have been previous episodes of obsession, hypomania, or mixed episodes, in order to rule out the possibility of bipolar disorder.

A subtype of recurrent depression is seasonal depression.
Recurrent or chronic courses of depression occur in about 20% of people with depression. The primary causes of this type are genetic and are related to the unique biochemical processes in the brain.
Temperament, childhood experiences, and life events also play a role in determining predisposition.

Impact on Life

With recurrent depressive disorder, the duration, intensity, and frequency of episodes can vary significantly. The symptoms do not always cause significant distress or impair daily functioning.

The fact that symptoms can persist for long periods without noticeable consequences makes diagnosis particularly difficult. It is not uncommon for people with several depressive episodes not to seek medical help.
The manifestations of the disorder may be perceived as a difficult period in life that will eventually pass. However, this poses a risk that each subsequent episode may be more severe than the previous one or become chronic, significantly affecting the person’s quality of life, relationships, and work.
Although recurrent depression is often described as milder than major depressive disorder, studies show that it may be associated with an even higher risk of suicide than major depressive disorder.

Treatment

As with many forms of depression, the most common and effective treatment during a depressive episode in recurrent depressive disorder is a combination of medication and psychotherapy.

Among psychotherapeutic methods, Cognitive or Cognitive Behavioral Therapy (CBT) is the most effective.
It helps identify maladaptive beliefs, assumptions, and thought patterns and replace them with alternative beliefs and more adaptive ways of thinking, which in turn helps regulate emotions.
Dialectical Behavioral Therapy (DBT) or Interpersonal Therapy (IPT) may also be applied.

In recurrent depressive disorder, the continuity of both medication and psychotherapy is essential.
To prevent relapse, it is usually recommended to continue treatment for at least one year after the end of a depressive episode.

Although the prognosis for full recovery in recurrent depression is less favorable than in major depressive disorder, most people experience positive changes through therapy. Full recovery tends to be associated with a longer treatment process.