Help a 22-year-old female deal with a relapse of her depression.

March 14, 2008 4:40 PM

I'm a 22-year-old female, dealing with a relapse of depression/almost-quarter-life crisis. I'm doing the therapy + medication thing, but what else I can do to help me get out of this rut? How do you deal with relapses of depression?

First of all: I have just started seeing a therapist + taking medication again.

I have been depressed on/off since I was 16 or so. I've been floating in and out of college since I graduated high-school. I was labeled a "gifted" kid & started taking college classes while I was in high-school. I did fine in my classes (3.4 GPA) but when it came time to graduate, I freaked out and didn't apply to any schools -- instead, I went to the local CC and got a decent job at a nearby university. After a time, I went to Portland for art school, where things seemed fine until I suffered a massive depression towards the end of 2005. I dropped two quarters worth of grades and ended up moving back to my hometown. (Also, I saw therapists in both my hometown and Portland, but December 2005 was the first time I had ever taken any anti-depressants. I stayed on them for 9 months.)

I'm at a point where I feel like I need to get my shit together and figure out what to do. I feel like I could do something great with my life if I could stop getting in my own way and let myself blossom. I am passionate about music -- I performed at SXSW a few years ago/had national radio airplay/etc. so I know I at least have some talent in that arena. Somehow I've managed to keep working on music and I almost have a whole record done. It seems I have a talent for photography but I am also interested in perhaps pursuing nursing as a career. I have plenty of general education credits and could easily transfer to a 4-year university somewhere, but I'm paralyzed with indecision over what to do/study. I have a great boyfriend who I've been dating for 5 months/friends with for 6 years, but lately I've been overwhelmingly numb to love/sex, hearing a horrible little voice in my head that's telling me he doesn't really love me, however irrational that may be. I currently live alone after having been in the company of roommates for sometime -- honestly, some days I feel so crappy I want to just move home and be around my mom and sister, who I am close to, although I'm not sure my mom would be particularly open to that.

I suppose when I first started going to therapy/taking medication, I naively thought it would be a 9-month gig and I would be good to go. And really, I felt a lot better/had integrated exercise into my life, etc. But it's come creeping back. I'm doing the therapy and medication thing, and I plan to stick with this therapist for a long while, but what else I can do to help me get out of this rut? How do you deal with relapses of depression? How can I help my family help me?

I am appreciative for any advice/anecdotes you can offer. Please spare me the snark because right now I am one delicate flower. E-mail is: [e-mail]

posted by anonymous to Health & Fitness (19 answers total)

Don't let yourself hole up alone at home. Build your life around this imperative.

1. Get a housemate. (Probably best if this is not your bf right now.)

2. Get a job that requires you to be at a specific place at a specific time everyday, and that has you working with people, not alone. This job should be something you can do with reasonable competence, about which you don't feel tons of anxiety -- work in a bookstore, teach music to kids, etc. It should NOT be working-for-yourself, or working-from-home, organize-you-own-time.

3. Get an exercise buddy who you will meet three times a week for some form of exercise. Can be low-key.

Don't worry about school now. Don't worry about wasted potential or anything like that. Give it 6 months or a year, and then re-evaluate. School will be there. Depression is common at this age, and especially in the unstructured environment of colleges -- for this reason, don't be afraid to wait a little while before going back. You'll make a lot more out of your time in school if you aren't depressed.
posted by LobsterMitten at 5:51 PM on March 14, 2008

1). Are you in a healthy, stable, loving relationship? If yes, good. If no, being in one has helped me through many dark times.

2). What do you LOVE to do most and makes you happiest? If you can answer this question, then do that as much as possible and commit as much of your time and resources as you can to it.

3). If you're up for it, and this is a really hard one to do, liquidate your material possessions as much as possible and live off of the bare bones of what you need to survive. Move to a cheaper place, get rid of all but the basic entertainment (internet is good), sell your TV/VCR/DVD player/stereo/game systems and download stuff and/or read. I've often been happiest when I've had nothing but books and access to the internet for amusement.

4). Learn to meditate/take yoga/study Buddhism (or another relaxing religion)/relax. Lots of depression is caused by stress which is often caused by an inability to relax.

These things have worked for me in the past and kept me from revisiting therapy, but YMMV.
posted by ChazB at 6:00 PM on March 14, 2008

LobsterMitten's advice is excellent. Try to get a roommate if possible... when you're alone it's much easier for things to get worse. Even if it isn't someone you are close with, just having someone there to talk to can help tremendously.

