Well, Rissa, the short answer is "nope" not all cases of RR end up going down that road. We have some people here who have been RR for their entire lives and no one in their worlds even knows they have it.
You hit the nail on the head when you said that it's different for each of us. It helps me to just live each day and not dwell on "what-ifs", life has enough fun packed into its days.