Struggling With Depression

Depression is an ongoing battle for many people. Knowing what can trigger a depressive episode can help you minimize or avoid a relapse.

If you have been struggling with suicidal thoughts, you are not alone. Having thoughts of wanting to take your own life is common among those dealing with severe depression. It is important to remember, however, that what you are feeling or thinking doesn't have to translate into action.

Major depression is a complex and challenging condition: Even when your symptoms are under control, you can potentially slide back into despair. However, knowing what might trigger a downward spiral can help you stop one from happening.

Depression relapse or recurrence is common, although these two terms aren’t the same thing. First, it’s helpful to know how recovery is defined: It’s when you’ve been free of depression symptoms (in remission) for at least four months. In clinical terms, a relapse is when depression returns after you’ve reached remission but before you’ve reached recovery. A recurrence is a new episode of depression after a recovery.

Whether it’s a relapse or a recurrence, about half of people who’ve had one episode of major depression go on to have another, says Deborah Serani, PsyD, a psychologist in Smithtown, New York, and author of the book Living with Depression.

If you’ve had two bouts of depression, you’re 80 percent more likely to have another, Dr. Serani says. If you’ve had three depressive episodes, you have a 90 percent chance that symptoms will return again, she says.

7 Possible Depression Relapse Triggers

While there are certain events that can be stressful for many people, that doesn’t mean that all of these factors will trigger an episode in a person with depression. “Triggers are usually very personal things,' Serani says. 'For example, things that are stressors for one person may not necessarily be difficult for others.' The reason a trigger sets off a depressive episode is that it overwhelms a person's ability to cope effectively, she says.

Potential depression triggers include:

1. Quitting treatment. Most people whose depression returns have strayed from treatment, Serani says. “They begin to feel better and stop taking their medications or quit psychotherapy.” As a result, they don’t reach full remission and depression symptoms slowly return, pushing them into another episode, she says. Keeping a healthy sleep schedule, exercising regularly, eating well, and avoiding alcohol, drugs, and toxic people are all part of effective depression treatment, Serani says. “Maintaining a healthy consistency with your life can dramatically lower your chance for depression relapse.'
2. Death of a loved one. About 1 in 5 people develop major depression after a loved one passes, according to the American Cancer Society. “Grief is expected after a loss, but if symptoms of mourning go on for a long time, normal grief may turn into a depressive disorder,” Serani says. “If a person is still struggling with depression months after a death, they may need professional help to address prolonged grief and major depression.”
3. Divorce. If you've already had depression, getting divorced significantly raises your risk for another episode, according to a 2014 study published in the journal Clinical Psychological Science. Researchers found that nearly 60 percent of divorced adults with a history of depression experienced another depressive episode. Only 10 percent of divorcees without a history of past depression experienced it.
4. An empty nest. Although “empty nest syndrome” isn’t a clinical diagnosis, it’s common for parents to feel sad when a child leaves for college or moves out of the house, according to the Mayo Clinic. But such a change might trigger depression in some people. Get help if these feelings last a long time or interfere with your work or social life.

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5. Traumatic events. Frightening events like terrorist attacks and natural disasters can bring on a relapse or recurrence, Serani says. Anniversaries of such events can be triggers, too. A study published in The British Journal of Psychiatry in February 2016 found that people involved in attacks, disasters, and military deployment are at a much greater risk for depression.
6. Hormone changes. Hormonal changes unique to women can trigger depression, according to the U.S. Department of Health and Human Services. Hormones affect the brain chemistry that controls emotions and mood. Women are more vulnerable to depression at puberty, during and after pregnancy, and at perimenopause (when a woman starts to experience menopause symptoms but hasn’t reached full menopause). Having a depressive disorder before you become pregnant puts you at the greatest risk for post-partum depression, Serani says.
7. Addictive behaviors. It may not be a surprise that alcohol and gambling can create a potentially-addictive temporary escape, but even too much TV can be a depression trigger too, Serani says. Binge-watching — viewing many TV episodes in a row — can bring on the common depression triggers of stress and anxiety, according to a 2015 survey presented at the American Public Health Association annual meeting in Chicago. “When a person stops binge-watching, it can lead to a sudden shift in neurochemistry and a psychological feeling of loss, just like those who stop taking drugs or alcohol,” Serani says.

Off the road google play. Ways to Minimize Depression Triggers

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Some depression triggers can be avoided, but others can’t. “A person has to learn how to move through the event or the experience as best as possible,” Serani says. If you’re starting to feel stressed or overwhelmed by something in your life, Serani suggests taking these steps:

• Get through it with positive talk. Tell yourself, 'This is temporary,' 'I'll feel better soon,' or 'I’m just experiencing a bad moment, I’m not stuck in a bad life.'
• Nurture yourself. “It's essential to feed your senses when triggers loom in your life,' Serani says. 'Listen to music, or savor a cup of tea, soup, or coffee.' You might stimulate your sense of smell with soothing peppermint, florals, or woodsy scents with aromatherapy, candles, or a walk outside. Taking a warm bath can also be soothing.
• Reach out to others. “It's easy to want to be alone when stress hits, but isolating yourself from people can worsen depression triggers,' Serani says. 'Let others know you’re struggling and talk about it openly as much as you can.” Consider joining a depression support group to be able to talk to other people who also understand what it’s like to live with depression.

