If you suffer from depression, you may know that some forms of depression come in waves. There can be such relief when an episode is over, and waves of disappointment and sadness when another episode appears. So, what can you do when you feel depression coming back?
Symptoms of Depression
First, understanding and knowing your depression symptoms can help. In order to be diagnosed with Major Depressive Disorder, symptoms have to be present for at least two full weeks. These symptoms include:
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness, or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in hobbies and activities
- Decreased energy or fatigue
- Moving or talking slowly
- Feeling restless or having trouble sitting still
- Difficulty concentrating, remembering, or making decisions
- Difficulty sleeping, early-morning awakening, or oversleeping
- Appetite and/or weight changes
- Thoughts of death or suicide, or suicide attempts
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
There is also Persistent Depressive Disorder, or commonly known as Dysthymia, which is where someone can experience a low mood, but not as severe of symptoms as a diagnosis of Major Depressive Disorder, for as long as two years. While the symptoms may vary in intensity and impact, when they do appear, it is called a depressive episode. Episodes can be triggered, or can happen more cyclically. Experiencing another episode may be considered a “depression relapse”, and why it can seem like depression isn’t treatable.
What can trigger a depressive episode?
There are a variety of factors that trigger an episode, and those factors can vary from person to person. Examples of depression triggers include:
- Having certain personality traits, such as low self-esteem, being too dependent on others, being self-critical or pessimistic
- Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems
- A genetic predisposition to depression, bipolar disorder, alcoholism or suicide
- Being a part of the LGBTQ+ community and not having a strong support system
- History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder
- Abuse of alcohol or recreational drugs
- Serious or chronic illness (recurring or a new diagnosis of illness)
- Certain medications, such as some high blood pressure medications or sleeping pills
Any variety of these causes can trigger another depressive episode. Some of these triggers can be very obvious, such as a traumatic event, and others can be more subtle. Dealing with depressive episodes is difficult, so what do you do when you start to feel depressed again? Consider what may have helped to get through your first episode.
Different Ways of Treating Depression
Treating depression can vary from person to person. It’s important to know that depression, no matter how severe, is treatable. What do you do when a depressive episode hits? Medication, therapy, brain stimulation therapies, and social support are some ways to treat and manage your depression.
A relapse of depression, or the recurrence of another episode, may be a good time to re-evaluate your medication. If you are not on any medications, such as an SSRI, scheduling an evaluation with your primary care doctor or a psychiatrist can help determine a diagnosis or an initial medication trial to consider. Medication can take some time to figure out, so practicing patience is encouraged, although difficult if you are struggling with depression.
Talk therapy is one of the most common forms of treatments for Major Depressive Disorder and other depressive disorders. Learning skills to cope with depression, talking through uncomfortable feelings, and having a supportive person or team can all be beneficial in treating and managing depression and anxiety. If you are experiencing a depression relapse, checking in with your therapist is encouraged. Much of your therapy can revolve around identifying and practicing ways to prevent depression from coming back or decreasing the impact another depressive episode has on you. Coming up with a depression relapse prevention plan, that includes skills or people to lean on, can be helpful.
If medication or talk therapy have either been unhelpful, or not as effective as you had hoped, there are other options. There are brain stimulation therapies, such as Transmagnetic Stimulation (TMS) that can reduce and potentially eliminate depressive symptoms. TMS is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS has historically been used as a treatment option when more traditional treatments are ineffective. However, most recently, it has been considered an initial treatment option, due to becoming more widely available and covered by insurance providers. TMS is also FDA cleared, pain-free, side-effect-free, making it a great option if you experience a depression relapse.
If you are fortunate enough to have supportive people in your life, consider checking in with them and leaning on them while you are struggling with depression. Talking with them, sharing your feelings, or asking them for assistance can take some of the physical or emotional burden off of you, so you can focus on coping with depression or anxiety. Recovering from depression relapse can be hard, exhausting, and scary. A combination of methods of treatment can help. And always being kind and compassionate with yourself, as much as you can, will be the most effective way to deal with a mental health relapse.
Mayo Clinic. (2018, February 3). Depression (major depressive disorder) – Symptoms and causes. Retrieved November 11, 2020, from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
Mayo Clinic. (2018, November 27). Transcranial magnetic stimulation. Retrieved November 11, 2020, from https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625
National Institute of Mental Health. (n.d.-e). NIMH » Depression. Retrieved November 11, 2020, from https://www.nimh.nih.gov/health/topics/depression/index.shtml