Ten Signs Your Depression May Be Returning
Depression is one of the most commonly co-occurring issues with a substance use disorder and treating depression effectively is essential to long-term sobriety. One study found that among people with a mood disorder such as major depression or bipolar, a staggering 32% also had a substance use disorder. A relapse of depression may also lead to a relapse of drinking or drug use, so it’s important to try to prevent recurring episodes if possible.
Unfortunately, there’s a high probability that depression will recur. About half of people who have had one episode and about 80% of people who have had two episodes of depression will have another. The good news is that if you spot the signs early, you can reduce the severity of another episode or possibly avoid it entirely. Here are some tips.
- Seasonal Changes
First, it helps to know your patterns and some possible causes of depressive episodes. Seasonal changes are one such cause. Moving from fall into winter triggers an episode for many people, most likely because the shorter days disrupt the circadian rhythm, which has been linked to depression. This is known as seasonal affective disorder, or SAD and is typically treated with lightbox therapy to recalibrate your internal rhythm.
Summer SAD can also trigger a depressive episode but the symptoms are typically slightly different. Whereas winter SAD usually causes increased appetite, excess sleep, and low energy, summer SAD more often causes decreased appetite, disturbed sleep, and agitation. Summer SAD may also trigger manic symptoms in people with bipolar disorder.
The anniversary effect is when some holiday or anniversary triggers a mood change. It’s especially common in connection with the death of someone close. For example, you may suddenly feel depressed as the person’s birthday approaches or when you have to celebrate a holiday without them. However, the same might happen for something related to any traumatic event, such as a breakup, an accident, or an assault. If you are aware of the anniversary effect and any upcoming anniversaries, you can prepare yourself and feel less ambushed by it.
It’s also important to be aware of any other triggers that might be specific to you. Stress is always a possible trigger of depression. It could be work stress, the death of a loved one, or a divorce, or it could even be something more positive, such as buying a new house or having a baby. While it’s always good to manage stress, you may want to seek out additional therapy or social support whenever you start to feel overwhelmed.
- Early Symptoms
It’s always good to know your patterns so you prepare for problems but if you’ve had a couple episodes of depression already, they may just recur more or less randomly. This often occurs at roughly 18-month intervals but that’s never exact. The following symptoms may indicate another episode is approaching. Obviously, any symptom of depression, though less severe, may be a warning sign of relapse.
Common symptoms include depressed mood, thoughts of suicide or death, feeling worthless or helpless, sleeping badly, appetite and weight changes, lethargy, lack of motivation, slow movements, poor concentration, and physical pains. However, the following signs are either lesser known or they are usually the first symptoms to appear.
- Low Mood
For most people, a bad mood is just a bad mood, but if you have a history of depression, a bad mood might spiral down into a depressive episode. If you do have a bad mood, it will usually pass but if it doesn’t, don’t stress about it. Instead, find a reliable way of interrupting the mood--a technique called behavioral activation. This has been shown to be an effective way to treat depression and it’s even more effective when you’re not yet in the grip of a full episode. Watch some funny videos, go out with friends, take a walk, or listen to some music--anything to lift your spirits, especially if you don’t feel like it.
When you’re in a full episode of depression, nothing is enjoyable. This is called anhedonia. Things you normally like just lose their appeal. In its milder form, anhedonia is more like boredom or restlessness. You do something you normally enjoy and you still feel flat so you try something else but that doesn’t work either. Sometimes this is a sign that you need to rethink your priorities or try something new but sometimes it’s an early sign of depression.
Isolation is a classic sign of depression. You don’t feel like going out or seeing anyone. Maybe you even skip 12-step meetings. You decline invitations, cancel plans, or just don’t show up. You don’t return texts or calls. The more you isolate yourself, the worse you feel, so it’s important to push against this tendency as soon as you notice it. Accept invitations and actually show up. Reach out to friends and family, even if it’s just a periodic text or call. Stay connected in any way you can manage.
Irritability is one of the most commonly ignored symptoms of depression. Most people with depression experience irritability but they often don’t connect the two. However, it may be one of the earliest symptoms. If everyone suddenly seems to be on your nerves or mundane tasks are suddenly incredibly frustrating, it may be an early sign of depression.
- Sleep Disturbances
People typically associate depression with sleeping too much or not being able to get out of bed. If you’re doing that, it’s certainly cause for concern. However, sleep disturbances are just as common and people less often connect them to depression. If you find yourself waking up at three or four in the morning and being unable to go back to sleep, it may be an early warning sign of a relapse of depression.
- Concentration Problems
Poor concentration can be terribly frustrating. You keep spacing off or if you do stay focused, it can feel really hard to make sense of whatever you’re doing. Sometimes this may just be situational. Perhaps it’s the end of a long day or you didn’t get enough sleep last night. However, if it seems to happen a lot, it could be a symptom of depression. It’s not just the body that slows down with depression, it’s your cognitive abilities too. If you’re having trouble with focus, working memory, or formulating a coherent plan, it may be an early symptom of depression.
Many of the items on this list are not enough on their own to indicate a relapse of depression but two or three together should be cause for concern. If you think you might be heading for a relapse of depression, make sure you’re still following your treatment plan, get in touch with your therapist, and try to stay socially connected. It’s much easier to avoid another episode than to climb out of the pit once you’ve fallen in.
At The Foundry, we know that addiction isn’t just a matter of drugs and alcohol--it’s about the whole system, including family, lifestyle, and mental health. We use proven methods to treat co-occurring conditions and teach our clients the emotional resilience skills they need for a long recovery. To learn more, call us at (844) 955-1066.