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Catnapper

How long do you feel fragile after a depressive episode finally ends?

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I have just come out of a 3 year depressive episode that was tough at first and at the end was terrible - lost almost all functioning, couldn't think, couldn't work, overwhelming inertia and anhedonia, etc., etc. I've got a great pdoc that also does therapy and has hung in there with me the whole way, and I also started ECT this year, which really turned the tide for me. 

Despite feeling a million times better, I still feel really fragile mood-wise, like the least little bit of extra stress will send me back over the edge of the cliff. Now that my mood has improved, my pdoc and I have started working on my lifelong binge eating disorder during therapy, which is upsetting, and I told him after a particularly hard session that although I do want to get better, I don't feel comfortable staying at that intensity for long because my mood state still feels so tenuous. 

I feel like you do after getting over the flu - the fever has broken, but you're still in a weakened state and it wouldn't take much for you to land back in bed again. My typical cycle over my life (I'm 61) has been 2 - 3 years of progressively worsening depression, followed by 5 - 7 years of relative normalcy. This last episode was the worst ever and was so hard to get out of, and I'm so worried about fucking it up. 

Once you have recovered (or as good as it's going to get) after a depressive episode, when do you start to feel like your improved mood won't suddenly crash or at least start slipping down?

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Honestly, I’m always a bit afraid and I haven’t had a depressed time in ages—but I was depressed for years at a time, meds didn’t work, etc, so I truly fear being depressed again. Right now I’m stressed and feel hyper in part of my brain but also feel like some depressed type thoughts are encroaching. I’m probably not typical. I know it sounds odd to fear depression after a long good spell (with some manic times) but I do. I sometimes wonder if I could deal with it again. So I wonder if others feel more secure?  

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@sugarsugar No I totally identify with that. Whenever I have a bad day or rough situation i can feel the worry creep up in the back of my mind, despite not having a full blown depression in probably three years. However, we never really found a "depression killer" med or med strategy that works great... except for ketamine but for these purposes I don't think that really counts. So, there is a really high threshold of depressive symptoms that i often have to "deal with" before we attack it from the med angle. This means that while i may not be in a full episode, i am constantly being reminded that my depressive symptoms are hiding in a dark quarter of my mind and waiting to pounce. The big one is that my thoughts about suicide have never gone away for long, typically my mind at least gets a flash a few times a day. Now, these are typically morbid (thinking about ways that it could happen) and not full of intent, but still... not easy to just put depression out of my mind. That said, the longer I am stable the better i am, because it makes me realize that stability(ish) is actually possible, so (handy CBT here) if things go bad they will likely be manageable in the long run. I was basically unstable from 14 to 20 with a lot of rapid cycling that disappeared as i got older. Sooooo- after that dumb tangent, the answer to the op is: its been 3 years, and while I still am not secure, it gets better with every not bad day. 

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I'm glad to hear I'm not the only one. I haven't had much in the way of suicidal thoughts since things cleared up for me, but the other night I had this really intense flash of suicidal thoughts, nearly with intent. It was pretty scary. Luckily it only lasted for part of the evening, but still...  It felt like a door opened and when I looked out it was just infinite blackness, with no floor or porch or anything to stand on, like if you stepped out you'd just fall or get sucked into the darkness. I wonder if I'll ever reach the point where I don't feel like I'm always traversing a minefield in my head. 

Not to sound like a salesman, but ECT has really helped me, more than all the meds put together. I can't recommend it enough. Luckily I finished my index series (the initial treatment of twice a week for 12 or so treatments) right before the coronavirus shut everything down. I'm just starting maintenance, going once a month. 

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4 hours ago, Catnapper said:

I'm glad to hear I'm not the only one. I haven't had much in the way of suicidal thoughts since things cleared up for me, but the other night I had this really intense flash of suicidal thoughts, nearly with intent. It was pretty scary. Luckily it only lasted for part of the evening, but still...  It felt like a door opened and when I looked out it was just infinite blackness, with no floor or porch or anything to stand on, like if you stepped out you'd just fall or get sucked into the darkness. I wonder if I'll ever reach the point where I don't feel like I'm always traversing a minefield in my head. 

Not to sound like a salesman, but ECT has really helped me, more than all the meds put together. I can't recommend it enough. Luckily I finished my index series (the initial treatment of twice a week for 12 or so treatments) right before the coronavirus shut everything down. I'm just starting maintenance, going once a month. 

