Depression Relapse

ImageRecovering from depression can be a long and tiresome journey.  If symptoms have been severe, the risk of it recurring is high.  The fear and anticipation of relapse is something we might learn to live with but, when it hits, it can feel more disappointing and devastating than the original episode.

The risk of recurrent depression is extraordinary high.  Figures I came across suggest that one episode can carry a 50% risk of relapse.  Two episodes jumps to a 70% risk and three becomes a staggering 90% risk of recurrence.

We all know that one of the worst things to do is isolate ourselves.  It is never conducive toImage ruminate.  This is incredibly difficult if you strive for that isolation.  My own preference for isolation has culminated in debilitating Agoraphobia.

Having a prevention plan is important, which should include a treatment of meds, therapy and on-going support.  I count my blessings for having a good Psychiatrist and Care Coordinator.  I’m also due to start a 6 weeks Mindfulness course in 2 weeks’ time and my two year Mentalization Based Therapy is due to start in the autumn.   After 8-10 years of complete isolation, this is an enormous change.  However, the prospect of such big changes does feel terrifying.

I am on mood stabilisers (400mg Quetiapine).  They have been the best medication for assisting me out the deepest recesses of depression and maintaining my mood on a reasonable level (until now) However, I reduced my antidepressants several months ago to the lowest dose, ever.  Maybe not such a good idea.

Somehow, reducing meds, feels like being more in control.  For me, they can represent aImage ball and chain.  There is a great deal of resentments for any dependence on something to keep me sane. 

Then we come to the possible triggers of a relapse – “Be aware of our triggers”.  These can vary for each individual, but it is imperative to recognise exactly what situations acts as a trigger to our depression.  We might not be able to avoid every situation, but we could learn to limit the devastating effect they can have on our mental wellbeing.

Personally, I don’t mind triggers.  Coming across a post with a “trigger warning” would never stop me from reading.  I find blogging an incredibly triggering experience, but I would not consider it as being a negative influence.  Often, another person’s experiences can trigger, but they will also enlighten and contribute to our ultimate healing.

Lately, I have been delving into areas of childhood that have been too traumatising to explore in the past.  This is probably the most triggering of them all, but I feel it is necessary if I am to heal.  Those childhood experiences were humiliating, degrading and demoralising.  Unfortunately, the memories carry the same painful emotions today.  They hammer defences and make me more vulnerable to depression. 

Sometimes, as hard as we try, we will be unable to avoid a relapse of depression (or any other MH disorder).  The early signs and symptoms are full of frustration, even dismay.  If we are lucky, the episode is mild and we manage to work through it.  At other times, it becomes major and debilitating.  Our perception of life suddenly changes and nothing seems to go right.  Whatever the ultimate level of our depression, the impending dread and fear can feel overwhelming.

ImageI’ve searched the web for some encouraging words to end this post.  The fact is, there are many but none of them brings me any comfort as I grapple with my own fear of relapse.  In the past, I would have given up and allowed it to engulf my senses.  Today, I might not be able to focus on a future, but my direction is pointing forwards.

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33 thoughts on “Depression Relapse

  1. Susan Irene Fox

    Cat, as someone who also walks with depression, I can affirm your courage. I can also tell you that the fear doesn’t go away, but your response to it can change. You can run away from it and hide. You can shout at it and tell it to bugger off. You can even put your arm around its shoulder and tell it to come right along if it dares because you have something Stronger, Wiser and More Loving carrying you along. Keep moving forward, love, even if it’s one step at a time.

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  2. Bourbon

    Is it weird that I have never really known whether I am in a depressive episode or not. To me it just feels like a life sentence; it is always there like the phobias are. Though of course some days it is worse than others. I’m astounded that you are on 400mg quetiapine. It always highlights to me just how sensitive I am to medication when I see the doses other people take. I take a quarter of a 25mg tablet at night if needed to knock me out. And it does knock me out. I think 400 would make my heart stop :/ I wish you the best in the new therapies you are trying. I’ll be reading along beside you 🙂

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    1. Cat Post author

      Hi Bourbon, I always feel that I live with various degrees of depression. Even on my good days, it hovers around like a shadow. But, then there are times like now when it feels like an entity that haunts every waking hour.

