After a bout of major depression, it's a relief when you start to feel like your old self again. Overall, you're improving as you go through treatment for major depression, "but it's often two steps forward and one step back," says Shoshana Bennett, PhD, a clinical psychologist. "It's rarely a straight line up."
Just knowing to expect some bad days with the good can help you be more patient with yourself. "These are dips, not relapses," Bennett says.
A risky time during depression recovery is when you start having several good days in a row. If you're not having symptoms, it can be easy to think that you don't need treatment for depression anymore. But going off medication or quitting therapy for depression too soon can lead to symptoms coming back.
Guidelines from the American Psychiatric Association recommend that people with depression who have been successfully treated with antidepressants should keep taking them for at least four to nine months—and sometimes longer. Similarly, people with depression who have fewer symptoms with talk therapy should talk with their therapist about how long to continue treatment.
Keeping depression symptoms away
Besides sticking with your depression treatment, you can take steps to keep symptoms under control. Connecting with friends and family, thinking positively, staying active, eating well, and getting enough sleep all help. But there's a catch, says Jon Allen, PhD, senior staff psychologist at the Menninger Clinic in Houston: "The nature of depression makes it difficult to do those things."
Don't be surprised if these healthy steps feel unnatural at first. Depression fosters hopeless thinking, so you may have trouble believing that they'll ever get easier. "They will," Allen notes, "as you pull out of depression."
Friends and family might see a change in your depression symptoms and depressed behavior before you do.
"It's remarkably common," Allen says. "People will say, 'Gosh, you look better,' or 'You sound better,' and the depressed person is thinking, 'Well, I still feel terrible.'" It can be very frustrating for the depressed person, who ends up feeling that other people don't understand how tough things really are.
Building a depression support network
A support group is one place to find other people who know what you're going through because they've had depression themselves. To locate in-person and online depression support groups, visit the support directory hosted by the Depression and Bipolar Support Alliance.
If you pulled away from friends and family while depressed, now is the time to start rebuilding those bonds. Allen suggests making concrete plans. For example, meet a friend for coffee.
"By making that commitment to someone else, you may feel obligated to show up," he says. It's added motivation to get out and rejoin the world. Friends and family can also be a source of encouragement on days when depression symptoms or worries about symptoms get you down. Gradually, you'll start to feel more hopeful, too.
