Depression: 5 Steps to Prevent Relapse
If you’ve struggled with depression in the past, you are likely all-too-familiar with how easy and subtle it might be to slide back into a depressive state. It can sneak up out of nowhere, kick you into auto-pilot and before you know it you feel like you are “back to square one.” When working with depression it is very important to get in touch with our relapse signatures that are the tell tale signs that we are beginning to slide. When I ask people to think of their signatures they say that more negative thoughts begin to visit them, there may be a feeling of wanting to isolate from friends and family, or the phrase “what’s the point” comes up over and over again.
Here is a step-by-step process of increasing awareness of when relapse is happening and what you can do to pre-empt it:
1) Relapse Signatures – Take a moment right now or make a plan to write down some of your relapse signatures just to increase awareness when they’re happening.
2) Breathing Space – When you notice one of these signatures occurring it is going to be important to ground yourself to the present moment so you can increase you chance of making a choice in that moment. Here is where you introduce mindfulness and bring your attention to the breath to anchor yourself to the present moment. Then take a moment to sense into the body to check-in with how you are feeling physically and emotionally.
3) Thoughts are not facts – It is important to remind yourself that thoughts are not facts. We know this because the same event can happen (e.g., a friend walking by us without saying hello) and our interpretation would be different depending on our mood. Therefore, it’s important to remind ourselves that thoughts are not facts, they are mental events in the mind that are temporary and mood dependent. What is a fact is that negative thoughts are circling and however we are feeling physically and emotionally.
4) Take Action – Now that we are grounded to the present moment and have come down from the mental rumination, we want to take action with 2 things that can support us in this moment. That is either an action that brings us pleasure or an action that brings us a sense of mastery or accomplishment. Here you want to make a list with two columns. Column 1 will include actions in your life that you consider to be pleasurable (e.g., having tea with a friend, taking a walk, giving yourself a manicure/pedicure). Column 2 will include those things that give you a sense of accomplishment (e.g., paying the bills, getting exercise, going to the post office). These lists may overlap in some areas, but have the list down so you have access to it and don’t have to think as much when you notice this relapse occurring.
5) A letter of encouragement – Sometimes when relapse is happening, the thought “what’s the point” comes on really fast. When you’re feeling well, write yourself an empathic letter spelling out the importance of engaging in this process. Be kind to yourself in this letter see if you can think of the words that would be supportive and helpful for you to here when in the midst of a slide into relapse.
Remember, this is a process to engage in when you are noticing yourself sliding into relapse and you have not fallen into the depths of depression. See if you can keep your lists and letter in a space that you can remember and have easy access to. Community is also an important aspect of this work, so share this plan with friend so they can gently help point out when they notice relapse signatures. Or look into online communities such as Therese Borchard’s Community at Beyond Blue.
As always, please share your thoughts, stories, and questions below. Your interactions here provide a living wisdom for us all to benefit from.
Goldstein, E. (2009). Depression: 5 Steps to Prevent Relapse. Psych Central. Retrieved on September 2, 2015, from http://blogs.psychcentral.com/mindfulness/2009/06/depression-5-steps-to-prevent-relapse/