Sure I’ve said before, but so glad on ECT... cuz it’s so effective if u can tolerate it. Unfortunately, it wasn’t super friendly to me 

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Hmm, I must always assume a bad episode is lurking. My depression is both chronic and "episodic" though. So It never really "goes away." The waves just vary in intensity. I mainly get ultra-rapid cycling (but no mania, what fun). It's as if depression (the more moderate form) has just morphed into my personality or something. It's always there and I cannot separate myself from it.

My cycles are erratic (like I'm stable/normal for a month, then I have an intense 2 days where all I can do is avoid everything, cry & sleep because it completely consumes me). I'm self-aware of triggers and try to avoid them. It's like learning to ride the waves (Or tsunamis?) It requires radical self-acceptance and telling myself "this mood is temporary, before long, I'll be back above water again..."

Unfortunately, I've little to no tolerance for stress and frankly, I'm doubtful whether I can ever sustain a real full time job ever again with this disease. I must constantly treat myself with "kid gloves" and force daily self-care routines, and reach out to pdoc as preventative, because it's the only thing that keeps me above water. I can function highly for only so long, and then need long periods of rest. I never want to be hospitalized again. Mental illness is exhausting.

Edited by Blahblah

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4 hours ago, Blahblah said:

Mental illness is exhausting.

 

This times one million, this sums it up in a nutshell.

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THis is not a question that has a solid answer. So many factors go into it and it varies highly by person.

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I'm going to go with "it depends on the duration and severity of the episode." At this point I'm not sure I will ever stop feeling fragile. If I ever feel better to some extent, I don't expect it to last for more than a few months, and it is not without reason that I feel that way. At times in the past, I haven't felt fragile at all after a depressive episode.

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Ironically, the day after I started this thread, there was a crisis at work and I worked several late nights till 10 or midnight, and through most of Labor Day weekend, and I found out something yet again that I've known for years and years - I'm not Superwoman and I can no longer work crazy hours, or I get sick again. I finally got some rest this past weekend, but it's Monday night a week after Labor Day and I feel like shit and feel like my goddamn mood is slipping again. 

As much as I hate, hate, hate to admit it, I am fragile, and it fucking kills me! I am a woman in an almost completely male-dominated occupation, and have been since the seventies, so to show any weakness related to work is nearly impossible for me to acknowledge, even when it's slapping me up side my head. 

The only good thing to come out of my superhuman accomplishment is that after being put on probation and nearly losing my job in July, I got a lot of positive recognition at work for my over and above performance, so it's good to get my reputation back, which had tanked before I went out on medical leave due to the most recent and hellish depressive episode. 

Luckily I have my weekly pdoc appointment in two days (he does therapy also), and I will finally be able to return for the re-start of maintenance ECT in a week. So if I can hang in there a little while longer, I have the support that will get me through this, but I wish I didn't have to keep learning the lesson about working too much and mood crashes over and over and over again. 

I am so sick of this fucking disease!

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50 minutes ago, Catnapper said:

Ironically, the day after I started this thread, there was a crisis at work and I worked several late nights till 10 or midnight, and through most of Labor Day weekend, and I found out something yet again that I've known for years and years - I'm not Superwoman and I can no longer work crazy hours, or I get sick again. I finally got some rest this past weekend, but it's Monday night a week after Labor Day and I feel like shit and feel like my goddamn mood is slipping again. 

As much as I hate, hate, hate to admit it, I am fragile, and it fucking kills me! I am a woman in an almost completely male-dominated occupation, and have been since the seventies, so to show any weakness related to work is nearly impossible for me to acknowledge, even when it's slapping me up side my head. 

The only good thing to come out of my superhuman accomplishment is that after being put on probation and nearly losing my job in July, I got a lot of positive recognition at work for my over and above performance, so it's good to get my reputation back, which had tanked before I went out on medical leave due to the most recent and hellish depressive episode. 

Luckily I have my weekly pdoc appointment in two days (he does therapy also), and I will finally be able to return for the re-start of maintenance ECT in a week. So if I can hang in there a little while longer, I have the support that will get me through this, but I wish I didn't have to keep learning the lesson about working too much and mood crashes over and over and over again. 

I am so sick of this fucking disease!

It took me a really long time to strike a balance between feeling “lazy” for not doing things and being totally wiped out for overdoing it. Eventually I learned that it’s not “lazy” if it’s how u stay healthy, but that lesson took a real long time to set in 

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