Signs that Major Depressive Disorder May be Returning

Those who have been following this blog may have noticed that after a remission of 16 years, depression returned to my life in 2010. I have been diagnosed (from three health professional sources) as suffering from major depressive disorder. As of today, I am not out of the woods yet, but I am slowly improving. I am currently experiencing about one ‘bad’ week of depression for every three ‘good’ weeks. I would also like to thank everyone who has been praying for me.

In my next few posts I will focus on recurring depression, more commonly known as major depressive disorder, and also as recurrent depressive disorder, clinical depression. Major depressive disorder differs from other types of depression in that although the person may have periods of normality between depressive episodes, future depressive episodes will continue to come. The breaks of normality can be anywhere from weeks to years apart. (This is different from the good day/bad day cycle that depression sufferers experience during recovery.)

Many if not most people who suffer from a depression never go through it again - the depression is an isolated event triggered by very difficult circumstances, such as the passing away of a loved one. So it never occurred to me that I could succumb to depression again after recovering from a major episode in the mid 1990s.

I had also learnt many coping techniques to deal with anxiety and depression, and so believed that should severe anxiety or depression attempt to invade my life again, I would be able to nip it in the bud.

Therefore, when in 2010 I began to experience a number of symptoms similar to what I went through in 1989; I did not think them significant nor join the dots to see a bigger picture unfolding.

At the beginning of 2010 my family began attending a new church. Three months later I had a panic attack that we had made the wrong decision. For several days I tried to think objectively and convince myself that we had made the correct decision, but due to overwhelming anxiety, I felt we had to go back. I finally recognised that I needed to get someone else’s perspective, so I shared what I was thinking and feeling with my wife. She helped me to see the correct perspective, that we had done the right thing, and this helped me to dismiss my fears and the anxious thoughts faded away. However, the next day, from morning until mid afternoon, I could feel waves of fearful adrenalin rippling through my body, something I had not experienced for nearly twenty years.

A few weeks later, for minor reasons that felt significant at the time, I suddenly deleted my ‘writing’ blog, where I had written short stories, flash fiction, and poems. Although I had greatly enjoyed making that blog, I lost all interest in it.

Around this time my wife said that I was looking exhausted and weighed down. She suggested that I cut down on my out of work commitments, so I took her advice and cancelled some of my social and church activities.

By April I lost my appetite. Each night I would half my dinner and then push the plate away. In June I noticed that my daughter had stopped teasing me for putting a bit of weight on my midriff, so I went and weighed myself. I had dropped from 70kg to 64kg. This was alarming, so from that day I forced myself to each my whole dinner every night, and added a small meal before bedtime every day.

I also found myself becoming envious of a couple we knew who were in the process of retiring. The thought of retiring was so attractive, so appealing. Why did I, in my mid forties, so desperately want to retire? It was because I was becoming more and more exhausted, mentally, physically and emotionally, as the year went on.

Finally, in July I had a nightmare in which I was afflicted by the fearful ‘topic’ that had terrorised me when I had been depressed in the 1990s. Although it had been largely dealt with by counselling, here it was again.

All of these signs had preceded my previous major depressive episode, yet unfortunately, I failed to join the dots in order to realise what was around the corner - another major depressive episode.

If we have been diagnosed as having major depressive disorder - What Can We Do?
1. Keep a list in our diary of common signs that have preceded our major depression episodes, so that we can recognise when a new episode is imminent. And then, if those signs reappear, there are a few things we can do that may reduce the severity and duration of the episode.
a. do not fear its return (this will only make it worse)
b. exercise at least three times a week
c. get at least 8 hours sleep a night
d. make sure we are not doing too many activities
e. revise our depression managing strategies, eg, read “Self Help for Your Nerves” again.
f. if currently taking anti-depressants, visit the doctor to discuss the possibility of increasing the daily dosage.
g. and very importantly, if not currently taking anti-depressants, talk to our doctor and seriously consider going back on them now, even if only a low dose. This is a preventive measure, and if depression does return, being back on the meds should reduce its severity from the start.

There is one thing I would like to stress about major depressive disorder/recurring depression - we must not fear its return. To fear its return can actually facilitate or hasten its return. Instead, we are to obey Jesus teachings to trust God and live each day as it comes, not fearing the future. Matthew 6:33-34 “But seek first his kingdom and his righteousness, and all these things will be given to you as well. Therefore do not worry about tomorrow, for tomorrow will worry about itself.”  

And if there are more depressive episodes waiting in our future, there is still no reason to fear them, for Jesus will be there, reading to take us by the hand and lead us through them when those times come. Isaiah 41:13 “For I am the LORD, your God, who takes hold of your right hand and says to you, Do not fear; I will help you.”      

When I look at my future through a perspective distorted by depression, I see a bleak, dark, oppressive future full of pain and suffering. But lately I have looking at my future from the perspective that Jesus is there in my future and will comfort me with His love and presence. And what a different, wonderful perspective that is! Genesis 28:15 “I am with you and will watch over you wherever you go,”

Important Note:
The things that I have mentioned in this article are not the signs or symptoms of depression, but merely a list of indicators common to myself that the return of depression was imminent. To see a list of symptoms that can accompany depression, please see this article : Symptoms of Depression and How it Causes Them

If you have major depressive disorder/recurring depression, what common indicators have you noticed in your own life that precede the return of each major depressive episode?