Supporting someone with depression: what the latest research says

A 2020 article for GPs repeated older estimates that about half of people treated for a first episode have another, rising to around 70% after a second and 90% after a third [1]. These are broad estimates from treatment settings, not a prediction for one person. A Dutch study of 687 people from the general population who had recovered estimated recurrence at 13% by five years, 23% by ten and 42% by twenty [2]. It combined past-history information with three years of follow-up; it did not follow everyone for twenty years. Risk varies with the people studied, their earlier illness and the time since recovery.

In an NHS service in England, researchers followed 439 people whose depression or anxiety symptom scores had improved after brief guided CBT. Within a year, 53% met the study's symptom-score definition of relapse, and nearly four in five of those relapses came in the first six months. Mild depression symptoms at the end of treatment were linked with a higher relapse rate [3]. This was one mixed depression-and-anxiety cohort, so its figures do not apply to everyone recovering from depression. A 2018 review also identified remaining symptoms, previous episodes and childhood maltreatment as important risk markers [4]. If they feel better but still struggle, they can ask the GP or therapist about further treatment and follow-up.

NICE says relapse prevention can include a plan to keep up what helped in treatment, and a list of the stresses, triggers, warning signs and habits that came before past episodes, with what to do about each. Its examples of warning signs are anxiety and poor sleep, and of habits, avoidance and going over and over problems. It also suggests planning ahead for hard dates in the coming year, such as anniversaries [5]. Our guide covers making a plan together. It helps to agree this before regular appointments end. If they're happy to, ask for a copy, and what they'd like you to do if you spot the signs first.

Mindfulness-based cognitive therapy (MBCT) is a group course for people who've had depression and are now well, or mostly well. It combines mindfulness practice with ideas from CBT. When researchers pooled data on 1,258 people from nine trials, those who had MBCT were less likely to relapse over the next 60 weeks, and it did a little better than other active treatments. It seemed to help most in people who still had some symptoms [6]. A 2023 analysis of 25 trials with 2,871 people also found benefits from CBT aimed at preventing relapse. Results varied by follow-up period and comparison treatment, so it does not establish one therapy as best for everyone [7]. NICE recommends group CBT or MBCT for people at higher risk of relapse: eight sessions over two to three months, with the option of more in the following year [5]. Ask the GP or NHS Talking Therapies what runs locally. Covering something at home on group nights can make it easier for them to go.

Medicines are a decision for them and their prescriber, but two UK trials are worth knowing about. In ANTLER, 478 people on long-term antidepressants who felt well enough to consider stopping were allocated to continue or taper to dummy tablets. Within a year, 56% in the stopping group had relapsed, against 39% who continued; withdrawal symptoms were also more common after stopping [8]. PREVENT compared continuing medication with MBCT plus support to taper in 424 people with at least three previous episodes. It found no clear difference in relapse over two years, but it was not designed to prove the options equivalent [9]. A trial's taper schedule is not a personal stopping plan. If they want to stop, they should agree a gradual plan and follow-up with the prescriber, and ask whether relapse-prevention therapy would suit them [5].

A Japanese trial allocated 57 people recovering from depression and their relatives to usual care with or without four group sessions for relatives. The sessions covered depression, treatment and problem-solving. Over nine months, 8% of patients in the family-session group relapsed, against 50% with usual care alone [10]. That is a promising result from a small trial, not a dependable estimate of what every family can expect. A 2017 review of ten studies described the evidence for family education as preliminary, with some benefits for patients and relatives [11]. A 1997 study of 39 couples linked lingering symptoms with continuing criticism, but could not establish which caused which [12]. If they agree, asking to join part of an appointment can be a starting point.

A 2018 review of 34 studies found that people with depression who felt poorly supported tended to have worse symptoms, recovery and everyday functioning [13]. A 2025 study followed adolescents and young adults in disadvantaged areas of three South American cities. Support from both family and friends was linked with recovery from depression and anxiety symptoms over two years [14]. These studies cannot prove that support caused recovery, and the younger study should not be generalised to all adults. Helping someone reconnect with people they want to see can still be a useful, practical aim.

Behavioural activation is a therapy built on the idea that, with depression, doing things often has to come before feeling like it. In the UK COBRA trial of 440 people, behavioural activation delivered by trained junior mental health workers was no less effective than CBT on depression scores at twelve months, and cost less [15]. The 2023 analysis also found a possible relapse-prevention benefit at later follow-up, but evidence was limited; this does not mean it starts working only after two years [7]. Once someone feels better, the routine that got them there can slip. Ask which activities helped most and keep one or two going together, such as a weekly swim or a walk on Sundays.

A 2024 BMJ review of 218 trials found that exercise, including walking or jogging, yoga and strength training, reduced depression symptoms on average. However, confidence in the estimates was low or very low because of weaknesses in the studies [16]. It supports discussing exercise as part of treatment, without promising a particular result. Offering to come along can help. If they also have an eating disorder, check with their care team first.

The Flow headset passes a weak electrical current through the front of the head. In a remotely supervised ten-week trial of 174 adults, about 45% using active stimulation met the study's remission threshold, against 22% using a dummy device [17]. Remission here means symptoms below a set score at that assessment, not a lasting cure. The average difference in depression scores was more modest, and participants could sometimes guess their allocation. NICE says this type of stimulation needs special arrangements for oversight, consent and monitoring, or research [18]. It is sold commercially; check current costs and terms [19]. Flow advises speaking to a doctor first about epilepsy, pregnancy, suicidal thoughts or bipolar disorder, and says not to use it during mania [20].

A review published in 2025 included 11 trials with 858 people with non-seasonal depressive disorders. In the eight trials reporting remission, about 41% receiving bright light alongside treatment met the trial's remission threshold, against 24% in comparison groups [21]. This is a short-term outcome, not proof of lasting recovery. Bright light can bring on raised mood in someone with bipolar disorder, so use it only with the care team's agreement and monitoring.

Sleepio is an online CBT course for insomnia. NICE recommends it as an option in primary care for people who would otherwise be offered sleep-habit advice or sleeping tablets [22]. NHS access is available to adults in Scotland; the Thames Valley NHS page explains its local access route [23][24]. Check eligibility before signing up. The course can temporarily reduce time in bed, so people with bipolar disorder should speak to their doctor first [30].

Space from Depression is an online CBT course with support from a trained practitioner or therapist. NICE permits its use in NHS Talking Therapies in England while further evidence is collected, subject to NHS England approval [25]. Ask the service whether it is available and suitable.

NICE considers the evidence for repetitive transcranial magnetic stimulation sufficient for use with normal clinical oversight, consent and audit arrangements [26]. This does not guarantee a local NHS service or that it will suit the person. Ask their clinician about assessment and referral. Private providers also offer it; check what assessment, treatment and follow-up a quoted price includes.

A 2024 review of 176 trials found small average improvements in depression symptoms with smartphone apps. Results varied, and most evidence concerned short-term outcomes [27]. It does not show that any app in an app store will help. The MHRA's 2026 guidance suggests checking the evidence, intended users and what happens to personal data [28].