My name is Jais Abraham and I am a Registered Counselling Therapist and a Certified Canadian Counsellor. I help adults who are struggling with anxiety, depression, stress, grief, emotion regulation problems, trauma, attachment issues and self- esteem issues.My goal is to provide safe and empathetic counselling services for adults struggling each day with these problems.
By Amy Smith
After experiencing depression once, it can be worrying to feel the symptoms creeping in again. But how common is depression relapse and what are the warning signs? Noticing the red flags early is often the key to preventing a full-blown episode from developing.
Depression is a mental health disorder with a high rate of relapse. About half of the people who experience an episode of depression for the first time will remain well. For the other half, depression can return one or more times throughout their lives.
For those people who do experience repeat episodes of depression, the warning signs may be different each time.
In this article, we list key signals of a depression relapse, its possible triggers, and ways people can prevent, treat, and cope with this condition.
Contents of this article:
- What is a depression relapse?
- 12 early signs of a depression relapse
- Possible relapse triggers
- Tips for preventing a relapse
- Treating and coping with a relapse
- Depression can come back weeks, months, or even years after a first episode.
- Depressive episodes may return in over 50 percent of people diagnosed with depression.
- Depression is most likely to return within 3 years after a first episode.
- Researchers are still figuring out why some people relapse, but others do not.
What is a depression relapse?
Sadness or a loss of interest in everyday activities can be a perfectly normal part of life. But if these feelings continue almost daily for more than 2 weeks, and if they begin to affect work or social life, then this may be depression.
According to the National Alliance on Mental Illness (NAMI), depression affects around 7 percent of adults in the United States every year.
After the first episode of depression, the American Psychiatric Association’s (APA) practice guidelines say that depression can return in two ways.
“Depression relapse” happens when a person slides back into depression during recovery from an earlier episode. Relapse is most likely to occur within 2 months of stopping treatment for a previous episode.
“Depression recurrence” happens when symptoms return months or years after a person has recovered from the last episode. This is most common within the first 6 months. Around 20 percent of people will experience a recurrence, but this can rise when depression is very severe.
After a person’s first episode of depression has ended, the APA estimate that between 50 and 85 percent of people will have at least one more episode of depression in their lifetimes. After two or three earlier episodes, the chances of depression returning are much higher.
Some depression-like disorders will frequently return and are usually identifiable by their name. These conditions include seasonal affective disorder (SAD), which comes back during winter months, and premenstrual dysphoric syndrome (PDS), which is a severe form of premenstrual syndrome.
12 early signs of a depression relapse
A person can often recognize the same warning signs of depression from their previous episodes. The symptoms of a new episode can also be different, however, so it pays to look out for all possible warning signs each time.
Here are some key warning signs of depression:
- Depressed mood: Feeling sad, empty, or hopeless.
- Loss of interest in things usually enjoyed: Taking less pleasure from hobbies, reduced interest in sex.
- Social withdrawal: Avoiding social situations, losing touch with friends.
- Fatigue: Daily tasks may feel more difficult and take longer, such as washing up and dressing in the morning.
- Feeling agitated: Restlessness, pacing.
- Changes in sleep patterns: Insomnia or excessive sleeping.
- Changes in appetite: Loss of appetite or an increased appetite.
- Increased irritability: Getting annoyed more easily than usual.
- Feelings of worthlessness and guilt: Thinking over past events.
- Concentration and memory problems: Thoughts and speech may feel slower.
- Physical aches and pains: Unexplained headaches, stomach aches, or muscle pain.
- Suicidal thoughts or suicide attempts: This may signal a severe depressive episode.
Five ways to cope with PTSD
How can you cope with PTSD symptoms? We look at five possible strategies.
Post-traumatic stress disorder (PTSD) is best known as the condition that affects people who have served in the military, and who are therefore most likely to have witnessed a disturbing event on the battlefield.
Yet developing PTSD can be a natural response to any number of distressing experiences, such as sexual abuse, physical assault, accidents, or any type of violence.
Symptoms of PTSD include a heightened state of anxiety — especially accompanied by persistent flashbacks of the traumatic event — sleeplessness, moodiness, and avoidance of places or social situations that might trigger flashbacks.
According to the Anxiety and Depression Association of America (ADAA), 7.7 million adults in the United States live with PTSD, though women are twice as likely as men to develop this condition.
