6 Things to Consider When You Have a Depression Relapse
Published Jan 28, 2016 for EveryDayHealth.com
Following my post on my recent depression setback, I heard from many readers who were comforted to know that they were not alone. As I said in that piece, if you suffer from chronic depression, you know all too well that setbacks happen — even to those of us who think we’re doing everything right to protect our limbic systems from intense sadness and anxiety.
I thought I would follow up, then, by listing some nuggets and things to remember that help me when I’m in a bad place. I hope they might help you, too.
1. Watch the Panic
When my son was about 9 months old, loving to climb on everything but not yet walking, we visited some friends who had a 6-year-old daughter. My son saw their stairs and immediately began to tackle them. Sitting on the fourth step, the little girl immediately pushed him down the stairs and, with the panic of someone whose house was on fire, declared, “He’s going after my tea set!”
I always remember that response in the first weeks that my mood plummets, and I can’t control the tears. “Oh my God! I’m going THERE AGAIN!” It’s the same sheer panic of knowing that someone is coming after my precious tea set. Of course, there is no tea set. Even if there was, I’m sure it would be quite ugly and no one would want it. But our minds are quite adept at convincing us of realities that don’t exist. When you panic and know for sure that you’re headed for the abyss — toward a depressive episode that’s worse than the one that had you hospitalized three years ago — remember the tea set and loosen your grip.
2. Avoid All Negativity and Triggers
When I’m fragile, I have to become a bit of a recluse because the least bit of negativity will trigger my reptilian brain into thinking that the saber-toothed tiger is, in fact, running after me and will be feasting on my organs by dinner. While connecting with other people who struggle with chronic depression is a lifesaver for me most of the time, I have to be careful of the sad stories when I’m extremely low, because I will make them my own story: “If she can’t get well,” I start to think to myself, “neither will I.”
During these periods, I can’t talk to certain people because I know their negativity will seep into my spirit and spiral me further down the rabbit hole, and I stay offline completely. Until I’m resilient enough to hear something negative and not absorb it, make it my own, or obsess about it day and night, I have to avoid certain people, places, and things.
3. Get Rid of the Line
In my relapse piece, I mentioned the Gilda Radner quote:
“I always wanted a happy ending … Now I’ve learned, the hard way, that some poems don’t rhyme, and some stories don’t have a clear beginning, middle, and end. Life is about not knowing, having to change, taking the moment and making the best of it without knowing what’s going to happen next. Delicious ambiguity.”
Getting rid of that line we all want to draw — before good health versus after good health — has afforded me a surprising freedom in the midst of extreme pain. As a result of my suffering, I’m gradually learning to replace the lines and squares in my life with circles and spirals. I’m not “going back” to a dreadful place of the past. The word “setback” is even wrong. I’m reaching a spot I haven’t been at before. Right now it’s packed full of heartache and hurt, but it’s also a new beginning, teaching me things I need to know and helping me to evolve in ways that will promote emotional resilience in the future. This space where I am right now is totally new. It exists somewhere outside of the radius I want to assign to it. There really is no line.
4. Know You’re in the Basement
When I was in the midst of a depressive episode a few years ago, a friend of mine insisted that I shouldn’t believe anything that my brain was telling me because “I was clearly in the basement.” She explained to me her theory of the “mood elevator”: When we’re feeling okay, we’re somewhere above ground level, with a decent view. We can look at the trees outside and even walk out the door if we want to enjoy some fresh air. When we’re depressed, however, we exist in the basement. Everything we see, smell, feel, hear, and taste is from the perspective of being on the lower level. So we shouldn’t take our thoughts and feelings so seriously when we’re down there, sitting among stinky boxes and mouse turds.
5. Focus on Positive Actions
My husband is much better at this than I am. My problem-solving skills aren’t so sharp when I’m in the basement. I want to dwell on how miserable I feel and leave it at that. But he always brings the conversation back to positive actions which, in turn, always give me hope. To help solve the insomnia problem, we bought a mattress for our bedroom closet since I needed a quiet place to sleep where I couldn’t hear snoring or barking dogs, as well as some meditation tapes, audio books, ear plugs, calming teas, and other sleep tools. These have granted me another hour or more of sleep a night.
We also brainstormed about what our next course of action should be if my depression doesn’t lift in the next few weeks. We decided that for me, investigating transcranial magnetic stimulation (TMS) is a good next step. After making the consultation, I felt huge relief that I was doing something to move in the right direction.
6. Be Kind to Yourself
We can be downright cruel to ourselves when we are in the midst of a depressive episode. We talk to ourselves like we would to no one else — even our worst enemies — calling ourselves worthless, lazy, unlovable, or pathetic. And yet it’s precisely during these times that we need to be most gentle with ourselves, offering compassion and kindness whenever possible. Now is not the time for the “tough love” that I think many of us on some level, even subconsciously, think we need.
We need to congratulate ourselves on every small accomplishment throughout our day — getting out of bed, going to work if we were able to do that, picking up kids from school — because the act of staying alive itself takes enormous strength and energy on those days when everything in us wants to self-destruct. We need to become our own best friend, swapping the self-flagellation with words of support and gestures of kindness.
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Photo credit: Getty Images