6 Things to Consider When You Have a Depression Relapse



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 are doing everything right to protect our limbic systems from intense sadness and anxiety.

I thought I would follow up, then, by listing some nuggets or 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 nine months old, loving to climb on everything but not yet walking, we visited some friends of ours who had a six-year-old daughter. He saw their stairs and immediately began to tackle them. Sitting on the fourth step, she 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 shear panic of knowing that someone is coming after my precious teapot. Of course, there is no tea set. Even if there was, I’m sure it’s quite ugly and no one would want it. However, our minds are quite adept at convincing us of realities that don’t exist. When you panic and know for sure that you are headed for the abyss, for a depressive episode that is 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 tooth 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 life saver 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, “either will I.” During these periods, I can’t talk to certain people because I know that their negativity will seep into my spirit and spiral me further down the rabbit hole and I stay offline completely. Until I am 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 am gradually learning to replace the lines and squares in my life with circles and spirals. I am not “going back” to a dreadful place of the past. The word “setback” is even wrong. I am reaching a spot I haven’t been before. Right now it is packed full of heartache and hurt, but it also a new beginning, teaching me things that 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 Are in the Basement

When I was in the midst of a depression 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 are feeling okay, we are 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 depressed, however, we exist in the basement. Everything we see, smell, feel, hear, taste is from the perspective of being in the lower level. So we shouldn’t take our thoughts and feelings so seriously when we are 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. However, 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 brainstormed about what our next course of action should be if my depression doesn’t lift in the next few weeks and decided that for me, investigating transcranial magnetic stimulation (TMS) is a good next step. After making the consultation, I felt a 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, pathetic. And yet, it is precisely during these times, 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.

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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4 Responses
  1. diana

    Thank you so much for your honesty Therese. I’m recovering from a depression episode and reading you makes me feel less guilty about this condition which is so poorly understood by those who do not suffer from it. One of my psychiatrists has given me hope that i can be cured, but I am 57 and really don’t have much hope. I think I should just learn to deal with my bouts better, as they really scare me.

  2. Ted Baxter

    I appreciate your thoughts, especially being.kind.to yourself. A beautiful and gentle resonance

  3. nessa3

    Its good to get your emails…this is the second one Ive gotten and they have come at the best time.
    Ive had a bunch of triggers this last two weeks …and feel the Black Vortex sucking me in.
    I seem to have very little resilience any more. And it even seems to much effort to try to snap out of it…