Anxiety and Depression “Relapses”
When working with addiction, the term relapse is thrown around all the time. It can refer to a slip up of using substances one time, or a full-blown return to the behaviors and patterns that were prominent at the height of addiction. Relapses are common in that world but the process of relapse can also apply to other conditions. Anxiety and depression are two conditions where we can look at recurrences as a case of relapse. Clients often start counseling with their first episode of depression or major anxiety, and they usually see improvement within a few months to the point where the idea sets in that they are “cured”. We know that conditions like Major Depressive Disorder, Generalized Anxiety Disorder, and Panic Disorder are chronic but at times they seem to disappear. For some, this dream that seems too good to be true is actually true. It can be the case that a person suffers only 1 episode of depression or just a period of intense anxiety in their life. More often however, there are recurrences or “relapses” of the conditions over the course of years. What can the concept of relapse do to help us deal with anxiety and depression? There are a few ways this concept can be of assistance.
Why did I relapse?
When we think of relapse, we often think of a person making the wrong decisions. This is only one of the ways that a relapse can occur in an addiction, but there are others. This is the same in anxiety and depression. Common reasons for recurrence or relapse are:
- Losing vigilance- we get comfortable when doing well and disregard the coping skills we were using to feel better. An example would be you started meditating every day to reduce anxiety, but once you feel better you quit your daily meditation.
- Tragedy- Sometimes life hits us in a way that triggers a relapse. A death of a loved one, a loss of a job, financial problems, or even tragedies on a national or international scale can be a trigger for relapsing.
- Physical health problems- Often overlooked, but a physical illness can be a cause of a depression or anxiety relapse. Even if you don’t struggle with health anxiety, being sick knocks us all off our equilibrium mentally and that can leave room for depression or anxiety to creep back in.
- Major life changes- Major changes in our lives, even good ones, can be another trigger for relapse in our mental health. Moving, having children, new relationships, new jobs, these are usually not negative things but they do cause enough temporary chaos in our lives that relapse is possible.
There is a possible trap in looking at the why we relapse with mental health issues. While knowing why can be important to avoid the same problem, we can become so obsessed with finding the exact reason why that we don’t use our focus to get better again. Working with a counselor to identify the why is necessary, but knowing why we relapsed does not fix our current state of discomfort. Having a future oriented thought process is always important after a relapse.
When speaking about preventing depression or anxiety relapses, it is necessary to first note that not all relapses are going to be avoidable. Looking back at the list of possible reasons for a relapse, you will notice that a good portion of them are out of our control. Tragedy and getting ill are usually not within our control. This paints a pessimistic picture about avoiding relapse, but the good news is that the why is not as important when we stay on track with using our coping skills. Whether it is lifestyle changes, meditation, yoga, medication, talk therapy, exercise, or a combination of multiple factors, keeping to these positive skills will help us prevent relapse no matter what comes our way. At the very least, it will reduce the severity of relapses. Many people find that there 3rd or 4th depressive episode seems to not last as long or not be quite as severe. Part of this is from familiarity and knowing you will come out the other side but another part of it is being able to focus on coping skills right away.
Like most things in life, being prepared is the best way to combat future events going wrong. Some things that trigger mental health relapses are almost guaranteed to happen sometime. Losing a loved one is experienced by everyone at different points in their lives, so knowing that it will happen the best preparation is to make sure you are in the best mental state you can be incase tragedy strikes. If we looked at it like a math problem, if you are walking around on a normal day at a 9/10 mood, and a tragedy strikes and knocks you down 4 points, you are still at 5/10 which would likely be functional. But if we are just barely hanging on during a normal day at 5/10, a tragedy can knock us all the way down to a 1/10 where we can’t get out of bed. Keeping ourselves mentally well is our best tool towards avoiding major relapses in our mental health.
It Will be Normal Again
In addiction, people struggle greatly with the thought that they have a life-long condition that will need constant vigilance. In mental health this is also a common issue. The chance that you may struggle with depression and/or anxiety for a long time, or even for a lifetime, can be an extremely challenging thought. Fatigue sets in quickly and the idea that we need to worry about these issues forever can create thoughts of hopelessness. Know that this is common and something a counselor can help you navigate. The most important thing to keep in mind is that all the evidence shows that even if you have a lifelong battle with any mental health issue, you will have more periods of normalcy than trouble. Clinical studies and personal accounts of those who deal with these issues show that while relapses are common, the times between are long and people feel well. In the depth of depression particularly, it feels like you are stuck and this is your new normal. But over time it becomes clear that your mental state will be in a better place for far longer than your depressive episodes last.
The fear of relapse may linger on our minds for quite awhile after our first encounter with mental health issues. But our mind is adaptive. It soon will be able to normalize the situation and be more focused on what is currently happening in our lives. Even the coping skills we may initially only discover as ways to treat an issue will become normal parts of our daily routines with little mental connection to the original feelings of anxiety and depression. Trust that time is on your side and all things can be integrated into our minds in a way where we live a life that feels normal and mostly positive.
Conceptualizing depression and anxiety as conditions that can have “relapses” is not necessary for treating them, but can be helpful for how we handle these feelings. The most important fact about relapse is it is part of recovery, in addiction and in mental health. If you were anxious, then feeling well, now anxious again, you are not back to where you started. You are in a different phase of recovering and are facing a new challenge. Keep doing what works and avoid what doesn’t and you will find yourself again in a place of stability.
If you are seeking assistance with mental health issues that seem to reoccur, please contact Life Enhancement Counseling Services today at 407-443-8862 to schedule an appointment with one of our experienced mental health counselors.