What helped older adults stay resilient after depression?

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Older adults who have experienced major depressive disorder (MDD) have a high risk of relapse. While depression risk factors have been extensively researched, less is known about protective factors and experiences that might strengthen later resilience and help prevent relapse. This qualitative study explored resilience factors in older adults who recovered from MDD and did not relapse over at least six years.

Researchers conducted 25 semi-structured interviews with adults aged 73–85 who had participated in the Netherlands Study of Depression in Older Persons from 2008 to 2014 and were re-interviewed for this study in 2020–2021. Participants were defined as resilient if they had an MDD diagnosis at baseline but not at the two- and six-year follow-ups. The researchers used grounded theory coding techniques and thematic analysis to identify factors contributing to resilience.

These factors included taking agency; receiving social support and engaging in social activities; doing activities individually; and managing thought processes. Resilience after late-life depression appeared to be a dynamic process involving internal and external factors, including finding a balance between rest and activity, between taking initiative and receiving support from others, and between accepting negative emotions and ignoring negative thoughts.

The ability to learn from depression also suggested that resilience is not only about avoiding psychopathology, but also about the recovery process and preventing relapse. The findings highlight a need for research and interventions to focus on understanding and influencing the dynamics underlying resilience.