When You Have a Depression Relapse

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For anyone who has ever been debilitated by severe depression, there is nothing more frightening than the feeling that he or she is relapsing into another episode. We chalk up the first few days of angst to a bad stretch and hope it gets better from there. But by the time we have hit six weeks of crying spells and the kind of anxiety that steals our appetite, there is usually some panic that we are headed into the Black Hole of Depression yet again.

All of us want so badly to be cured and to find the magical remedy that will make depression and anxiety disappear forever, whether that be a medication combination or a mix of natural therapies. When we find that what we are doing isn’t enough to keep us immune to the setbacks that often happen with chronic depression, it can be so incredibly frustrating, discouraging, and maddening. It is especially scary when the tools that once worked for us during past depressive episodes are no longer effective or cause other problems, and we are forced to figure this thing out all over again, feeling around in the darkness for sources of light and hope—not knowing if what we hold in our hands is a flashlight or a mouse trap.

In this blog I try to include all kinds of tips and suggestions for living with depression and anxiety that I’ve gleaned from research or from my own experience. I want to be a source of encouragement for you and inspire creative ways of tackling an illness. However, I realize what helps the reader the most is to know that he or she is not alone. When I hear from you, your messages most often say thank you for being real, for admitting that I don’t have sanity figured out, and that I am merely a companion on the road with you, trying to do my best to reach a point where I’m doing more living and less coping.

In the spirit of that honesty, let me say that I have been really struggling for the last few weeks and it has made me more in touch with the exasperating efforts of so many of you to stay sane. Sometimes the act of getting up in the morning (if you can sleep, that is) and putting on your shoes, trying to tackle another day when you feel so defeated, so completely dead to the world, is the most beautiful act of courage there is. Sometimes the agreement to hang around for another day on this earth despite the raw pain inside is a warrior’s act of bravery and integrity.

I hate relapse. There is nothing more unsettling to my core than the first few weeks that I can’t restrain my crying, especially in public places, and when simple decisions that I have to make in a grocery store between two types of brands of yogurt can render me disabled. I detest the painful ruminations that play over and over again in my brain even as I try like hell to practice mindfulness techniques and stay in the moment. I abhor lying awake at night knowing that my sleeplessness will cause more tears the next day. And I loathe that feeling of being trapped in this world—with no exit ramp available—which stalks me throughout the day and night.

However, resisting and running from the relapse only makes things worse. I am learning with each depression setback that I must lean into it–that I can spare myself some of the suffering attached to it if I simply let it be. It’s important to identify any triggers that may have caused it, to make amendments wherever possible, and to get the necessary blood work done or to check in with a physician about certain biochemical changes in your body that may be causing it. In my case, there were lots of those. But I keep on learning the same difficult message in the midst of relapse: that by wanting things to be different, I add to my pain. Conversely, when I can let go of that person I wish I were, the functioning body I so desperately want, the reality that I want to be mine—when I can accept the very painful moment or hour or day for what it is, I can experience a bit of calm within the anguish.

What has consoled me when I begin to panic and let fear drive my emotions is to remember that setbacks are not permanent conditions. Relapses don’t last into infinity. The perspective I have in the midst of my intense struggle insists that I will feel this way forever. However, my track record for getting better is 100 percent. So is yours. Even within the worst hours of my relapses are found moments where the pain in less intense, where I can catch my breath and get ready for the next round of contractions. If I analyze the discomfort, I will find that it isn’t solid, and that there are holes of stillness I can looks forward to, that I can attach myself to like buoys in the waves of distress.

Relapse teaches me over and over again that life isn’t linear and often can’t fit into a neat outline. As hard as we try to control all the aspects of our mental health, those of us who have suffered the beast of depression in a chronic way will most likely run into relapse more than once in our life. These setbacks, as painful as they are, teach us invaluable lessons, like how to accept messiness, frustration, and ambiguity with grace. They teach us, like Gilda Radner once wrote, that “some poems don’t rhyme, and some stories don’t have a clear beginning, middle, and end” … that “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.”

Join Project Beyond Blue, the new depression community.

Originally published on Sanity Break.

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Therese Borchard
I am a writer and chaplain trying to live a simple life in Annapolis, Maryland.

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13 Responses
  1. Jan Barnett

    Thank you once again for sharing this information… It really helps me to read it.Sleeplessness and restlessness drovrs me crazy…as well as other problems I don’t what to do about. I can say this though
    ..when I give it to God I am better and have hope. May God bless you for your wonderful work.

  2. Karen

    I can’t thank you enough for your message. You have a gift of describing the throes of depression so clearly to me. I am comforted by your message of not being alone in this struggle. I want to encourage you to keep it up, you are making a difference.

  3. Jeff Duggan

    Therese,
    We can all feel your pain and can relate to the relapse into the dark side. I too, have been struggling and reached out to my Doctor, Counselor, and inner strength to pull myself up. I’m not up yet but can feel myself lifting.
    You coined January “Yuck Month” and we can all relate. Get through Yuck Month, we all need and love your openness, honesty, leadership, and courage.

  4. I just began a relapse myself. The drabness of everyday and the lack of energy to simply ‘be’ is overwhelming. There are days when I don’t want to make the effort to feel better, I want to just allow myself to feel awful and wallow in the, blah, self-pity emptiness of it all. It’s simply too much work. I am always weary of another relapse. Again? I think. Then I feel guilty as a mother and wife and teacher that I’m not trying harder to feel better. You are right though, I have survived other relapses and in time I will survive this one too. Thank you for that reminder. It is the smallest glimmer of hope that can lift the spirit even if only for a moment.