PTSD can last for years, and its symptoms can severely impact overall quality of life. That being the case, it can sometimes be tempting to apply negative coping strategies to deal with symptoms of PTSD.
Negative coping strategies may seem helpful on the spur of the moment, yet they can easily turn self-destructive in the long-term. These can include resorting to alcohol or recreational drugs to numb your feelings, decrease stress, or quieten your thoughts.
Alcohol and other substances may take the edge off to begin with but can cause addiction if used as a substitute for a proper treatment, such as cognitive behavioral therapy (CBT), which has been recognized as a “safe and effective intervention” for this disorder.
So what are some things you can do, in addition to CBT and any other treatments recommended by your doctor, in order to keep your PTSD symptoms under control? Here are a few approaches you may want to consider.
1. Mindfulness meditation
Increasingly, meditation and mindfulness-based relaxation techniques have been shown to help manage a range of disorders.
A review of mindfulness-based treatments for PTSD points to a few therapies that have been found effective in reducing avoidance and self-blame in people diagnosed with the disorder. These are:
- mindfulness-based stress reduction(MBSR), which is an intensive 8-week program focused on the practice of mindfulness meditation that aims to train people to focus their attention on their breath and learn to avoid getting carried away by intrusive thoughts
- mindfulness-based cognitive therapy (MBCT), defined as “an adaptation of MBSR,” has a very similar structure but is designed to target depressive moods and negative thoughts, more specifically
- mindfulness-based exposure therapy, which includes a 16-week non-trauma-focused programthat incorporates MBCT techniques and favors safe and controlled exposure to avoided stimuli, focusing on self-compassion training
- meditation-relaxation, such as loving-kindness meditation, was also deemed effective in increasing self-compassion and reducing depressive symptoms related to PTSD
- mantrum repetition practice, which refers to “the silent repeating of a sacred word or phrase,” appears to be effective in targeting anger, hyperarousal, or the state of being constantly on guard, and symptoms of anxiety and depression
2. Regain focus through physical activity
Many people who have been diagnosed with PTSD say that finding an enjoyable physical activity that they can perform regularly has helped them to reduce their levels of stress and cope with their symptoms.
Rebecca Thorne, who was diagnosed with PTSD following childhood trauma, explains how runninghas helped her to cope with the symptoms that were impacting her life.
“I am a runner – and I suffer from [PTSD],” she says. “One of the many things I think about while I’m running, and also when I’m not, is the relationship between the two.”
“I embrace running in all weathers […], always with a considerable amount of ascent. As I fight my way up the climbs, I often imagine that the hill is my illness and I am going to slowly and steadily conquer it. Yet it never feels like suffering and, once at the top of the hill, I can reach out and touch the sky.”
Researchers from Anglia Ruskin University in Cambridge in the United Kingdom found that surfingcan be an effective coping strategy for war veterans diagnosed with PTSD.
According to the team, this sport helps veterans to attain a focused mind state known as “flow,” in which they are so absorbed in the activity they are performing that all other thoughts and emotions are pushed aside.
Dr. Nick Caddick, who was involved with the study, compares this with the effects of mindfulness meditation, just that it is more active. He calls it “a moving form of mindfulness.”
Medical News Today also reported on a study that suggested that Tai chi — a form of martial arts — can help war veterans to manage their PTSD symptoms.
Know the Symptoms and Treatment for Bipolar II Disorder and how is it different from Bipolar Disorder
By Jenna Fletcher
Bipolar II disorder is a form of this disorder characterized by cycles of depressive episodes followed by hypomanic periods. Hypomania is a period of mood and behavior that is elevated above normal behavior. It is not as extreme as a manic period.
Contents of this article:
- How does bipolar II disorder differ from bipolar I disorder?
The main difference between bipolar I disorder and bipolar II disorder has to do with the intensity of the manic period.
Bipolar I disorder is characterized by at least one episode of mania before or after a hypomanic or major depressive episode. Sometimes, the manic episodes that occur in bipolar I disorder may trigger a psychotic episode where the person disassociates from reality.
People with bipolar II disorder do not experience true manic episodes, where their mood and energy levels are so high that it causes trouble with work and socializing and may cause psychosis. Some individuals with bipolar I disorder have to be hospitalized during periods of mania.
