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It’s a wonderful feeling when depression finally lifts and life seems to be getting back to normal. For some though, this is just the calm before the next storm. About half of those with clinical depression will relapse within three years. This longer cycle of depression, feeling better, and then a repeat episode compounds the frustration. Patients are never quite sure if they are done or only waiting for the next bout to arrive.
Most therapies are designed to address the acute phase of the depression cycle. This is because patients are the most symptomatic here and in most need of help. But to avoid the cycle of clinical depression, the in-between phases need to be looked at.
Chronic depression shouldn’t be treated as simply a disconnected series of acute events. Everyday strategies are needed to help prevent a full-blown depressive episode from reoccurring. These include thinking realistically, physical wellness and learning to have fun and take pleasure in your own life.
When a specific trigger can be identified, care can be focused on that element. For example, some cyclical depression is linked to seasonal changes in sunlight, temperature or allergies. Identifying these gives a line of attack and a useful avenue for depression treatment and prevention. Breaking the cycle then becomes a matter of altering the environmental cues that trigger an episode.
What if the cause beyond personal control? Relationship issues, the economy (job loss or inability to find a job) and especially health issues may present reoccurring triggers for depression. Even though they cannot be avoided, you still gain an advantage if you can identify them. Any particular life situation can be helped with coping strategies.
In the same way you might prepare for a trip, you can gather the tools needed to prepare for a coming crisis. In many cases, one of the best coping tools is to find some action, even a relatively minor one, which gives a sense of control. Real, relevant and consequential decisions in one area can help you cope with those parts of your life that you cannot control.
• Job loss or financial upheaval
• Loss of a relationship through death or divorce
• Post traumatic stress from violence or injury
• Stresses at work
• Not exercising or getting good nutrition
• Not participating in social activities or loss of opportunity
• Losing interest or dropping a pleasant hobby
• Involvement with drugs, alcohol or addictive behaviors
• Relationship troubles – loved ones, work relationships, online relationships
• Situations or substances that interfere with a normal sleep cycle
• Even such seemingly minor things like watching the news or taking in troubling information to excess could trigger a larger depression.
Professional therapy is sometimes the best way to uncover things about your life that have escaped your notice. Many therapists will have you keep a kind of diary about how you are feeling and what is currently occupying your mind. A log like this can help them see a pattern you may have missed.
Medication may also be appropriate to prevent a reoccurrence of a major depressive episode. Typically, patients start easing off their medication when they have felt normal for some period of time, but this should only be done under medical supervision and with the advice of the prescriber.
It is possible that withdrawing the medication can trigger a new round of depression.
The important point is that therapy, while usually seen as a treatment for an active depressive episode, is worthwhile to prevent relapse.
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