The busier you are, the better, in my experience. Structured time is your friend. In addition to a structured (non work-at-home) job, maybe you could try to find some volunteer work (maybe something related to nursing?) to pass the time. If you feel like you are doing something valuable, it's harder to slip back into the ruts of depression.

I went through a couple of severe bouts of depression in college, and these helped me a lot. Especially getting roommates... having regular, constant contact with people was one of the best things to help me get better.

Best of luck.
posted by stilly at 6:02 PM on March 14, 2008

You sound quite similar to me. 22 year old, floating in and out of community college, in a rut, dealing with relapses of depression. While I can't give you a silver bullet obviously, there are a number of strategies I have learned to, if not deal with depression, then at least mitigate it.

1) Write. Pick up a pen and start writing, even if it's just "This is stupid," or "I feel bad." Keep going. Lay out your thoughts, your fears, your anger, etc on paper. I started doing this, and when I would read these rants later, especially if I was happy that day, I would realize the uselessness of these thoughts. Later, when I felt depressed and dead again, I would remember what it felt like to read these thoughts in a happy state. Remembering that would have the effect of distracting that annoying voice in my head just long enough to do something from the list that I describe in #2.

2) Make a list of things that take a little effort, but are good for you. Such as, go for a 5 minute walk, or pick up a couple of pieces of clutter or trash in your house. Try to make them as low-effort while still making a difference as you can. Make sure you list them out on paper, so that it takes that much less effort out of the idea of getting up out of bed and doing something. When you feel up to it, try to do one of these. For me, this has the effect of distracting me from my thoughts, and sometimes I even feel like continuing to clean or walk. It's not foolproof, but my whole day has been turned around after doing something on my list. Also, try to write on the list that if you don't do these things, there's no reason to feel guilty.

3) Tell yourself that you have permission to be depressed and numb. Do things anyway. Yeah, I know what it sounds like to tell someone who is depressed to "do things anyway," it doesn't work like that, right? Well, it has for me a couple times. Not always, I admit.

When I start to feel happy again, I always kinda think in the back of my mind that I've conquered depression, as much as I don't want to entertain that thought because it's unrealistic. When I start feeling depressed again, the mere thought that I haven't seen the end of depression makes me more depressed. I sit there staring off into space, thinking a familiar chain of thoughts, one leading to the next, leading finally to "Will I never be rid of this depression? How can I ever get my life together if this is all I have to look forward to?" Usually, this would send me right back around to "Who can I blame for this depression?" which of course makes things worse, but one time, I was staring into space and looked down at a tissue on the ground. At first, I thought, "I'll never feel happy enough to feel up to cleaning this room." Then I realized, well, I could pick up that tissue right now, couldn't I? So I did. And it didn't make me feel any happier, but I saw the tissue in the trash can and realized that despite my depression, I had effected a change in my surroundings, however minor.

The key was inserting the urge to pick up that tissue at the right place in my weary chain of thoughts. If I had thought that at a different moment, I would not have done anything about it. There are certain moments that you can seize, even when you are depressed. Be mindful of, well, your mind. You are something separate from all of your thoughts, even when you're depressed, you are not your depressed thoughts. Try to harness your thoughts to do what you want.


I am not a psychologist, and I may quite possibly have just embarassed myself in front of everyone here, but there it is. This is what helps me. I hope it helps you, even a little bit. Be kind to yourself, and I wish you the best.
posted by malapropist at 6:19 PM on March 14, 2008 [9 favorites]

Step 1. Consider not taking any mood medication. Instead, perhaps you should try calming yourself down and taking a bit of good old fashioned advice. You're only young; you've got plenty of time to find direction in your life. You are in this world to learn, so your first step is to thank Providence that you can feel, that you're a sensitive person and you're aware that something isn't quite right, unlike most of the mindless rat-racers who go about their unfulfilling drudgery they call a life and only realize something is wrong at the mid-life crisis. You're a quarter-century ahead of the curve! But you mustn’t dull your senses with any funny pills designed to make you think everything’s OK when it’s not.

Step 2. Read Robinson Crusoe. You should learn to count your blessings from this book. List them. Meditate on them. They will breathe life back into you. If you focus on what you lack, you'll be miserable, but if you focus on what you have, you'll see that you are rich beyond measure. You should begin to see that less material wealth is actually potentially more spiritually wealth, in that it creates less distraction from your mission on this planet. All too often, pride closes our spiritual eye and inhibits our growth. Thank your guardian angel for protecting you from the dangers of pride.