If you suspect you’re experiencing a new bout of depression, don’t hesitate to contact your doctor or therapist. Remember that depression relapse is common and nothing to be ashamed of.

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Anyone who's ever been married knows that making a relationship last is hard.When two people marry, they try to build a life together that often involves differences of opinion on living habits, money trouble, kids, and so on. Even something as simple as sharing a toothpaste tube can make a relationship difficult. (Just ask my wife about the importance of squeezing from the bottom of the tube.) But throw depression into the mix and it transforms the level of marital difficulty from the 'this is pretty hard' category into 'this is nearly impossible.' My wife Casey and I have been married for 13 years. Like most long-lasting relationships, our marriage has been hard and we’ve faced our share of difficulties and near-misses.

Making it to our 13th anniversary wouldn’t have been possible had I not tried really hard to understand having a depressed spouse and deal with my wife’s severe depression.She's been dealing with depression for the majority of her life. Her episodes of depression vary, and there are no patterns as to when they come and go. She can go six months at a time without suffering any effects from depression, and when she has an episode it can last anywhere from a couple of days to several weeks.Because this article glosses over 13 years of marriage, it would be easy to assume that my wife is constantly in a depressive state, which wouldn't be an accurate assumption. My wife also receives help from doctors. But depression doesn't come with a magic on/off switch, so although she receives medicinal and medical help, there are still times when we have to deal with this disease in our marriage.The first time I experienced my wife's depression was a few weeks after we met. She came over to my apartment late at night, and without much warning or reason, burst into tears. She cried 'ugly tears,' as we called them, with every bit of energy within her.

I pulled my soon-to-be wife into my arms and we sat together on the couch (while she sobbed) until we both fell asleep.At the time, I didn’t know what depression was. I had no clue that depression was even a disease, a disease that can take complete control of someone’s mind and wreak havoc.I believed that a person could simply choose to be happy, and I assumed my wife, too, could choose to be happy if she wanted to. And yet, for some unexplainable reason, she was choosing to be sad.The beginning of our marriage included many tear-filled episodes. Throughout the entire second year, my wife stayed home (voluntarily — she wasn't fired or unable to get a job) mostly because of her depression.

Getting out of the house to do anything was too much for her, and most of her days were filled with tears and sadness. Four years in, when my wife was pregnant with our first child, I came home from work and found her unconscious with empty pill bottles on the bed. She. I rushed her to the hospital and she spent the next week in a psych ward trying to deal with her depression.I don’t know when the light bulb finally came on. When I look back now, I can't pinpoint the moment when I finally began to understand the disease. There was no Oprah ah-ha moment. I didn't go to a class on depression and I didn't read any books on depression.

Instead, I started to recognize the signs of my wife's different stages of the disease, and through trial and error, started to notice which actions actually helped and which ones made her depression worse.RELATED:We also started talking more about depression and how she felt when struggling with it. Eventually, I began to understand what depression does to a person and that my wife's actions while going through it weren't her fault.

Now, I approach my wife’s depression as if it isn’t part of our marriage. I view it as a disease that takes control of my wife’s brain and renders her temporarily incapacitated.Does a son blame his dad who suffers from Alzheimer’s from forgetting who he is?

Similarly, the woman who sleeps through the day and sobs through the night isn’t really my wife. My wife is in there somewhere, but the hurt and the struggle and pain that affects both of us isn’t caused by my wife.Her inability to do things like dress the kids, go to the grocery store, or even something as simple as showing love isn’t her fault and it isn’t her choice. She isn’t choosing to feel the way she feels, and allowing something that she can't control to damage our marriage is unfair to both of us.Living with (and raising kids with) someone who struggles with depression is difficult. There are weeks at a time where my wife will struggle just to get out of bed, leaving me as a single parent of two kids.

Also, when the stresses of everyday life hit me, I can't go to my wife with my struggles because she can't mentally help me cope with them.A few years ago, as a criminal defense attorney, I represented an individual who had been accused of molesting a child. The stresses that came with that case were immense.Because of the nature of the crime he was accused of, they weren't typical courtroom-related stresses; they were very dark and emotional feelings that impacted my mood and my quality of life. I often found myself awake for hours in the middle of the night worrying about the case.When I tried to get help from my wife, it was too much for her.

She mentally couldn't handle it. I needed her more at that time than I had at any other time in our marriage, and it just wasn't possible for her to be there for me. The most painful part of having a depressed spouse and being married to Casey, however, is her complete lack of affection when she's depressed. When she's suffering, there are no 'I love you's' and no hugs goodbye or kisses hello.Depression sucks the love out of her life and it's hard not to take that personally. I still struggle sometimes to know if her lack of affection is coming from the depression or if she has just fallen out of love with me. Viewing depression in an objective manner has saved my marriage.Managing the family and life without my wife's help at times is very difficult and stressful.

And it isn't always easy to take an objective view of my wife's depression, but understanding her disease has allowed us to work through the episodes and come out of them without much marital damage.And although the approach we take has helped us eliminate most of the damage depression can do to our family, our two young daughters don't always understand why their mom stays in bed all day and isn't interested in seeing them in those moments.