However, this does not make bipolar II disorder less severe than bipolar I disorder. In bipolar II disorder, the depressive episodes are similar to those in bipolar I disorder and cause significant disruption to the person’s daily life for an extended time.
Symptoms of bipolar II disorder include periods of hypomania followed by depressive episodes.
While it can be normal for people to experience periods of feeling upbeat followed by periods of sadness, in people with bipolar disorder, these swings are more extreme.
People experiencing hypomania may notice a combination of the following symptoms:
- an increase in energy or feeling more agitated
- feeling more upbeat or wired
- increased self-confidence
- decreased need or inability to sleep
- racing thoughts
- talking too fast or talking much more than normal
- a tendency towards reckless behavior, such as spending too much, drinking or using drugs, or risk taking
- impaired decision making
For these periods to be classified as true hypomanic episodes, they must last for at least 4 days and have at least three of the above symptoms.
People experiencing hypomania may feel very good during these periods, and may not know anything is wrong. However, loved ones watching a person with bipolar II disorder will notice abnormal changes in behavior during hypomanic episodes.
When people with bipolar II disorder are not in a hypomanic state, they may be in a major depressive state. Symptoms of major depressive episodes include the following:
- feelings of sadness, emptiness, or hopelessness
- loss of interest in activities
- inability to sleep or sleeping too much
- decreased energy
- feelings of worthlessness and guilt
- trouble concentrating or focusing
- weight gain or weight loss without dieting
- suicidal thoughts or tendencies
Other signs and symptoms of bipolar II disorder may occur during both periods of hypomania and major depressive episodes. These may include the following:
- rapid cycling between states
There are no known risk factors for bipolar II disorders, although some studies suggest there may be a genetic component.
Anxiety: Causes, Symptoms and Treatments
Anxiety is a general term for several disorders that cause nervousness, fear, apprehension, and worrying.
These disorders affect how we feel and behave, and they can manifest real physical symptoms. Mild anxiety is vague and unsettling, while severe anxiety can be extremely debilitating, having a serious impact on daily life.
People often experience a general state of worry or fear before confronting something challenging such as a test, examination, recital, or interview. These feelings are easily justified and considered normal. Anxiety is considered a problem when symptoms interfere with a person’s ability to sleep or otherwise function. Generally speaking, anxiety occurs when a reaction is out of proportion with what might be normally expected in a situation.
Anxiety disorders can be classified into several more specific types. The most common are briefly described below.
Generalized Anxiety Disorder (GAD)
Generalized Anxiety Disorder (GAD) is a chronic disorder characterized by excessive, long-lasting anxiety and worry about nonspecific life events, objects, and situations.
GAD sufferers often feel afraid and worry about health, money, family, work, or school, but they have trouble both identifying the specific fear and controlling the worries. Their fear is usually unrealistic or out of proportion with what may be expected in their situation. Sufferers expect failure and disaster to the point that it interferes with daily functions like work, school, social activities, and relationships.
In this short video from The Psych Network, Dr. Sylvia Gearing discusses Generalized Anxiety Disorder and how it affects sufferers.
Panic Disorder is a type of anxiety characterized by brief or sudden attacks of intense terror and apprehension that leads to shaking, confusion, dizziness, nausea, and difficulty breathing. Panic attacks tend to arise abruptly and peak after 10 minutes, but they then may last for hours. Panic disorders usually occur after frightening experiences or prolonged stress, but they can be spontaneous as well.
A panic attack may lead an individual to be acutely aware of any change in normal body function, interpreting it as a life threatening illness – hypervigiliance followed by hypochondriasis. In addition, panic attacks lead a sufferer to expect future attacks, which may cause drastic behavioral changes in order to avoid these attacks.
A Phobia is an irrational fear and avoidance of an object or situation. Phobias are different from generalized anxiety disorders because a phobia has a fear response identified with a specific cause. The fear may be acknowledged as irrational or unnecessary, but the person is still unable to control the anxiety that results. Stimuli for phobia may be as varied as situations, animals, or everyday objects. For example, agoraphobia occurs when one avoids a place or situation to avoid an anxiety or panic attack. Agoraphobics will situate themselves so that escape will not be difficult or embarrassing, and they will change their behavior to reduce anxiety about being able to escape.
In this short video from HealthGuru, Dr. J. Clive Spiegel M.D. talks about the difference between fear and phobia.
