A resilience framework for promoting stable remission from depression

Abstract

A significant proportion of people in remission from depression will experience a recurrence of depression. One theoretical mechanism for this recurrence is that with each additional episode of depression, people become more sensitive to the deleterious effects of less powerful stressors. We propose that research on resilience - the ability to adapt to and recover from stress - can inform interventions to prevent recurrence in people in remission. We conceptualize resilience as a dynamic process that may be deficient in people in remission from depression, rather than as a static personal quality that is unattainable to people who have experienced psychopathology. The three aspects of resilience that we suggest are the most important to target to prevent recurrence are (1) improving stress recovery from minor daily stressors that may aid remitted people in coping with major stressors, (2) increasing positivity, like promoting positive emotions during stress, and (3) and training flexibility-the ability to identify different demands in the environment and employ the appropriate coping strategy to meet those demands. We offer suggestions for the appropriate assessment of changes in resilience in remitted people and provide some examples of effective resilience interventions.

Keywords: Depression; Flexibility; Positivity; Remission; Resilience; Stress.