Cycles of depression and maintaining hope
Depression often comes in cycles. This means there are periods when it feels absent or very mild, and other times when it feels much worse. The bad times with depression are sometimes classified by health professionals into categories such as minor (less severe) or major (more severe) ‘depressive episodes.’
Young adults we interviewed almost all described their depression as waxing and waning over time. Some said their cycle is predictable: for example, several people with a particular kind of depression called ‘Seasonal Affective Disorder’ talked about regularly feeling more depressed in winter, and less depressed in the other seasons of the year. Others could describe specific triggers for depression such as life events, stress, or their menstrual cycle. A number of people said depression ‘just sort of feels like it comes in episodes,’ but were unsure why it gets better or worse at particular times. Sophie captured the cyclical nature of her experience by saying depression is ‘like a wave situation. I would be, I would be all right for maybe two or three weeks then something would happen and I would just sort of crash back down.’ In contrast, though, a few people said their depression is constant rather than cyclical.
Ryan says he has experienced cycles of depression his entire life.
For Natasha, depression is constant rather than cyclical.
Living in the shadow of depression
For some people, knowledge that depression comes and goes can undermine good feelings even when depressive symptoms are mild. As Julia put it, ‘I try not to get my hopes up because I feel like as soon as I do that I’m going to have a really bad phase triggered by like totally random things.’ Casey says he struggles not to have the way he deals with things when depressed become the frame he applies when he is feeling fine. Many people find that while they’re feeling good they have to spend a significant amount of energy trying to prevent or prepare for the next cycle of depression.
Shayne says managing depression is like managing diabetes: she has to constantly monitor multiple factors in order to keep on an even keel.
Mara works hard to enjoy things during good periods, but still finds herself wondering when depression will return.
Several people talked about how transitions in their lives (like moving or changing schools) played a role in their cycles of depression. Most often, transition seemed to promise a new lease on life, corresponding with a ‘high’ in the mood cycle — but then proved disappointing, difficult or even traumatic, triggering a terrible ‘low.’ Meghan, for example, felt ‘all stresses in life were over’ after high school, because that was her goal for the summer, but really things were ‘just getting worse and worse’ and her depression became worse than ever once at college.(See ‘Depression and transitions to adulthood‘ for more on depression.)
Jacob thought each milestone would bring welcome change to his life, but altered circumstances had little effect on his depression.
Crystal kept vowing to start over, but cycles of harder and easier persisted.
Many people we interviewed yearned for the capacity to remember, even during their darkest times, that bouts of depression are temporary. Even while acknowledging that it might sound ‘cheesy,’ several people emphasized the importance of being able to see ‘the silver lining behind every cloud.’ Others focused on repeating reminders to themselves in the form of little phrases such as ‘there is a way to get through this,’ or ‘it will get better,’ or ‘hard days will go away.’ As Elizabeth put it, ‘ sometimes you have to literally tell yourself it’s going to be ok, even if you don’t believe it, even if you don’t think it’s going to happen, and that really does reframe my thinking.’ Colin says it’s helpful to remember that ‘the only constant is change’; even if he is feeling severely depressed now, in the future he will again have energy, motivation and desire.
Nadina says that the first step in maintaining a hopeful attitude is learning not to give up, and remembering that bad times have come and gone in the past.
Brendan has learned that periods of hopelessness are temporary, and that if you wait them out you will find new solutions.
During a tough period of unemployment, Elizabeth felt severe depression threatening to descend. She headed it off by drawing on coping skills such as taking decisive action, persisting, and speaking positively to herself.
Sam has learned that depression can always be made better by using one of several specific coping mechanisms.
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