Social Anxiety Disorder
Social Anxiety Disorder is a type of social phobia characterized by a fear of being negatively judged by others or a fear of public embarrassment due to impulsive actions. This includes feelings such as stage fright, a fear of intimacy, and a fear of humiliation. This disorder can cause people to avoid public situations and human contact to the point that normal life is rendered impossible.
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Veteran Professional Scott Anstadt Opens Online Therapy Clinic
Press Release: FORT MYERS, Fla. – June 13, 2017 — Scott has taught graduate students full time for over 10 years in clinical and community intervention skills. He offers some unique opportunities for subscribers through the flexible use of social media and internet based communications during the counseling process,
Areas of expertise address mood and sleep disorders and how a balanced lifestyle of purpose and personal fulfillment can reduce stress and its harmful effects. During counseling, Scott uses a number of evidenced based methods to help reduce self defeating patterns of communication and interaction. In turn, the clients build a practical and balanced lifestyle drawing from an inner sense of knowing about their inherent worth as unique individuals. To help integrate new and positive pathways of thinking about oneself in relation to those closest, people draw upon some of the latest findings on nuerology and cognition and make them practical and understandable. This relates to transitions and life changes of all kinds including family changes and adjustment to aging.
Diabetes and mood swings: Effects on relationships
Written by Rachel Nall, RN, BSN, CCRN
Diabetes is a condition that impacts the way a person’s body uses sugar for energy. However, diabetes affects much more than blood sugar. It can impact nearly every body system and have an effect on a person’s mood.
Stress associated with managing diabetes as well as concerns about potential side effects can all contribute to changes in mood. In addition, the actual highs and lows of blood sugar levels may also cause nervousness, anxiety, and confusion.
It is important for people to recognize their own individual symptoms of high or low blood sugar. They must also ensure they seek support for any concerning mental health symptoms they might experience.
Watching these mood swings can often be difficult for friends and family to understand. However, learning why a person may experience mood changes related to diabetes and being supportive can help to promote a stronger, healthier relationship.
Contents of this article:
How do diabetes and mood swings go together?
Adjustments to their diet and constantly checking their blood sugar can also add to a person’s stress and enjoyment of life. As a result, they are more likely to experience feelings of anxiety and depression.
Blood sugar swings can cause rapid changes in a person’s mood, such as making them sad and irritable. This is especially true during hypoglycemic episodes, where blood sugar levels dip lower than 70 milligrams per deciliter (mg/dL).
When a person’s blood sugar returns to more normal ranges, these symptoms often go away. In fact, changes in mood and mental status can be one of the first signs that someone’s blood sugar levels are not where they should be.
According to Johns Hopkins Medicine, the mental symptoms associated with low blood sugar levels may include:
- feeling confused
- feeling anxious
- having difficulty making decisions
Symptoms that indicate a person may have high blood sugar levels include:
- difficulty thinking clearly and quickly
- feeling nervous
- feeling tired or having low energy
Having diabetes can also cause a mental health condition called diabetes distress. This condition shares some elements of depression, anxiety, and stress.
While a person may not have symptoms severe enough for a doctor to diagnose them with a more severe mental illness, these symptoms can affect the quality of life for a person with diabetes.
An estimated 33 to 50 percent of people with diabetes experience diabetes distress at some point during the course of their disease. The sources of distress can include the responsibilities of managing the condition to worrying about potential complications.
Effect of diabetes on mental health
People with type 1 or type 2 diabetes are at increased risk for experiencing depression.
A diabetes diagnosis can also add to a person’s experience with depression. For example, a person who struggles with depression often lacks motivation and energy to engage in healthful behaviors. This could include healthful eating or exercising regularly.
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A leisurely walk can boost mood, psychological well-being
Written by Honor Whiteman
Regular exercise is considered key for improving and maintaining physical health. When it comes to psychological health, however, new research suggests that you do not need to hit the gym in order to reap the rewards.
Researchers from the University of Connecticut (UConn) in Mansfield found that simply going for a leisurely walk can improve mood and boost subjective well-being, particularly for adults who are normally sedentary.
Lead study author Gregory Panza, of the Department of Kinesiology at UConn, and colleagues recently reported their findings in the Journal of Health Psychology.
While a number of studies have shown that physical activity can benefit psychological health, Panza and team note that it remains unclear how the intensity of physical activity impacts subjective well-being, defined as a person’s own evaluation of their lives.
