Staying Well after Your First Depression
The first episode of depression can come as a big blow. Everything you thought, or hoped you were as person, unraveled. Over time, things gradually eased and whilst you may never be the same person again, you’re feeling better. Now come the questions that embed the big fears – will it happen again, will it be worse next time and when might it happen?
It’s true that for some people their chances of depression are much higher if this runs in the family, however for the majority of people this isn’t the case. So what happens to you in the future could very well depend on the course of action you choose from this point. Consider these statistics. The American Psychiatric Association (2000) point out that if you’ve just experience a major depressive disorder you have a 50% chance experiencing a further episode at some point in your lifetime. Actually, once a first episode has occurred recurrent episodes will typically start within five years. If you do experience a second episode of depression the likelihood of further episodes increases to 80%. In a worst-case scenario you may have as many as nine separate episodes in your lifetime.
Let’s revisit those statistics. A 50% chance of experiencing a further episode of depression is a bit like saying things are in the balance. Let’s rephrase this. If everything in your life that may have contributed to your depression stays the same, the chances are you’ll become depressed again, only this time your reserves are depleted.
If you’ve had depression and you feel better now it’s perhaps because of the effects of time, support, medical treatment self-help and/or therapy. You mustn’t squander this opportunity. Okay, this is the point where you may be thinking it’s easy for me to sit back and say that. You may want to say, ‘you think my work will change? You think I can just drop my responsibilities? You think the bills will go away, the demands on my time will decrease and the payments on my car will stop because I need to change? Get real!’
But who actually needs to get real? Where did your depression come from in the first place? I can tell you it wasn’t that especially stressful week, or those nights you spent putting reports together or planning for the following day, it was the whole package over a period of time. You’ve been exceeding your capacity, giving too much and doing too much. In point of fact your very strengths of diligence, reliability, responsibility, conscience and seeing to the needs of others, are your kryptonite. But you are not superhuman and if you step back into the same situation and behave the same way that 50/50 chance of avoiding further depressive episodes will simply slip through your fingers.
You could dismiss my assessment as doom and gloom, in which case I genuinely wish you all the very best. Alternatively you might want to lessen your resistance a little in order to let the message sink in. That message is simple - you must power down - consistently. But take heart, you don’t need to pack your bags and move into the woods. You really can continue with what you’re doing but things have to change. For example, you must delegate where you can, you must leave work at work and you must learn to say no, pace yourself better and try to leave gaps in your working day. Take your breaks, go home when you’re supposed to and take your vacations. If after trying these things you begin to feel unsettled and guilty then it’s a sign that you’re doing exactly what’s needed in order to protect your mental health. I know it’s a big pill to swallow but it’s who you are that got you to the point of being depressed. It will be effortful to apply new insights to yourself but if you don’t your chances of a relapse will increase by the day.