How to Recover from a Depression Relapse

I dreaded writing about this for a long time.

Even after I overcame depression and maintained a stable, happy state of mind for a few years, there was a lingering fear of reverting back to my depressed state. I sometimes wondered what would happen if the perfect storm of events caused me to become depressed again.

My last post in 2019 was to tell my triumphant story of weening off of antidepressants. A couple months after, I faced a current of change. In December 2019, I broke my finger playing dodgeball. Probably not a big deal for some, but I had never broken a bone before and I was terrified. It was an unstable fracture, so I needed surgery to set the broken bone with metal pins. Not only had I never broken a bone, but I had never gone under for surgery (and my experience with getting four wisdom teeth pulled hadn’t exactly been a pleasant one for reference).

Suddenly, I found myself experiencing the things that terrified me most in rapid succession – pain, procedures, and needles. With my left forearm immobile, I couldn’t do many of things that made me happy on a daily basis. As anyone in a cast has known, even the most mundane tasks were frustrating.

This was followed by what, on the surface, should have been an exciting opportunity. My employer at that time asked me to move to San Francisco to work out of the West Coast office. I was eager for a change after living in one place my whole life, and I made the decision to move to California. By January 2020, I was moving across the country. I was healing from my injury in a completely new city, in a new office, surrounded by new people. It was a heap of change all at once, and I was struggling.

It was a compounding of factors – not being able to function physically, feeling the need to prove myself to my new coworkers, and trying to grasp a new way of life in my apartment, alone, many miles from my support network of family and friends. While this was happening, there was another source of uncertainty and anxiety all around me – COVID. When I first moved to San Francisco, there was fear stirring; less than two months into my move, the city went into lockdown.

I guess I wasn’t sure how to cope with all of the change in my life, so maybe I turned to something I knew. I threw myself into my job to an unhealthy degree, spending virtually all my time working. I felt lonely and stressed out constantly. I found some of my old depressive thoughts creeping back into my day-to-day.

“What’s the point of living if I feel like this?”

I had fallen into a downward spiral. Neuroscientist Alex Korb Discusses this phenomenon and its opposite, the “Upward Spiral,” in his book by the same title. It begs the metaphor that depression and happiness are a progression – a chain reaction of neural activity that sucks us in like quicksand.

The causes of my relapse had been manyfold and to get myself back to a stable mindset, I had to address each of those causes individually.

Months into this scary downturn, I managed to pull myself away from a full-on relapse before it got out of control, using principles of behavioral science and neuroscience.

Capitalize on Habits during Times of Change

Change is a really important catalyst for habits. During my move, I hadn’t paid attention to the fact that positive habits have more potential to stick during life changes or “fresh starts”1. What I should have done when I first moved to California was to solidify good habits and try to abandon the bad habits because they would be more likely to stick during life changes. Overworking was a negative habit that I allowed to take over my waking hours. In the next section, I’ll discuss that particular habit in more detail.

Other habits that I had to reign in were related my physical fitness. Throughout 2020, I went from eating too little (while I was over-working) to eating too much (as many people did once the lockdowns started). I lost 15 pounds and then gained 15 pounds over a year. For a 5’ 4’’ woman, that meant a huge change in my body.

I noticed the change only once it got bad enough that I hated the way I looked and felt. Just like I had reached a tipping point with my depression years ago, I reached that point when I was really upset for letting myself get out of shape and knew that I had to make a change or I would just keep being miserable about it. I often laud the benefits of gamification and one way I was able to build a habit of exercising again was by using Ring Fit Adventure, a video game for the Nintendo Switch which made me look forward to working out. Once I got back into the groove of exercising and healthy eating, (something I’ve made a habit in the past) I started lifting weights again as well. Today, I’ve lost almost 10 pounds and I feel much better physically and emotionally.

I also brought back some old habits that I had abandoned when I first moved that made me really happy, like doing jigsaw puzzles and reading books. Don’t forget that there are things that made you happy at some point. Make it a priority to bring those activities back into your life.

Recalibrate a healthy work-life balance

Part of what stopped the momentum of the downward spiral was moderating my work. It didn’t mean being a lazy worker, but making the choice to take breaks and manage my working hours. Those nights I would call my mom and I remember telling her that I felt like I did nothing but work. Humans did not evolve to work until they break, and it takes a noticeable toll on the mind and body.