      I had a giggle at your quarter of Quetiapine. Tolerance builds very quickly. When I first went on it, I took 25mg and I was high as a kite. 400mg was the recommended dose, so I increased over a month. At first, it was amazing. It was the first time I became aware of just how deeply depressed I had been. If I take just 25mg over my usual daily dose, I can feel very stoned.

      Having lovely bloggers behind me makes a huge difference to my journey. Thank you, Bourbon.

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  3. Red

    I was thinking today about my own battle with depression that never seems to end and was wondering what would happen if I just sat down and never moved again? Then I thought of those in the blogging community, like you, who’s stores and courage keeps me motivated to keep moving and trying. You make a difference by sharing your determination and strength,not to mention your wisdom.
    Always forward Cat, one small step at a time. 😉 Best of luck with the therapies, I’ll be here cheering for you.

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    1. Cat Post author

      I sat down and allowed the depression to consume me for years. I still find it difficult to grasp just how many years I was in that position. The only thing that moved me forward was the internet community – first Forums and now blogging. I take my courage from all you bloggers and I can hear you cheering me on, Red, thank you.

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  4. releasing lunacy

    Hi Cat, sorry I’ve not been keeping up w/ blogs lately. I’m sorry relapse seems to be looming out on the horizon. But you’re right about your future direction pointing forwards! You have a lot of really great things lined up. I’m happy for you! Recognizing that you’re not feeling well and purposefully trying not to let it take over is a big deal!! *sending big gigantic hugs* Take care, rl

    P.S. Pepper has been doing really well the past two days!! I’m still cooking for her. Her appetite is insatiable now though!! I know it’s enough because she’s putting on a little of the weight she lost. She just keeps wanting to eat! I never thought anyone would like my cooking!! LOL

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    1. Cat Post author

      Thank you, RL. I also think it is a big deal to recognise and try to push past the depression looming; it is not how I usually deal with it.

      Great news about Pepper. The reason why she is eating more might be that she is not getting enough protein. You can get that from adding more eggs. It’s all a very tough time for you *sending a big hug back*. I’m just trying to get on your blog today…?

      PS. I am thinking of starting a twitter. Is it something that bloggers share in?

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    1. Cat Post author

      I also hate the word relapse and I’m not even sure if recurring depression is necessarily a “relapse”. I initially had a Bipolar diagnosis and now they have changed their mind to “recurring depression disorder”. So, technically it is not relapse but the nature of my illness.

      I hope you’re doing okay today. Many thanks for your support, Cate.

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  5. stacey1979

    I’m here for you too, Cat. It’s a right pain when the old “recurrent depressive disorder” rears its ugly head, but you CAN and WILL get through this latest episode. Remember where I was in June/July? I’m still not back to writing properly but I figure it will come back when I’m ready for it. I can tell that the medication has helped so I will continue to take it until I feel able to stop. I used to hate having to take medicine to feel better – I was “weak” if I needed it. I was thrilled to come off it after 6 years, but in 4 months I was on the slippery downwards slope again. I’d still like to try coming off it at some point in the future but if I can’t then I’ll have to live with it.
    I only took Quetiapine once and was completely stoned. My BPD hated it!
    Hugs, Stacey x

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    1. Cat Post author

      Hi Stacey… it is never an easy PHASE to go through. I use the word ‘phase’ flippantly because I’m coming to understand that I need to learn to live with the blips and have faith to know they will pass. They don’t happen that often but utterly scare the *bleep* out of me, when they do. Fortunately, the head is now well above water. Just trying to analyse what was triggering it in the first place. Usually that revelation doesn’t come until the fog has lifted….

      Many thanks for your words of encouragement.

