Depression is one of the most common co-occurring mental health issues with substance use disorders. Studies show, for example, that between 20 and 67 percent of people seeking help for an alcohol use disorder also had major depression, and more than 30 percent of people seeking help for cocaine use have had at least one episode of major depression.
Given that only about seven percent of Americans suffer a depressive episode each year, those numbers are incredibly high. Depression is also very likely to recur. About half of people who recover from a depressive episode will experience another episode at some point and about 80 percent of people who recover from two episodes will experience another episode.
In a previous post, we looked at some of the early warning signs that another depressive episode is coming. These include feeling “off,” irritability, restlessness, poor concentration, isolation, sleep disturbances, changes in appetite, and fatigue. In this post, we’ll look at some ways to prevent a relapse or at least minimize its severity when you notice some of these early warning signs.
If you’ve already recovered from an episode of depression, there’s a good chance you had help from a therapist. You probably also discussed some long-term strategies for staying well. However, as time goes on and you start feeling better, you may have started skipping some of that. Maybe you put off renewing your prescription and it seemed fine so you just stop taking your medication.
Maybe you’ve gotten lax with exercise and healthy eating. Maybe you’ve forgotten some of your lessons from therapy and you’ve slipped back into unhealthy thinking patterns. Have a look at what you’re actually doing every day and see if resuming some healthy behaviors makes you feel better.
As noted above, you may have started cutting some corners on things like diet and exercise. Both of these are crucial for managing your mood. Sitting around too much or letting inflammatory foods such as sugar, processed foods, and vegetable oils sneak back into your diet can make you feel flat and irritable and you may not even realize it.
Getting enough sleep is also crucial. Those are the basics. However, it’s also important to make sure you’re taking time to relax and have fun. Instead of trying to push through a bad mood, sometimes it’s better to take a break, rest, take a walk, and let yourself decompress.
If you have stopped seeing your therapist regularly, now is a good time to resume. If you never had a therapist to begin with, now is a good time to find one. Finding a good therapist can be a bit of a process, so if you feel depression coming at you fast, you might consider contacting a crisis hotline. The National Suicide Prevention Lifeline is the best known, at 800-273-8255. You don’t have to be actually suicidal to use it.
They can help with any kind of emotional distress. They also have an online chat service. If you are already seeing a therapist, be sure to share your concerns. You don’t have to know exactly what’s wrong. You can just say you feel off somehow and you’re afraid you might be heading for another depressive episode.
One of the early signs that you might be approaching a relapse of depression is that you want to isolate yourself. You may find yourself declining invitations, canceling plans, or just not showing up. Unfortunately, this is the exact opposite of what you should do, since isolation only makes depression worse. Although you may not feel like it, it’s important to keep your social commitments, accept invitations, and reach out to people who care about you.
Even if you’re not up for a party or a night on the town, try to make plans with friends and family on a regular basis. It’s one of the best ways to reduce stress and improve your mood and having to pay attention to other people helps get you out of your own head.
When you’re in the pit of a full depressive episode, the notion that you could do something to cheer yourself up seems absurd but, if you’re just starting to feel the approach of an episode, finding ways to lift your mood can be powerful. This will be different for everyone.
Watching a funny movie or TV show or listening to music are powerful ways to change your mood quickly. Or maybe you prefer socializing, going for a drive, or having a nice dinner. It doesn’t matter, as long as it interrupts your bad mood before it becomes a full downward spiral.
The second arrow is feeling bad about feeling bad. The allegory is that if you’re hit with an arrow, you suffer the pain from the arrow, but then if you become angry or distressed about it, then you have the pain from the arrow plus the added distress.
Depression can work in a similar way. We all have ups and downs. You might find yourself in a rotten mood and start thinking, “Oh no, I’m in a bad mood, this is terrible, it’s probably going to turn into another episode of depression and I can’t deal with that right now,” and so on. However, most of the time, a bad mood is just a bad mood.
Let it come and let it go. It’s ok to feel bad sometimes. Research shows that the more accepting you are of challenging emotions, the less likely they are to turn into depression. Managing depression is an important part of recovering from addiction.
You don’t want to get to the point where you’re wondering “Why bother?” or feeling like you would do anything to escape the misery of depression. Taking action early is key. Take care of yourself, talk to your therapist, and try to stay socially connected. If you do have a relapse of depression anyway, remember that you made it through the first one and you can make it through this one.
At Hired Power, we know that everyone recovering from a substance use disorder faces different challenges and needs different kinds of support. We offer a variety of services to help our clients and their families maintain addiction recovery in the long term, including helping to coordinate mental health care. To learn more, call us today at (714) 559-3919.
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