Step 3. Pray for help. You can learn a little from any organized religion, but your spiritual growth and the keys to your enlightenment, or nirvana, or heaven, or whatever you want to call it will lie in your own communication with your conscience, which is that little spark of divinity within you. Some people call this type of communication prayer; you can call it whatever you want. Just don't let a bad experience with religion prevent you from taking important lessons away from the experience. Prayer is your most powerful tool. "Seek and you shall find, ask and you shall receive, knock and the door shall be opened to you." You asked for help, and I hope you'll agree that through this message part of your request has been provided for. Keep asking, and open your eyes to the guidance that will come to you, in a variety of forms. Most of all don't make the mistake of worrying about the technicalities of, and distinctions between, the religions, just try to find the essence of the lessons, and move on.

Step 4. Watch The Count of Monte Cristo. Would the Count's victories have been as sweet if his unjust punishment hadn't been so miserable? Would he have been motivated to do anything at all with his life? The more you overcome in life, the sweeter your victory. Because you will have learned so much through your troubles, you will rise to the occasion when it’s time for you to become victorious. Don't doubt it, and don't even think about the nature of your victory, or about how others will perceive it. It is between you and your God. Don't worry about the things you don't know right now, nor the things you don't have. You have more than enough. You will learn so much, and you will see through the grand illusion to such a degree that later on your life you will pray for misery and get only bliss. There will come a day when you will beg for your death, for your reunion with your Creator, and yet your cup will overflow with material wealth, and you will hardly notice, and you will be blessed beyond your wildest dreams. It's ironic, but true, that "whosoever seeks to save their lives will lose it, and whosoever seeks to give their life will save it." The truth of that statement lies in that fact that you are not truly living until you no longer fear death, but rather relish the thought of it. Which brings me to the next step:

Step 5. Read Harry Potter: The Deathly Hallows. You have but one thing to do in this life: die. And I don't mean by taking your own life. Suicide is out of the question, since it is the ultimate arrogance. You must accept a certain degree of uncertainty and allow yourself to be trained by your God. So you will learn not to force things, like your own death, for instance. From the Deathly Hallows you should learn to choose something worth dying for, and get busy spending your life for whatever it is. You will recognize your true calling in time, but in the mean time, you must simply learn to follow your conscience, or your gut, and let it be your guide. If you pray for the certainty of knowing what your gut tells you, you will learn to decipher your own feelings.

If the idea that life is precious, that it is something to be safeguarded and preserved, prevents you from spending your life (with emphasis on the word "spending"), then you must rid yourself of that thought. All these people around us, all these petrified people, keeping things safe, collecting objects, all these pointless items, keeping themselves out of places they perceive to be unsafe or infested to protect their health, these people are all time-bombs. When they start to wrinkle and get old, they will be so unprepared for the thought of aging that misery and shock will subsume them, and they will find themselves in their own well-guarded, private hell on earth. You won't let that happen to you because you will have spent years anticipating your death, and you will have found something fulfilling to SPEND your life doing.

Step 6. Don't rush into your decision, but rather, meditate on the following analogy after you've gotten yourself out of your depression. Imagine that the entire world can be compared to a dinner table, where people gather to eat their meals. The people seated at our dinner table represent all human beings. Imagine each person has a 6 foot long knife attached to their right hand and six foot long fork attached to their left. A delicious meal is laid before them, and while their oversized utensils are useless for feeding themselves, they are unable to set them down and eat with their hands. Some try ricocheting food off the walls and ceiling, most of which goes to waste. Others put their faces directly into their plates, humiliating themselves, and even these people are not able to tear meat from bone with their teeth. At this dinner table, no one is fully satisfied.

In an adjacent room, under the same conditions, the bemused guests laugh hysterically at their predicament and see all sorts of possibilities. They can easily feed everyone else at the table with their prodigious utensils, and derive great pleasure from procuring the perfect bites for their companions and seeing the look of pleasure on their faces when they've provided just the right combination to suit the taste of the neighbor they are feeding. Everyone is satisfied, and the strange situation actually yields a stronger bond between the guests.

Like the guests at the tables in the above examples, no man is an island unto himself. He must rely on his neighbors to feed him, and when he realizes this, man's experience is more fulfilling than it would have otherwise been. So our curse is actually our blessing, if we would just open our eyes to the facts. Be blessed!, email me at [e-mail]
posted by tosteka at 7:20 PM on March 14, 2008 [7 favorites]

Bicycle a good amount in the nice weather and just a little in the bad. Serious.
posted by Rafaelloello at 8:03 PM on March 14, 2008

Both my daughter and I share some of your symptoms and what works for us is getting some exercise, preferably outside. She runs, I bike.

Just talked to her on the phone and I was glad to hear how up she was feeling. I then realized she's 5 days into getting back to her running schedule, after an injury. A week ago she was scattered and unhappy, didn't know where to get started on things - which is how I've been all day, so tomorrow, I will get back on my schedule of biking.

