What is a mental health relapse?

Depression is not so much something that can be cured, more something for which we have a variety of treatment options. It operates in cycles and phases, which are often unpredictable. It could be likened to a potential shadow, lurking ominously in the background, ready at any moment to descend.

We have all experienced periods of low mood or depression, which no matter their duration, can be difficult to manage, and bring forth painful and upsetting feelings and experiences. These episodes can leave us with an uncomfortable sense of unease, and the fear that the feelings may return. This says much about the link between relapse and anxiety.

In its most basic form, a relapse can be understood as a deterioration after a period of increased improvement. This often results in an increase of unhelpful thinking patterns or behaviours and difficulty in managing and taking on day to day activities. In moments of relapse, there are often triggers, a date such as an anniversary, a change of job or ending of relationship for example. All these can provide uncertainty, and lead to an increased sense of fragility in one's own mental states. These triggers can also be difficult to identify and occur outside of our conscious awareness. By increasing your own understanding of the things that can be detrimental to you during a period of depression, you may limit the risk of a relapse occurring.

Feeling that you have lost progress

A depression relapse can be incredibly damaging and difficult to tolerate and can lead us to feel as if the progress or changes we made prior to a relapse have been swept away. Regaining our momentum or equilibrium can feel very difficult, and it can be challenging to hold onto any sense of historic achievement.

In other words, there can be a removal of the past and the future, and the sense that only the present remains. Without a sense of knowing or feeling what may happen beyond the current difficult and painful feelings, can be a worrying and difficult experience. This experience speaks to the power of depression, and the hold it can have on us.

Stop blaming yourself

Being kinder to ourselves is never the easiest of tasks, and this challenge becomes more difficult during times of depression relapse. The internal persecutory voices we experience can become louder, more frequent and more damaging. These can be thought of as internal attacks on the self, and can be likened to a weakened immune system, more exposed and vulnerable to attack from infection. In our vulnerable moments, we can be more susceptible to latching on to this internal script and becoming entwined within it.

How to identify a relapse

A depression relapse will be different for us all and impact us in various ways depending on our personal experiences. However, there are some commonalities to look out for in identifying a relapse. The list below is not exhaustive and is intended to give an outline only.

• Altered patterns of sleep - having less sleep, waking up in the night or difficulties getting up in the morning or a lack of sleep entirely
• An increase in stress
• Finding yourself feeling more on edge, anxious or worried than before
• An increased persecutory internal voice
• A lessening of personal care - not showering, eating or looking after yourself
• A removal from social activities and a sense of needing to hide away
• Noticeable changes in your usual behaviour - a lack of libido, an increase of insecurity or self-doubt
• Problems with concentration, keeping focused or being active