Depression recurrence: can you defend yourself against another episode?

I had depression, but I’m better and now I live happily ever after, right? Or maybe not…

There is no doubting that I have found the last year a bit difficult. Not the hardest I have ever had by a long shot thank goodness. But possibly hardest that I have had without being under a cloud of depression. Stressful life events and an approaching time of change in my life.

And at times I have felt on the edge of the precipice. So my thoughts have turned to the possibility of recurrence of my depression.

Depression affects a huge number of people, with various statistics estimating that it can affect 4-10% of people over their lifetime. Ironically despite the fact that I have been a long term sufferer of depression, it wasn’t until I was thinking about this subject that I looked at how likely recurrence of depression is.

Shockingly, once you have had one depressive episode your chances of suffering again are about 50% and rise with each subsequent episode, to at least 90% after 3 episodes. I have had 3 major episodes in my life. Given my personal experience I can’t say I was surprised, but I had hoped that I might never have to go through another episode again.

Of course all the work I put into my counselling journey was a part of my recovery and will hopefully play a large part in staying well in the future. But I remember how awful I felt and that motivates me to not become complacent with my mental health.

Can I be an exception? And if so how?

I came across an opinion online that was the only way to prevent recurrence of depression was to commit to a lifetime of treatment (either medication or therapy). This is not the answer for me. It feels defeatist and limiting. What is it exactly that makes recurrence likely?

Some risk factors for recurrent depression essentially fixed by past experiences such as difficulties in childhood and age of first depressive episode. These are in effect external factors over which someone has little control.

There is one risk factor though that I came across, which is to a degree an internal factor. A way of thinking, an attitude. Low sense of mastery, a feeling that I recognise well. Of course this is something that exists too because of past experiences but it also can be affected by everything we do now and in the future, so is at least possible to address in theory.

How could mastery help defend against a depression recurrence?

depression recurrence avoid prevent

Mastery is the sense of being an expert, not just in the sense of a skill or knowledge, but also being an expert in your own life, being in control of what happens to you, self-directing. It is closely linked it seems with self-efficacy which is the belief that you can do something, allowing you to persevere at it.

During my life I have had a variety of interests and jobs to occupy my time, but I have not stuck at anything long enough to become what I perceive to be an expert. Additionally choices I have generally made in my life regarding my direction have been reactionary rather than proactive, increasing my feelings of lack of control.

This history is something that I have been grappling with as I approach changing times in my life. But together with this knowledge of about the impact of mastery has given me the idea that if I can combat this I will have a better chance of avoiding a depression recurrence in the future.

Next steps

The approaching point of change has led me to evaluate my purpose in life. I question what motivates me and what I want to achieve with this time. Moving into this phase, it feels important to build up my sense of mastery. Researching this hasn’t thrown much light on specifics of how to do this. However I have developed some ideas of my own for moving forwards positively.

1. Narrow my areas of interest and occupation. Don’t spread myself so thinly. I have a tendency to spread my attention around. But this lack of focus makes mastery harder to achieve. If I narrow things down, I can invest more energy in what is left over.  There is less to feel I have (or haven’t) got control over.

2. Identify learning opportunities. Although I like to learn, I have always needed to do it for external reasons rather than being internally driven.  Instead investing in learning will help me gain skills and knowledge.

3. Give myself specific, but linked, action points. I get overwhelmed by my fragmented approach and end up doing nothing. I can build mastery step by step and acknowledge each point as a waymarker towards mastery. Recognising each step when it is achieved will help in seeing mastery forming.

These ideas sound basic and similar to a lot of self-development strategies I have read in a variety of places. The key to how I have thought about them though is with the purpose of developing mastery.

Having put this plan together, I feel much more positive moving onwards and upwards. Whether it will help me avoid a recurrence of my depression is not really easy to say. What I do know is that working on this particular attitude and way of thinking is what I need now.

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