Recovery from depression is rarely, if ever, a straightforward progression. Rather than a steady path toward symptom relief, a more realistic scenario involves steps forward, and steps back.
Lapses and relapsesWhen clinicians refer to a lapse they are really describing something quite normal. A** lapse** simply refers to a brief return to feeling down. It’s a temporary situation, and it’s extremely common.
Relapses are somewhat different. A lapse may develop into a relapse if symptoms are allowed to take control. When a person relapses, all the negative thinking and avoidance they experienced during the darkest times begin to reassert themselves. The key to preventing an early relapse developing into something deeper is to understand the warning signs.
There are many signs and symptoms associated with depression, but for the sake of simplicity let's consider just two as they relate to relapses. The first is that your lowered mood hangs around for more days than your improved moods. The second is that you, or perhaps your partner or a loved one, notices that those old ways of thinking are starting to dominate. You may also notice you’re becoming a little more irritable or more distant.
One of the dangers with the signs of a lapse or relapse is that they can become the start of a vicious cycle of depression. Many people feel so depleted after a period of depression that the mere thought that their symptoms are returning can be hugely frustrating and disappointing. It is, however, possible to turn things around. Even if you don’t succeed fully, you may find your relapse is less severe and lasts for a much shorter time if you take action.
How to respond
Start by considering the obvious. A very common cause of relapse is coming off of antidepressant medication too early or too quickly. The fact that you have been feeling better isn’t a good reason to stop taking your medication. No matter what your views are about antidepressants, the fact remains that coming off them too quickly can cause a sharp rebound effect. Consult your doctor, who may recommend a phased reduction in dose over a prescribed period of time.
In a previous post I recommended something called the outside-in method. In the post I explain that the method replaces the way we feel inside and prioritizes some kind of outside plan. Target activities planned in advance take priority over how you feel about doing them.
Try to stick with those routine tasks that make up a day. Take a little exercise, eat a balanced diet, get into a regular sleep pattern and avoid stress.
These simple tips may be the very things that tip the balance in your favor. Don’t isolate yourself or try to shoulder your recovery without the support of others. With a planned strategy there is every chance you will nip your lapse or relapse in the bud and get back on the road to recovery.
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Dr. Jerry Kennard is a Chartered Psychologist and Associate Fellow of the British Psychological Society. Jerry's clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.