Page 59 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

• identifying stressful circumstances, triggering events, warning signs (such as anxiety or

poor sleep), or unhelpful behaviours (such as avoidance or rumination) that have
preceded worsening of symptoms and personal or social functioning, and making
detailed contingency plans of what to do if each of these re-occur

• making plans for any anticipated challenging events over the next 12 months, including
life changes and anniversaries of difficult events. [2022] [2022]

1.8.8 Discuss with people who have remitted from depression when treated with a
psychological therapy alone, but who have been assessed as being at higher risk
of relapse, whether they wish to continue with their psychological therapy for
relapse prevention. Reach a shared decision on further treatment. [2022] [2022]

1.8.9 Discuss with people who have remitted from depression when treated with a
combination of an antidepressant medication and psychological therapy, but

who have been assessed as being at higher risk of relapse, whether they wish to
continue 1 or both treatments. Reach a shared decision on further treatment.
[2022] [2022]

1.8.10 Continue the same therapy for people who wish to stay on a psychological

therapy for relapse prevention (either alone or in combination with an
antidepressant), adapted by the therapist for relapse prevention. This should
include at least 4 more sessions of the same treatment with a focus on a relapse

prevention component (see recommendation 1.8.7) and what is needed to stay
well. [2022] [2022]

1.8.11 Review treatment for people continuing with antidepressant medication to
prevent relapse at least every 6 months. At each review:

• monitor their mood using a validated rating scale (see the recommendations on
delivery of treatments)

• review any side effects

• review any medical, personal, social or environmental factors that may affect their risk
of relapse, and encourage them to access help from other agencies

• discuss with them if they wish to continue treatment; if they wish to stop
antidepressant treatment, see the recommendations on stopping antidepressant
medication. [2022] [2022]

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