Medical News Today: How to cope with a depressive episode

A depressive episode in the context of a major depressive disorder is a period characterized by low mood and other depression symptoms that lasts for 2 weeks or more. When experiencing a depressive episode, a person can try to make changes to their thoughts and behaviors to help improve their mood.

Symptoms of a depressive episode can persist for several weeks or months at a time. Less commonly, depressive episodes last for over a year.

According to the Anxiety and Depression Association of America, approximately 16.1 million adults in the United States experienced at least one major depressive episode in 2015.

Read on to learn more about the symptoms of a depressive episode and 12 tips for coping with one.

Symptoms

man in bed with a depressive episode
Symptoms of a depressive episode may include anxiety, frustration, feeling hopeless, fatigue, and a loss of interest in things once enjoyed.

Symptoms of a depressive episode are more extreme than normal periods of low mood and may include:

  • feeling sad, hopeless, or helpless
  • feeling guilty or worthless
  • anxiety
  • irritability or frustration
  • fatigue or low energy
  • restlessness
  • changes in appetite or weight
  • loss of interest in things once enjoyed, including hobbies and socializing
  • trouble concentrating or remembering
  • changes in sleep patterns
  • moving or talking more slowly than usual
  • loss of interest in living, thoughts of death or suicide, or attempting suicide
  • aches or pains that do not have an obvious physical cause

For a diagnosis of depression, people must experience several of these symptoms for most of the day, almost every day, for at least 2 weeks.


Twelve tips for dealing with a depressive episode

Tackling depression as soon as symptoms develop can help people recover more quickly. Even those who have experienced depression for a long time might find that making changes to the way they think and behave improves their mood.

The following tips may help people deal with a depressive episode:

1. Track triggers and symptoms

Keeping track of moods and symptoms might help a person understand what triggers a depressive episode. Spotting the signs of depression early on may help them avoid a full-blown depressive episode.

Use a diary to log important events, changes to daily routines, and moods. Rate moods on a scale of 1 to 10 to help identify which events or activities cause specific responses. See a doctor if symptoms persist for 14 days or more.

2. Stay calm

Identifying the onset of a depressive episode can be scary. Feeling panicked or anxious is an understandable reaction to the initial symptoms of depression. However, these reactions may contribute to low mood and worsen other symptoms, such as loss of appetite and disrupted sleep.

Instead, focus on staying calm. Remember that depression is treatable and the feelings will not last forever.

Anyone who has experienced depressive episodes before should remind themselves that they can overcome these feelings again. They should focus on their strengths and on what they have learned from previous depressive episodes.

Self-help techniques, such as meditation, mindfulness, and breathing exercises can help a person learn to look at problems in a different way and promote a sense of calmness. Self-help books and phone and online counseling courses are available.

3. Understand and accept depression

Learning more about depression can help people deal with the condition. Depression is a widespread and genuine mental health disorder. It is not a sign of weakness or a personal shortcoming.

Accepting that a depressive episode may occur from time to time might help people deal with it when it does. Remember, it is possible to manage symptoms with treatments, such as lifestyle changes, medication, and therapy.

4. Separate yourself from the depression

A condition does not define a person; they are not their illness. When depression symptoms begin, some people find it helpful to repeat: “I am not depression, I just have depression.”

A person should remind themselves of all the other aspects of themselves. They may also be a parent, sibling, friend, spouse, neighbor, and colleague. Each person has their own strengths, abilities, and positive qualities that make them who they are.

5. Recognize the importance of self-care

Self-care is essential for good physical and mental health. Self-care activities are any actions that help people look after their wellbeing.

Self-care means taking time to relax, recharge, and connect with the self and others. It also means saying no to others when overwhelmed and taking space to calm and soothe oneself.

Basic self-care activities include eating a healthful diet, engaging in creative activities, and taking a soothing bath. But any action that enhances mental, emotional, and physical health can be considered a self-care activity.

6. Breathe deeply and relax the muscles

woman deep breathing and meditating at work
Inhaling and exhaling slowly has psychological benefits.

Deep breathing techniques are an effective way to calm anxiety and soothe the body’s stress response. Slowly inhaling and exhaling has physical and psychological benefits, especially when done on a daily basis.

Anyone can practice deep breathing, whether in the car, at work, or in the grocery store. Plenty of smartphone apps offer guided deep breathing activities, and many are free to download.

Progressive muscle relaxation is another helpful tool for those experiencing depression and anxiety. It involves tensing and relaxing the muscles in the body to reduce stress. Again, many smartphone apps offer guided progressive muscle relaxation exercises.

We have reviewed some meditation apps that can help with depression and anxiety.

7. Challenge negative thoughts

Cognitive behavioral therapy (CBT) is an effective therapy for those with depression and other mood disorders. CBT proposes that a person’s thoughts, rather than their life situations, affect their mood.

