One of my earliest memories as a young professional working in the field of mental health was the morning I arrived at work to discover a patient had taken her own life a few hours earlier. I didn't really know her but I determined that she had been admitted with a deep depression from which she was just beginning to recover. The staff who knew her better were clearly shaken and upset. The previous day she had been laughing with them, talking about the future, and she seemed optimistic and hopeful. What had gone wrong?
In the case of a major depressive episode the common view is that suicidal thoughts, if they arise, increase the risk of suicide as the person becomes more depressed. Well this is true and it's a dangerous time. What is also true, but perhaps less well known, is that the early stages of recovery can be just as dangerous. During the black hole of depression everything shuts down. There is often no motivation to move let alone contemplate suicide. As things begin to change the person may start to look at what they have experienced and this, perhaps alongside their perception of the future, provides sufficient impetus to end their life.
The process of recovery from depression varies from person to person. Sometimes it happens relatively quickly and sometimes not. What I've just outlined actually points to a failure in recovery. In most cases, thankfully, recovery is more gradual but ultimately leads to great improvements or complete recovery.
Recovery isn't a process that can be rushed and it also involves different processes. For example, you may find that your mood gradually improves before your sleep pattern sorts itself out. One day your mood may feel perfectly fine and the next you're back in a slump. The contrast between the two may seem that things are slipping back but actually it's more likely to be a result of mood fluctuations. Your energy levels might improve before your mood and you may mistake this for recovery, but it's still only part of the whole package.
One of the great difficulties for people in recovery is the fact that they've already had a belly-full of depression. The fluctuations in mood, the almost daily contrasts between misery and hope, are interpreted as things going wrong. For some people the length of time it takes then to recover seems longer than the time they were depressed, but that's just the way it is.
In my next post I'll be considering how best to cope during the recovery process and how you should pace yourself.