By Ashley Bobo, LCSW, told by Kara Mayer Robinson
Knowing what to expect when you have major depressive disorder (MDD) can help you cope with the emotional ups and downs. When someone I work with is newly diagnosed with major depression, I spend a lot of time educating them and explaining the trajectory of major depression.
Life for people with major depression is often unpredictable. While you may only experience depression once in your life, most people experience depression several times. Depression can subside over time, so it’s important to be prepared and have a plan.
Managing MDD over time
With MDD, every day is different. Sometimes you may have the energy and motivation to do something you love, but then have a hard time getting dressed the next day.
Starting depression counseling can be a big step toward healing. As you try new strategies, you may notice an improvement in how you feel. It may start small and then add up to make a bigger difference. Your mood may improve. You might start living a better life. You may start to wish you could feel better.
It’s common to feel better and then experience a setback. You may feel frustrated, but it’s important to understand that this is normal for MDD. You may start and stop a lot.
When I work with people who have major depression, I first prepare them for the ups and downs. I help them develop new skills that they can use not only immediately, but also in the future when symptoms return.
Setbacks are common in MDD
Expect setbacks and try to be patient with yourself. Feeling better may look more like a roller coaster or a twisted ball of yarn than moving in a straight line.
As you learn new ways to manage depression, you may need to think about yourself and your environment differently. You can try new strategies, evaluate what happened, and adjust for next time. This takes time and is not always an easy process.
Depression can also lead to negative thinking patterns and strong, deep-seated beliefs about oneself. This way of thinking may take time to understand, relax and relearn.
What to do if you feel depressed
Look back and remember times when you encountered setbacks and were able to recover from them. Sometimes, just remembering that setbacks are part of growing and learning can change your thinking.
Work with your therapist to determine when you will feel better. Try keeping a mood journal or using a mood app to track your ups and downs. It can help you remember the ups and downs of your emotions and remind you that they will come back again.
Be aware of negative thoughts. Do you ask yourself questions like “What’s wrong with me?” or “Why do I feel better?” This is common in major depression, but it’s important not to blame yourself for feeling bad. A vicious cycle of negative thinking will only make the situation worse. Try to remember that setbacks are not personal failures.
What to do if you feel uncomfortable
While your progress may not be linear, it’s still important to see a trend in symptom improvement over time.
If your treatment stalls or isn’t working, talk to your therapist.
When this happens to someone I work with, I look at what worked in the past, what works now, and what doesn’t.
We may decide to try something different, such as adding or changing medications, trying a different type of therapy, or adding social support such as group therapy. We will also explore other levels of care that may be helpful. I may consult with other care providers to make sure we are all working together on the same plan.
Tips for managing the ups and downs of MDD
There are many things you can do to feel better and cope with the ups and downs of MDD:
speak out. If you feel depressed, tell your therapist. Sharing feedback can keep your recovery on track.
seek support. Join a support group or connect with other people living with MDD. Spend time with the people in your life who encourage you.
Reset your expectations. Every moment, second, minute, hour or day is a new opportunity to do, think or say something different. You might have a bad day today, but tomorrow might be better.
Recognize your danger signs. Pay attention to the symptoms of frustration. They may include:
- Frequent overeating
- Get up and go back to bed
- increased rumination or anxiety
- Not wanting to do usual activities, such as sports or favorite hobbies
- decline social invitation
Have a self-care plan. When you or a loved one notices these signs, make a plan for specific actions to take. what will you do? Call a friend? See your counselor? go out? As soon as you see the signs, put your plan into action.