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  6. Gel

    Just getting to know you a bit recently. In reading this post it seems that you are making huge progress…what with having depression for so long and the isolation…and now you are blogging and going to take a mindfulness class and more therapy and delving into past traumas etc…that sounds like big progress to me.
    I’m learning that as I keep working on my recovery and yet I still have a lot of difficulty it can seem like I’m not making progress because I was judging progress by how I feel not what I am doing. Once I recognized this it made a difference in my level of acceptance. I don’t expect to be totally free of depression and other problems…but if I can function (even with limits) and do do things and relate with people in a real way then that is pretty awesome to me now.

    I agree with what you wrote about trigger warnings. I read anyway. My triggers are unpredictable and I don’t usually blame anything outside myself if/when I get triggered.

    Thanks for writing even when you are struggling…in a way that’s even more helpful to me…it’s real and it helps me see how OK it is to share myself when I’m having a hard time.

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    1. Cat Post author

      When we live with depression, success can never be measured by what mood we are in. I’m just coming to realise that I need to work on accepting it as a recurring depression. Success is measured on various levels. At one time it was just by staying out of bed, today those expectations are a little higher. Sometimes, we need to get our head down and plough through it, but it takes a long time to reach that stage. Blogging is like stepping stones towards healing, triggers and all.

      Thank you for your very kind and encouraging comment.

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  7. dharmagoddess

    I am proud of you for being positive in the face of something so challenging and seemingly negative. I especially appreciated that you explained how you feel about triggers as it seems to reflect my own thoughts on such things. I’ve been in and out of depression – or at various levels of depression – for most of my life I’m guessing. Most of the time it’s transparent to me except for when taking a shower and extreme isolation tendencies keep me down. It is so hard to shake for any length of time and sometimes it is just better to keep such things to oneself, sharing only with their health care professionals and those closest on a “need to know” basis.

    I have never had good results with pharma for my depression and generally choose to manage it through diet, exercise, therapy, and lifestyle changes. I have no idea whether this is easier or better or harder and worse. Like you, I choose to have a little control over how my depression is treated, even if it is harder and worse before it gets easier and better.

    Hang in there kiddo. You are inspiring, truly.

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    1. Cat Post author

      Various levels of depression sounds familiar, Dharma

      The trouble with meds is that there can be so many side effects, sometimes we wonder if it is all worth it. If we can manage with other things like food and especially exercise, it is better in the end.

      Inspiring? *blushes* Thank you, Dharma, appreciated

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      1. dharmagoddess

        Your points about meds articulate my inherent concerns. Sometimes it’s hard to say whether the meds are worse than the actual root cause of the problem. ugh.

        It is my pleasure to make you blush! 😀

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  8. RisingSong

    It’s beautiful to see how far you’ve come, Cat. It’s beautiful to see how positive you are thinking. Going from years of isolation to blogging to trying out new therapies is impressive! Good for you that you are able to recognize and name this progress in yourself.

    I agree with what you said about gauging your progress based on what you are able to do and not necessarily how you feel. I often remind myself that bad days will come, “stuff” will happen, challenges will be presented, but it’s how I handle these “punches” that lets me know how far I’ve come. There was a time when the things that bring me to hide in my room or my car crying and shaking used to send me to bed for days. At least I can cry now, and know why I’m crying, and then get up and go live life.

    My own fear of relapse is with self-harm. In the past, I have been able to feel it coming on like a prodrome. I have dreaded and resented this “intruder” and tried by all means to look away and push it aside. I am immensely proud of myself for having gotten through the past few days without resorting to this…progress. As you said in my favorite line on this post…

    …”my direction is pointing forward”.

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    1. Cat Post author

      RS… Thank you for your kind words of encouragement. We are usually the last to see our progress, so it is positive to receive feedback like this. Sometimes it takes time for us to realise the progress we are making. I’ve never had an issue with self-harm but I used to have massive issues with self-destruction, which I liken to SH. I know you’ve been going through a rough time lately. Remember my email address if you ever need to pour it all out!

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  9. shoe1000

    Cat
    It is good to see you.
    I care not what it “is,”
    that is in front of us.
    I just care that you are there.

