Depression is one of the most common co-occurring mental health issues among people with substance use disorders and managing depressive symptoms is one of the keys to a strong recovery. Unfortunately, if you have had an episode of major depression, you are likely to have recurring episodes.
Research shows that about half of people who have an episode of major depression will have at least one more episode at some point in their lives and if you have had two episodes, your risk of another episode rises to 80 percent.
However, there is also research suggesting that if you catch the symptoms of an encroaching relapse early, you can limit the severity of the episode and perhaps even prevent it. The following may be early warning signs of a depressive episode.
Keep in mind that although these are common depressive symptoms, you don’t want to wait for them to get severe before you act. While someone with no history of depression might dismiss some of them as a bad mood, you should definitely pay attention and take action.
Know Your Patterns
First, it helps to know your patterns. For example, many people with a history of depression are vulnerable to seasonal affective disorder, or SAD. Typically, the approach of winter is worse for precipitating depressive symptoms but some people experience summer SAD too.
Winter SAD is typically treated with light therapy, which entails sitting in front of a full-spectrum light for half an hour to an hour in the morning to help correct the disruption in your circadian rhythm. While seasonal patterns are common triggers for a depressive episode, you may also have patterns that are more specific to you.
For example, anniversaries are often tough for people who lost a loved one through a breakup, divorce, or death. Holidays can be difficult already, and they can be even more stressful if they are your first holiday without a loved one. Be aware of the anniversary effect as well as any kind of stress that you are particularly sensitive to.
Something Is “Off”
When an episode of depression is approaching, you probably won’t recognize it right away. It looks different from the crushing despair or fatigue you might have felt in the depths of a previous episode. At first, you’re more likely to just feel like something is off, perhaps in ways you can’t really describe. You feel like your thoughts and mood are out of synch with your actions and environment. This often shows up as irritability and restlessness.
Irritability is simultaneously one of the most common symptoms of depression and one of the least recognized symptoms. You may find you’re annoyed by little things, that people get on your nerves, that you lose your temper more easily lately, or that routine tasks are suddenly more frustrating. You may even notice that you’re behaving more aggressively, perhaps by driving more aggressively or getting into arguments or fights.
Restless is often a harbinger of anhedonia—the loss of the ability to feel pleasure. You do something you normally enjoy but it’s somehow unsatisfying and so you try something else and get the same result. You don’t feel a sense of reward for your normal activities and you don’t feel as driven or goal-oriented as usual. You just feel a bit adrift.
Difficulty concentrating is another very common symptom of depression that few people recognize and one that can compound the problem of restlessness. Concentration actually takes quite a bit of energy and if you feel fatigued or sleep-deprived, then it’s hard to focus.
Of course, everyone has occasional lapses in concentration, either from normal distractions or just feeling tired at the end of the day, but if you find yourself spacing off a lot, unable to follow what’s going on or unable to remember things that normally don’t give you trouble, it may be a warning sign.
Sleeping problems are perhaps a more definitive sign that you’re entering a depressive episode. Typically, people associate depression with sleeping too much but disturbed sleep, such as insomnia or waking up in the middle of the night and not being able to fall back asleep, is at least as common.
People often don’t realize that waking up feeling anxious at three or four o’clock every morning is a fairly typical sign of depression. It sometimes happens because a sleeping brain is less able to regulate emotions, so these kinds of sleep disturbances may mean there is a depressive episode coming.
Changes in Eating Habits
Typically, depression is accompanied by loss of appetite but sometimes increased appetite. Here is another situation in which it helps to know your patterns. If you find yourself skipping meals or eating despite not feeling hungry just because it’s time to eat, that may be a warning sign. On the other hand, if you find you’re constantly hungry and snacking on foods you know you would be better off avoiding, that may also be a red flag.
Fatigue is one of the better-known symptoms of depression but it’s also not that uncommon to feel tired sometimes. Often, the character of depressive fatigue feels different from ordinary tiredness. It often feels more like a physical heaviness or perhaps achiness or slowness. You might feel like you haven’t really done anything to justify feeling so exhausted. It may feel more akin to the exhaustion you feel when you have a cold.
Canceling Plans or Declining Invitations
Another commonly recognized symptom of depression is social isolation. You feel like you just don’t want to be around anyone. Or maybe you do but it just seems like too much effort. As a result, you find yourself canceling plans or declining invitations that you would normally accept.
Unfortunately, this tendency to isolate only hastens the approach of a depressive episode. If you notice that you’re starting to isolate, one of the best things you can do is to consciously push against it, even if you don’t feel like it. Accept invitations, reach out to friends, and drag yourself to whatever you’ve already agreed to. Most of the time, you’ll be glad you did.
What to Do
If you have already had an episode of major depression and gotten treatment, you probably know basically what you should be doing and you probably have a treatment plan. The first thing is to make sure you’re following that plan. Take your medication, get some exercise, watch what you eat, and, as noted above, stay connected to your support network.
If you’re not currently seeing a therapist, either find a therapist or make an appointment to resume sessions. In the short term, find ways to manage your mood. Take something off your plate, if possible. Take some time to relax. Listen to music that cheers you up or watch a funny movie. These smaller, tactical interventions can have a much bigger impact early on when you first notice symptoms rather than later when you’re in the grip of a full depressive episode.
At Hired Power, we know that completing a treatment program is just the first big step on a long journey. For recovery to succeed, you have to have a plan and the resources to follow it through, which includes having a plan to manage depression and any other mental health issues. We help with the transitional care and long-term management that treatment programs typically neglect. To learn more, call us today at (800) 910-9299.