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How Can I Stop Depression From Recurring?

Question:

I am 38, work full time (teaching), have 2 children (8 and 4). My first diagnosed depression was about 15 years ago and it took about 3 months to return to “normal” (ish!) and another year before I felt “over it”. Achieved that through meds and group therapy as an outpatient. I had minor episodes after that, returned to meds briefly, came out of it. 15 mo ago I rapidly slipped into another major depression. Outwardly I am over it (with the help of meds and counseling), but stress was a major feature and I keep finding myself succumbing to it, feeling exhausted and despairing of ever being “on top” again. My Dr has told me that my lifestyle and attitude make it very likely that the depression will recur. His opinion is that my tendency to expect 101% of myself all the time puts too much pressure on me. However, I can’t see where I can cut down (and friends / advisors can’t either) and though I have had some success in my expectations of myself (which were totally unrealistic!) I can’t seem to make the necessary step to reduce the probability of depression. Any comments on the likelihood of recurrence, and/or suggestions would be welcome. My counselor is currently unavailable, so I feel somewhat isolated though other friends have been very helpful.

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Answer:

First, you must realize that it is a feature of depression for it to reoccur in many people who have had it before. There are things you can do to minimize the likelihood of reoccurrence, but it is maybe not an option for it to just go away. It sounds like you’ve talked out the various ways that you can help to prevent recurrence with your counselor (e.g., cutting back on stressful activity, making social supports a great priority, checking in regularly with a counselor/physician who can monitor you, and working on changing perfectionist attitudes, etc.). The problem doesn’t seem to be that you don’t know what to do – but rather that you can’t conceive of a life that is organized differently than the one you have now.

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p>I don’t know the constraints you are under (economically, etc) that might drive your stressful activity, but I can say that just because you can’t see how change can occur doesn’t mean that it isn’t possible or that it doesn’t need to occur. You may have a choice of sorts – either continue as you are right now and put yourself at increased risk of depression, or change how you live your life in ways that are not conceivable to you right now and maybe decrease your risk of relapse. Other people may be able to help you find the way to a less stressful, more forgiving life. Find people who seem to have made the type of shift you are contemplating and ask them how they did it.

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