    We wander in and out of “it,”
    Wondering if “it’s” there or not
    feeling lost, shallow, shaken
    We ask at times, what is my name?

    But when I see you sitting there
    Bent over, holding on,
    I know that Ggod is here
    and we will get some rest

    When we do is not for us
    to know or guess
    it is ours to keep moving
    to not make it a bigger mess

    No it is not our mess
    We just get to “be” in it
    and pray that when the day is done
    That we realize we are blessed.

    Because without hope
    Without bonding or breath
    We just walk around like zombies
    waiting for the peace of death.

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  10. mindretrofit8

    I thank you for all that you share here on your blog!

    I struggle with wanting isolation and that does not help my depression in the least. I go back and forth though, I want to be social and I want to alone at the same time. I find that my social anxiety intensifies if I am too social activity, but I get down if I am not social enough. If I have too much social interaction then, I can spiral into depression too. (But I think that is derived from my social confusion – I get seriously confused with many social interactions.)

    There are some days when I can read things and the triggers are a good thing and then, other days when I find they can spiral me into to many PTSD, anxiety, and depressive thoughts. I have to limit myself like you shared about in the post. However, I have found that reading what others share has helped me tremendously with my healing journey so I just gauge when I can and went I can’t.

    Honestly, though there are days when I hate my triggers, they take over my brain and body.

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    1. Cat Post author

      My isolation was severe, it’s still quite bad. I often used to feel lonelier in social situations.

      I can understand about your triggers. There are days when it is more difficult. I think it is always best to follow your ‘inner-guidance’.

      I thank you for reading and commenting on my blog. The support I feel here is immense.

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  11. Athena Brady

    Hi Cat, a very thought provoking post that explores a lot of issues that people with mental health problems suffer with. A common theme is the shame people feel because they need medication to get through the day. At my worst, I was suffering extreme distress and a friend of mine talked me into getting some antidepressants, as I was unable to structure my thoughts. This for me felt like the beginning of the end, like I had failed and the memories and all that was attached to them had got me, beaten me. I went on a low dose of Citralopram 20 mg and almost at once after about a week, felt an improvement.
    I told myself once I felt alright, I would come off them. Now I no longer worry even if I need to be on them for the rest of my life, they enhance it. I can still hurt and feel I am not a zombie, my thoughts are coherent and I can keep it together. However, if I ever do feel I can manage without them, I will come off them under supervision. I know if I dont that I could end up even worse than I was before.
    I always wanted to be a writer and now I am, in every sense of the word. I have published one book which is quite a spiritual book and am editing 2 as you know. Whilst writing number 3 which is vastly different from the other 2. Right in the middle of the pain was all this good, a silver lining. a reason to go on and connect with others on their own journeys and make a difference. I have no doubt you will get there too, my friend and I will be with you cheering you on.

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    1. Cat Post author

      Hi Athena… I was on 30mg of Citalopram for 6 years. I think the maximum dose is 30/40mg. I came off them to go onto Quetiapine, which is an anti-psychotic that they use as a mood stabiliser. A few months later, a Psychiatrist put me on 30mg Mirtazapine. I didn’t realise they were making me aggressive, which is the opposite of who I am. I’m now only on 15mg Mirtazapine and feel more like myself again.

      I don’t know whether to go back to the Psychiatrist and get the Mirtazapine changed to something else. Part of me feels that my depression probably needs a higher dose of antidepressant. It’s difficult to know what to do for the best, so I am doing nothing for the time being!

      I’m looking forward to reading the 4th chapter and will definitely buy the book once it is published. You write from the heart and that will shine from the pages…good luck. Being a writer is something I have wanted to be for many years. There was a time (not that long ago) when I couldn’t even write a sentence. I left school barely able to read or write. Freelance writing for magazines is a dream that I am not sure if I can pull it off. I’m currently looking around for some courses that will introduce me to the basics (ie how to approach Editors, etc)

      Pew, this is like another post! Thank you, Athena, for taking the time to write

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  12. Pingback: Relapse Happens | Leslie's Illusions

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