Research studies suggest that humans in hunter-gatherer societies (on which our evolutionary framework is based) work somewhere between 20 and 40 hours a week, on average2. Importantly, the nature of that “work” is different. Humans in these societies work more based off of survival needs as opposed to a “9 to 5” schedule. There is plenty of time for the hunter-gatherer to play and enjoy activities. It’s not just the sheer amount of work, but also the type of work.

Consider that many modern workers have to work, at a minimum, 40 hours per week to earn a living wage. That doesn’t include the potential for a commute, appointments, errands like grocery shopping, childcare, and separate time for exercise (as opposed to the hunter gatherer society in which movement is linked to daily routines). That leaves little time for leisure.

For me, personally, it is very depressing to look at my life and think that all that I do is “work”. I made changes accordingly when I realized I couldn’t survive the workaholic lifestyle. I stopped working late at night and gave myself off-time before bed. I prioritized the most important tasks and saved the rest for another day. I communicated my time constraints with my manager and coworkers so that there were no surprises if things couldn’t always get done immediately. To my surprise, the world didn’t end when I put up boundaries between work and personal time. If anything, I was making fewer mistakes because I was taking more breaks, getting better quality sleep, and feeling less stressed. I was still a highly reviewed and regarded employee without working all the time.

It makes sense that happier and healthier people generally make better employees. We always hear the scientific facts regarding the positive effects of breaks on work productivity and engagement3,4. These days, there’s chatter about studies that show the benefits of the four-day workweek without a hit to productivity5.

If you don’t have the ability to set healthy boundaries at your job, there’s always the option to leave a company, too, if you have the means.

I look at it this way: I am the only person who is directly responsible for my own physical and mental wellbeing, so I have to prioritize it.

Regulating my work-life balance made me happier, healthier, and more well-rounded (which in turn, actually made me a better worker).

Be Thoughtful About your ‘Sense of Self’

Besides that fact that overworking is simply not good for us, it also impacted my self esteem in a counterproductive way. When I was working constantly, I found myself tying my feelings of self-worth to my job performance. If all you do is work, the job becomes who you are. That means that a mistake at work was more devastating because I didn’t have a healthy, well-rounded sense of self at that time. I didn’t have balance in my life.

To reverse my downward spiral, I had to reassess my identity. Let’s start with the language I used during self-talk.

Consider the way words affect our perception of reality. There are two verbs for to be in the Spanish language: ser and estar. Ser has a sense of permanence or quality of being while Estar has a temporary connotation.

Consider these two sentences in Spanish:

Yo estoy feliz

Yo soy feliz

One implies that you’re feeling happy now, and one implies that you are a happy person. We don’t always have that distinction in the English language.

One of the ways I pulled myself away from catastrophizing negative thoughts was by putting my feelings into perspective. I would get off the phone after crying to my mom; my mind’s first reaction would be to say, “what’s the point of this?” Later, I would take a step back, observe my own thoughts, and remember to look at my feelings from a distance.

I may not feel happy right now, but I can be happy. This is a temporary feeling.

When you’re depressed, it’s very easy to fall into black or white statements like “I’ll never be happy,” or “I am a terrible person”. One of the most effective ways I’ve gotten myself out of this destructive thought process is by acknowledging that nothing is permanent, especially feelings. I changed the way I narrated my inner dialogue.

Another important consideration for our internal dialogue involves the link between our identity and cognitive dissonance. Cognitive dissonance “suggests that we have an inner drive to hold all our attitudes and behavior in harmony.”6 Accordingly, if you label and internalize your “depressed” identity, you could start rationalizing based on that label: ruling out and even seeking information and behaviors that prove the opposite. Kristen Lee Ed.D., LICSW wrote that “The eagerness to understand and explain can lead [people to] take on their diagnosis as a label, and even internalize it as a full-out identity.”7

I want to stress that this point is a very slippery slope. On one hand, it’s not productive for a depressed person to bottle it up or lie and say, “I’m fine! I’m not depressed!” However, there could potentially be negative consequences for making depression a permanent, holistic, and irreversible part of your identity. When I relapsed into a low point, I helped get myself out of the hole by acknowledging that something was wrong, but my depression was not who I was nor was it permanent to my sense of self. Allow yourself to balance these two perspectives.

Yes, you may be depressed right now. No, your depression is not who you are as a person. You would be doing yourself a disservice by thinking of it as a life sentence.

Starting Antidepressants (Again)

That fact that I stopped taking antidepressants right before a big move was poor timing that I couldn’t have predicted. I found out from my psychiatrist later on that you shouldn’t consider going off antidepressants if you’re about to undergo a major life change.