The researchers decided to investigate this association further with their new study, which included 419 healthy, middle-aged adults.
The physical activity of each adult was monitored over 4 days using accelerometers, which participants wore on their hips.
Additionally, subjects completed questionnaires detailing their daily exercise routines, psychological well-being, level of depression, whether they experienced pain and its severity, as well as the extent to which pain disrupted their day-to-day activities.
Light, moderate activity led to greatest improvements in well-being
The researchers found that adults who were sedentary had the lowest levels of subjective well-being and the highest levels of depression, which indicates that lack of physical activity is detrimental to psychological health.
Overall, the team found that people who engaged in physical activity demonstrated greater subjective well-being. However, the benefits of physical activity were found to vary by intensity.
Light-intensity activity, for example, was associated with greater psychological well-being and lower depression, while moderate-intensity activity was linked to higher psychological well-being and reduced pain severity.
Light-intensity activity was defined by the study as a leisurely walk that does not noticeably raise heart rate, breathing, or sweating. Moderate-intensity activity was defined as walking a mile in 15 to 20 minutes, with a slight increase in heart rate, breathing, and sweating.
Notably, the study results revealed that sedentary adults who increased their exercise levels to light or moderate activity demonstrated the greatest increases in subjective well-being.
However, vigorous-intensity activity – defined as jogging or briskly walking a mile in 13 minutes, with very noticeable increases in heart rate, breathing, and sweating – appeared to have no impact on subjective well-being. However, the researchers say that this is not necessarily a bad finding.
“Recent studies had suggested a slightly unsettling link between vigorous activity and subjective well-being,” says study co-author Beth Taylor, associate professor of kinesiology at UConn. “We did not find this in the current study, which is reassuring to individuals who enjoy vigorous activity and may be worried about negative effects.”
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Has your relationship lost its spark? Breathe new life into it to stop familiarity breeding contempt
The first in an occasional series on relationship issues by ProvenTherapy Director and Therapist, Matt Butler
Relationship feeling a little jaded? Lost the spark with your nearest and dearest? It’s unfortunately all too easy to take our partners for granted sometimes. The familiarity factor whereby we drift along in our most important relationships is common, though ultimately corrosive. We all need that extra spark in our relationships to keep them alive – the feeling that we are involved in something special; a frisson of excitement, a soupcon of … well … sauce. When in a committed relationship though we need to realise that we must act to make these things happen. This is vital in order to keep our relationships alive. It’s no accident that the word for keeping relationship alive is the same as that for keeping a fire going – relationships need kindling and re-kindling. The fire needs stoking. Ultimately such sparks of desire signify something we all yearn for but are sometimes phased by, maybe even a little scared of, intimacy and perhaps for some this is the root of the problem.
Relationship difficulties should remind us of the central importance of intimacy in our lives. Clearly a human desire, it is perhaps more than that, a human need.
Psychologist Robert Sternberg said, “Passion is the quickest to develop, and the quickest to fade. Intimacy develops more slowly, and commitment more gradually still”. In an age of advanced communications it remains the case that people can still feel lonely amid apparent togetherness, even in outwardly committed relationships.
So, to keep your relationships kindled, re-kindled and positively fizzing here are ProvenTherapy’s tips for maintaining a great relationship.
6 tips to give your jaded relationship a boost
- Make a point of paying your loved one a compliment or two, pick out something you like about them and tell them you like it! Don’t lay it on too thick – just be honest about it
- Be physical but gentle. Take time for touch – a hug, a kiss .. and who knows, maybe something more ..
- Go on a date together. It’s so easy when in a long term relationship – especially if you have children – to get out of the habit of going out together so make a date and stick to it. Even if you can’t go out try taking time to dress up and have a candle lit dinner together indoors every once in a while
- Talk! Spend time each day talking to your significant other, find out what’s happening for them
- Listen! Take time to really listen to your partner. You might feel tempted to dive into communications with ‘answers’ or comments on your partner’s self-expression. Try not to act on these – really give them space to talk and freely express themselves. This will be time well spent
- Have some fun! Try not to take things so seriously. Even in the most difficult situations it is often possible to find some humour
In summary, if you find your relationship with your significant other is showing signs of strain then take some time out to re-connect – make time to rekindle those closest of relationships with tenderness, gentleness and understanding – before things have a chance to take a turn for the worse.