I've learned when you are stressed or anxious, routine is important. Try to sleep and eat at the same time each day. I also agree being with people is very important. It's trite, but laughter is the best medicine.

Nursing can be a great career - it will provide decent pay for part-time work that will allow you time to pursue your art, if you feel the need to have something to fall back on.

Best of luck, with the music, photography and life.
posted by readery at 8:07 PM on March 14, 2008

1. strongly agree with the exercising part. could be a really effective mood lifter.

2. heard from somewhere that sleep deprivation could be a temp but amazingly effective cure for depression. could try once to see?

3. did you try the book "Feeling Good: The New Mood Therapy"? to sum the book up, you need to vigorously rebut IN WRITING EVERY SINGLE negative idea / thought in your mind. find a note book, write down your negative thought on the left side, then start attacking it from every angel you can think of. keep the note book handy, do this exercise whenever and wherever.
posted by kingfish at 8:09 PM on March 14, 2008 [1 favorite]

Nursing is a very stressful career. Every move you make on the job is probably regulated by some agency. There are mountains of records to keep. Many of your co-workers will be 'burnouts' and unpleasant to deal with. You are exposed to other people's body fluids. You have to work odd shifts, weekends and holidays, and the pay is not that great.

That said, it's very rewarding in many ways, too. When I start to get depressed, it's real easy for me to find people much worse off to whom I can compare myself and see that I'm really doing better than I was thinking. I usually get a lift of spirits when people express their gratitude for whatever I might have done for them, which is often as simple as just "being nice". And I think it's good for my self-esteem to know that I have the knowledge and skills to assist others through their stressful times.

Your local CC might offer an Associate Degree in Nursing which would be the quickest way to the jobforce. Plenty of opportunity- there's a huge national shortage of nurses these days.
posted by dkippe at 8:33 PM on March 14, 2008

Really seconding exercise and maintaining human contact. Eat well. Get out of the house every day, even if you just go down to the corner store or something. Take care of yourself.

kingfish: being short on sleep can make many people slightly manic and, AIUI, can briefly alleviate depression— but it's not something you can really use as an ongoing treatment.
posted by hattifattener at 8:33 PM on March 14, 2008

I have four words for you:

Dance Dance Party Party. If there is not one in your town, start one with a friend.

I'm serious. I've been battling bouts of depression that have been pretty miserable lately. I went to this on Sunday, and for the first time, I felt my spirits completely lifted. Exercise definitely helps, but this was really something special. It was like being 8 years old and not caring. Seeing my friend dancing her little heart out in the corner while I did the same was pretty awesome, too. I highly recommend it.
posted by pazazygeek at 9:34 PM on March 14, 2008

Excellent advice already given, but I wanted to add one thing. DUMP the label of being a capital "D" depressive. While you may suffer from depression at times, don't let that define who you are as a human being.
posted by LiveLurker at 9:54 PM on March 14, 2008 [1 favorite]

1). Are you in a healthy, stable, loving relationship? If yes, good. If no, being in one has helped me through many dark times.

Being in a stable relationship is good; being able to sustain and love yourself is better. When you are depressed you want a network of friends, not just the one partner. I'm not dissing on relationships -- I'm in one now -- but if you're depressed now is not the time.

These are things I have found really lift me up when I was feeling down:

• Scheduled fun/play Every Tuesday there was karaoke. And every Tuesday, almost no matter what, I would go and sing my little heart out. You can really bond with strangers in this environment, meet new friends, and its karaoke so unlike other endeavors the pressure to be "good" is lower.
• Nthing excercise Gym stuff never worked for me so I started taking Wushu classes. They were great. I was able to learn moves, which distracted me from the world around me for a while. I find if I'm doing something like using a stairmaster clone or an exercise bike all I can do is let my mind wander, which is sometihng you don't want to do too much of right now.
• Focus your intent on self-nurturing This is different than being self-centered or ignoring the needs of others. It simplly means ensuring that your needs- physical, emotional, mental, and spiritual -- are being fulfilled before you try to give of yourself to others.
• Do something meaningful This doesn't have to be something amazing, profound, or something that touches hundreds of people. It just needs to be something you care about, that you can devote some time to, and that you find some purpose in. I volunteered at my local community theater to do some tech work from time to time. I enjoyed it, it gave me something to focus on (again) and people really appreciated the help. Not to sound like a approval whore or anything, but sometimes it is really wonderful to hear "What you are doing is very helpful. Your contributions to this process really are appreciated." ... in other words, "What you do matters". I know this might seem a bit contradictory to the previous point -- giving your time to others when you are an emotional wreck -- but this is the point: I never felt drained from my volunteer work at the community theater. It was occasionally very physical work but it left a nice soreness in my muscles without any of the anxiety or stress of other far less physically demanding activites.