CBT involves changing negative thoughts into more balanced ones to alter feelings and behaviors. A qualified therapist can offer CBT sessions, but it is also possible to challenge negative thoughts without seeing a therapist.

Firstly, notice how often negative thoughts arise and what these thoughts say. These may include “I am not good enough,” or “I am a failure.” Then, challenge those thoughts and replace them with more positive statements, such as “I did my best” and “I am enough.”

8. Practice mindfulness

Take some time every day to be mindful and appreciate the present moment. This may mean noticing the warmth of sunlight on the skin when walking to work, or the taste and texture of a crisp, sweet apple at lunchtime.

Mindfulness allows people to fully experience the moment they are in, not worrying about the future or dwelling on the past.

Research suggests that regular periods of mindfulness can reduce symptoms of depression and improve the negative responses that some people with chronic or recurrent depression have to low mood.

9. Make a bedtime routine

Sleep can have a huge impact on mood and mental health. A lack of sleep can contribute to symptoms of depression, and depression can interfere with sleep. To combat these effects, try to go to bed and get up at the same time each day, even at weekends.

Establish a nightly routine. Start winding down from 8 pm. Sip chamomile tea, read a book, or take a warm bath. Avoid screen time and caffeine. It may also be helpful to write in a journal before bed, especially for those whose racing thoughts keep them up.

10. Exercise

Exercise is extremely beneficial for people with depression. It releases chemicals called endorphins that improve mood. An analysis of 25 studies on exercise and depression reports that exercise has a “large and significant effect” on symptoms of depression.

11. Avoid alcohol

Alcohol is a depressant, and alcohol use can trigger episodes of depression or make existing episodes worse. Alcohol can also interact with some medications for depression and anxiety.

12. Record the positives

Often, depressive episodes can leave people focusing on the negatives and discounting the positives. To counteract this, keep a positivity journal or gratitude journal. This type of journal helps to build self-esteem.

Before bed, write down three good things from the day. Positives include regular meditation, going for a walk, eating a healthful meal, and so much more.

Asking for help

Mother and daughter chatting over coffee
Asking for help is an important step in dealing with a depressive episode.

Dealing with depression can be daunting, but no one has to do it alone. One of the most important steps in dealing with a depressive episode is asking for help.

Seek help from:

  • Family and friends. People experiencing depression should consider telling family and friends how they are feeling, and asking for support where they need it.
  • A doctor. It is essential to speak to a doctor who can make a diagnosis and recommend treatments. Research suggests that tailoring early treatment to the individual offers the best possible outcomes.
  • A therapist. Talking to a counselor or psychotherapist can be beneficial. Talk therapy can help address low moods and negative thoughts. A therapist can also teach coping skills to help people deal with future depressive episodes.
  • Support groups. Look for a local support group for people with depression. It can be beneficial to talk to others who are experiencing the same thing.

Support lines and crisis hotlines are another way that people with depression can reach out to others. Save important numbers to a cell phone, so they are easily accessible in times of need.

Helpful numbers in U.S. include:

Support groups and helplines similar to these are also available in other countries.


Types of depression

Major depressive disorder is the most common form of depression. Other types of depression have similar symptoms and can also cause depressive episodes. These include:

  • Persistent depressive disorder lasts for a minimum of 2 years. During this period, symptoms may vary in severity but are always present. Approximately 1.5 percent of adults in the U.S. may experience persistent depressive disorder in any one year.
  • Psychotic depression causes symptoms of psychosis as well as severe depression. A person may experience delusions and hallucinations. Approximately 4 in every 1,000 people may develop psychotic depression.
  • Bipolar disorder is a mood disorder similar to major depressive disorder. Someone with bipolar disorder may also experience periods of extreme highs, called mania or hypomania. According to the National Institute of Mental Health (NIMH), approximately 2.8 percent of adults in the U.S. might develop bipolar disorder each year.
  • Postpartum depression causes major depression symptoms during pregnancy or after delivery. This condition affects nearly 15 percent of new mothers and typically requires treatment.
  • Seasonal affective disorder (SAD) causes symptoms of depression during the winter months. According to the American Academy of Family Physicians, between 4 and 6 percent of people are estimated to have SAD, while another 10 to 20 percent have a milder form of the disorder.

Possible triggers

Depression is a complex condition with many possible causes. Even though a person may be more susceptible to depression than someone else, they usually only experience a depressive episode when a stressful event triggers the condition.

Possible triggers include:

  • changes in daily routines
  • disrupted sleep
  • poor eating habits
  • stress at work, home, or school
  • feeling isolated, alone, or unloved
  • living with abuse or mistreatment
  • medical problems, such as Alzheimer’s disease, stroke, or erectile dysfunction
  • some medications, including certain antibiotics and blood pressure drugs
  • a significant life event, such as a bereavement or divorce
  • a traumatic incident, such as a car accident or sexual assault

However, it is important to note that not every depressive episode will have an obvious or identifiable trigger.

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