This aspect of my “recovery” was the most difficult to contend with. I was extremely proud of myself when I stopped taking antidepressants and I argued against loved ones who suggested I should try medication again.

This is actually a big part of the reason it took me so long to start writing my blog again. I felt like a failure and a hypocrite for a while. Who was I to give advice to people with depression when I had taken, I had thought, a step backward in my progress?

Eventually, I got over the feeling of being a “fraud” so I could take steps to focus on the real priority, which was to feel better. I’m currently taking half the dosage of antidepressants compared to the past. I’m not sure how long I’ll continue taking medication or if I’ll stop, but I would much rather feel comfortable with my current mental state than to take an unnecessary risk right now. That doesn’t make me weak and it doesn’t invalidate everything I’ve done to make myself happy (I’m confident in that, because antidepressants never “cured” my depression to begin with). I needed to accept that they were a tool to getting me back to a happy mindset.

Capitalize on the good moments and be grateful

It seems like every post on the internet tells us we should be thankful. As someone who has been depressed to a point where life seemed meaningless, I used to find this advice really frustrating.

“OK, so I’m not starving and impoverished, but I’m still absolutely miserable. What do I have to be grateful for?”

It’s not always easy, but to get out of my depression relapse, I had to weigh the reality of my circumstances. I broke my finger and couldn’t do anything with my hand for months, but it was just a finger and it was temporary. My hand healed. It’s like when you get a cold and you tell yourself, “I hate being sick and I don’t even remember what it feels like to be healthy,” and then you’re incredibly relieved on the day you finally wake up feeling “good”. Cliché or not, catching the positives, no matter how minute, was imperative to keeping me away from the edge of the emotional cliff.

Here are some of the things I appreciated to keep myself in check:

I have a job and savings that allow me to go about my day not worrying that I won’t be able to pay for basics like food.

My immediate family members are alive.

I have people I can call or text when I need someone to talk to.

It’s human nature to default to life’s particular status quo and measure from there. We evolved to constantly want more. This is great for a species’ survival, but not so great in the modern era when we compare ourselves to billionaires and Instagram models. While we can’t (and maybe even shouldn’t) hop off the hedonic treadmill completely, we should at least stop sprinting every once in a while and take a look at the good things in our lives. Otherwise, we’ll only remember them when they’re gone.

These days, I am at my happiest. I don’t dwell on my relapse but I don’t want to forget it either. I’m keeping in mind that life is full of change and I know I’ll face challenges again. However, I know that I can and will come back from the downward spiral and I’ll be prepared with the mental strategies that saved me more than once.

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  1. Weingarten, E., & Weingarten, E. (2021, May 21). Speaking with Katy Milkman about “how to change” – by Elizabeth Weingarten. Behavioral Scientist. Retrieved November 30, 2021, from https://behavioralscientist.org/speaking-with-katy-milkman-about-how-to-change/.
  2. Play makes US human V: Why Hunter-gatherers’ work is play … Psychology Today. (n.d.). Retrieved November 30, 2021, from https://www.psychologytoday.com/us/blog/freedom-learn/200907/play-makes-us-human-v-why-hunter-gatherers-work-is-play.
  3. Kohll, A. (2018, May 30). New study shows correlation between employee engagement and the long-lost lunch break. Forbes. Retrieved November 30, 2021, from https://www.forbes.com/sites/alankohll/2018/05/29/new-study-shows-correlation-between-employee-engagement-and-the-long-lost-lunch-break/?sh=25698704efc7.
  4. How do work breaks help your brain? 5 surprising answers … Psychology Today. (n.d.). Retrieved November 30, 2021, from https://www.psychologytoday.com/us/blog/changepower/201704/how-do-work-breaks-help-your-brain-5-surprising-answers.
  5. Villegas, P., & Knowles, H. (2021, November 11). Iceland tested a 4-day workweek. employees were productive – and happier, researchers say. The Washington Post. Retrieved November 30, 2021, from https://www.washingtonpost.com/business/2021/07/06/iceland-four-day-work-week/.
  6. Mcleod, S. (n.d.). Cognitive dissonance. Cognitive Dissonance Theory | Simply Psychology. Retrieved December 1, 2021, from https://www.simplypsychology.org/cognitive-dissonance.html.
  7. Sussex Publishers. (n.d.). Why labels can give us even more anxiety. Psychology Today. Retrieved December 1, 2021, from https://www.psychologytoday.com/us/blog/reset-247/201510/why-labels-can-give-us-even-more-anxiety.

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