posted by Deathalicious at 10:44 PM on March 14, 2008 [2 favorites]

Was the depression relapse caused due to your maybe going off your meds? If that may have been a reason, try not to talk yourself out of taking your medication, no matter how long its been and how good you may think you feel now that you've been regularly taking them for 9 months. (If you do feel like going off them, best to consult your doctor, before you take any steps, and don't go off them cold turkey, as was brought to my attention this week by a friend, after I'd stopped taking my meds, and had a relapse.)

Other than that, there's a lot of good advice here, which I can use myself, so good luck to you, and I hope you kick this thing real soon.
posted by hadjiboy at 11:52 PM on March 14, 2008

Change is the key, it always perks me up. Put yourself in a situation where everything and even everybody is new to you. See it as a fresh start via which you can really reflect your best qualities onto the new world that is reflecting back onto you. Pay attention to the way people treat you and take note of the positive things they say. I tend to believe that 90% of self image is that which others project onto you. Believe your own hype.
posted by 0bvious at 3:02 AM on March 15, 2008

This is all from Ms. Vegetable, who is a 23-year-old female who suffers from depression on and off.

- Are you seeing a psychiatrist or a therapist? A therapist is awesome for talking to (my primary defense against depression), but a psychiatrist is specifically trained to deal with relapsing depression.
- I highly do NOT recommend options suggested by tosteka. Those things always just made me angry and feel more depressed (especially anything related to religion), rather than better.
- Hiking. Nature makes me better. Or mountain biking. Or tubing. Or canoeing.
- Group exercise classes. Especially ones for newbies. You might make a friend, and it's always fun to be a doofus with other people.
- Fancy coffee and people watching. I've wanted to work at a coffeeshop for a LONG time, and when Mr. Robot finally finishes school and gets a job, I'm going to.
- Scheduled dates with my sisters. Tea parties, manicures, and goofing around.
- Fun bubble baths. Think Lush (bath bombs, bubble bars, bath melts).
- My adopted adorable cat.
- My brother (who also suffers from depression) suggests a Wii.
- Books by Sophie Kinsella. Hilarious.
- For a while I was keeping a journal, and every night I would write down four things: something I learned that day, some new place I went, something that made me smile, and something new I saw (like shoe observations - I was living in Europe at the time). Coming up with those was fun.
- Schedule parties. Game nights (taboo, balderdash, scattergories). Make them potluck. This forces you to clean and have relatively cheap social time. And you can show off the one dish you know how to make (for me, homemade pizza).

Good luck!
posted by a robot made out of meat at 7:16 AM on March 15, 2008 [2 favorites]

I concur with readery and a robot made out of meat. Exercise is one of the best natural medicines for depression. Here's why.

I'm normally a very active runner and while living abroad for almost a year, I couldn't get to it. I gave myself various excuses: the traffic was too dangerous, the men were too dangerous, the sun was too hot, blah blah. Because of other extraneous reasons, I fell into a pretty dark state of depression and it was very tough to handle. Friends encouraged me to get back into running or at least swimming and I was pretty unsure that it could work. While it didn't cure the whole thing, it made it a lot more manageable. When I don't exercise, I feel like crap, I get tired more easily, and I get down on myself much quicker. This is just one tool to combat depression, but good luck!
posted by cachondeo45 at 8:01 AM on March 15, 2008

i have a family history of depression. it's been tough to deal with. the biggest thing that has helped me out of it and on to normalcy is music. for me it's been sitting by a lake near my house playing guitar. or thinking up a song. it also has helped me not to be in my house or in places that make me feel more down. so maybe try to get outside.....take in some fresh air......listen to music.......go be by some water.....ya know, stuff like that. hope that helps.

Loco
posted by locoindio at 11:10 AM on March 15, 2008

Malapropist and Deathalicious both have excellent advice. Although contray to Malapropist, I don't think you may have just embarrassed yourself. You took a very big risk opening yourself up to the criticism of strangers, and I for one respect the hell out of that.

Pay no attention to the man behind the curtain, who actually thinks you should go off your meds, read classic novels and get saved so that Jesus can heal you (nice try, Tosteka, I was an evangelical charismatic christian; I know the lingo).

Love is the gift you give yourself, and the only god that can save you is You.



Best of luck.
posted by mynameismandab at 11:17 AM on March 15, 2008 [1 favorite]