  5. Once again you have spoken right to my heart. Thank you for sharing your personal struggles and encouragement.

    I just finished your book “Beyond Blue “. It was such a blessing to me
    I went through many of the same things and felt like I was a horrible mother and wife. I felt the same way you did when I thought that I should kill myself so my small children and husband could find a “normal” mom and wife. This filled me with shame and despair
    I also encountered the same well meaning advice givers esp. Religious
    people that doubted I could be a Christian and try to commit suicide. It was so hurtful and I was and am so low sometimes.
    I have really been helped by your articles, thank you for your courage.
    Teri Phillips

  6. Lisa

    You are helping me understand what my beloved 83 yr old mother is going through. It’s especially hard to understand because she was a strong woman and a psychotherapist. Thank God I found you.

  7. Cynthia

    Dear Therese I thank God that I found your blog. You cannot imagine how you have help me with your wise words. I am taking the supplements you are using and I think they help me lifted my depression. Thank you for sharing. God Bless you.

  8. Robin

    I stumbled across your blog today, and it resonates with me and my times of struggling with recurring anxiety and depression. I’m writing to say, if it hasn’t been mentioned before, that one of the most helpful guides in the area of depression is a book, Ending the Depression Cycle: A Step-by-Step Guide for Preventing Relapse, by Peter J. Bieling and Martin Antony. published by New Harbinger.

    This guide/workbook outlines the definitions, some causal factors, the nature of relapse in depression, medical/pharmaceutical information, treatment methodologies and their success rate(s), and has places to record your own history, medical information, to uncover what trigger symptoms you might have, what has worked for you in the past, your own particular journey, etc.

    Of particular note is the quote, “”Almost all patients who recover from an initial episode of depression will experience at least one more depressive episode in the future and the likelihood is even higher if some symptoms remain after the initial recovery.

    Furthermore, with each additional episode of depression, the chances of having more episodes increases. For example, individuals with a history of two or more past episodes of depression have a 70 to 80 percent likelihood of having another episode of depression in their lifetime.
    HELPING YOU TO PROTECT YOURSELF FROM RELAPSE IS THE GOAL OF THIS BOOK.”

    Personally, I found this book helpful for learning about combining therapies, cognitive plus medication, shock therapy, tmi, meditation and mindfulness and finding a way to combine a number of modalities on a prophylactic basis. Plus having a place to record information on medical protocols, etc. is very helpful so as to be able to be accurate with professionals about my history–dosages, treatments, etc. (especially so in crises when you aren’t thinking normally.)
    Also, there are chapters on analyzing one’s own core beliefs, values, etc., etc. learning to tolerate uncertainty, perfectionist thinking and self-critical tendencies, ways to examine dependent behaviors, triggering incidents. etc. And all this is covered in a practical down to earth way.

    In the worst of times, I was simultaneously taking two medications, listening to guided meditation tapes, attending a 6-week mindfulness course, going to yoga 4 times a week, and seeing not one but two therapists. And was crying and incoherent and experiencing a variety of symptoms.

    I don’t know about other people’s experience, but thanks to this book, in the past 8 years, I’ve been able to pinpoint when I was heading down into depression and pull myself out of that trajectory at least 3 times–circumventing the full blown depression situation. I now know that just getting past the pain and suicidal thoughts isn’t enough–that there are ways to head this darkness off at the pass and be aware and alert to my own idiosyncratic “early warning symptoms.” Like my flat feet, my vulnerability to depression is part of me . . . and something to recognize and address.

    And yes, the brain imaging studies in Cleveland hold out a lot of promise for people. Endlessly going over my childhood and adolescence has not been helpful.

    My best wishes for fellow sufferers to have hope . . . you are not alone and IT WILL GET BETTER!

  9. Judy

    Thank you. There is nothing like honesty and realness which you generously give. To feel less alone as someone else relays her journey is invaluable. I especially like “life is about knowing, having to change, taking the moment and making the best of it, without knowing what’s going to happen next. That helped me a great deal!

  10. Jack Conley

    I, too, stumbled across your blog some time ago, and I am most grateful. I am a Catholic priest, and I suppose I have struggled most of my life with depression. Therapy has been helpful, faith has certainly assisted me, and friendships are tremendous gifts. Your transparency and gentleness make for a wonderful part of the healing process. Thank you.

  11. Lee

    Hi Therese
    So glad to read your blog and readers’ sharing…. very timely to stumble and so apt as I feel a relapse is imminent.
    It’s been 8 weeks since my suicide attempt. It was almost a perfect plan. I guess the word ‘almost ‘ (1%) is the reason why I am here sharing. Luck, Divine Intervention, not-yet My time??!!
    Today, a rare and overwhelming, drowning feeling like a huge wave hit me. Honestly i mustered the courage to write you to remind me of this moment & that am not alone!
    …..till 2 months back, I have been a very strong-willed, determined person, a workaholic …till i got burnt out, same time a stepdaughter who recently moved back home (2 1/2 months ago) after a failed marriage with an unruly 7y.o, currently supporting our youngest daughter about to take senior high school exams critical entry to University and looking after a recovering husband from a (2yr) Post RenalTransplant.
    Last night i needed to get affirmation from my husband as am in the preparing to leave work and possibly the workforce, instead received an irritating response, for me to snap-out of whatever am brooding, stop fixating on work which drove me to my madness and move on to support my stepdaughter.
    Seeing a therapist and practicing day to day mindfulness. Focusing on the glass half full. Soldiering-on!
    Your words today yanked me out of that tempting Black Hole of loneliness & feeling of hopelessness.
    All the best to you and your readers!
    Lee