Unexpected episodes of MDD

Major depressive disorder (MDD) can have a huge impact on your life. A bout of depression can make it difficult to get through your normal daily activities. But one of the most frustrating things about MDD is that you don’t know when an episode will strike. Even though you may expect another episode, it likely catches you off guard each time.

Knowing your triggers and practicing self-care can help either prevent or minimize the effects of an episode.

How to spot MDD triggers

An episode of MDD can seem unpredictable, but most people can identify possible triggers. If you know the potential triggers that can lead to an episode, you can be more prepared.

Some of the most common risk factors for MDD episodes include:

  • The loss of someone important to you. It’s not unusual for people to have an episode after a significant interpersonal loss. You can still experience pain whether the loss is due to death or the end of a relationship.
  • Being or feeling rejected. You may find yourself feeling a more lasting sadness after rejection by a friend or a job.
  • Just coming off of a previous episode. Still, not everyone who has a first episode goes on to have a second.
  • MDD appears to have a genetic component. Research reported in the Journal of Psychiatric Research has found a link between family history and MDD.
  • Hormonal shifts can trigger a depressive episode, particularly in women. Pregnancy, the postpartum period, and menopause are all common causes of major depression.

Remember that not every episode of major depression has a direct cause. It’s OK if you can’t identify a specific trigger.   

Self-care tips for managing an MDD episode

Even when you spot an episode of MDD on the horizon, that doesn’t always mean you can prevent it. Putting in extra effort can be difficult when you’re depressed, but it’s important to take extra good care of yourself. Here are seven self-care strategies that may help:

1. Get more rest.

Research shows a strong link between sleep and mood. Inadequate sleep leads to irritability and anxiety. Sleep plays an important role in regulating your emotions and helping your brain recover. Ask your doctor about treatment options if you’re having trouble falling asleep or staying asleep.

2. Exercise more.

The link between exercise and mood is clear: The natural endorphins your body produces through exercise are a mood booster. A study in the Journal of Psychiatric Research suggested that exercise can be effective in treating major depressive episodes.

But lack of motivation is a common depression symptom and exercising may be challenging. If you’re struggling to motivate yourself, start slowly. Something like a brief walk around the block can improve your mood. Aim for 30 minutes of mild to moderate exercise at least five times per week. Try gentle exercises like walking, swimming, yoga, or tai chi.

3. Add more structure to your day.

Depression makes it easier to lose focus. This leads to a tendency to let days become free and unstructured. While this may sound appealing, it’s likely to make your depression worse. Make plans for each day and set appointments for yourself. You can schedule time for tasks like shopping, calling a friend, or cooking. Use sticky notes, a planner, or your calendar in your smartphone to schedule your day. Promise yourself to follow your schedule even if you don’t have places to go or things to do. The regular structure will have a positive effect on your mood.

4. Spend time with friends and find a support group.

Becoming isolated tends to worsen and prolong a depressive episode. Have some close friends check on you if they don’t hear from you. Depression makes it hard to pick up the phone to call a friend. Find a support group, possibly through the National Alliance on Mental Illness or through your local hospital.

5. Remind yourself of your accomplishments and past victories.

If you’ve experienced MDD episodes before, you can take pride in being a survivor. Remember acts of kindness people have shown to you. If you remember even one thing that ever made you happy, it can give you hope.

6. Try writing your feelings in a journal.

Writing in a journal can be a great way to release negative feelings and put them into perspective. Set time aside for journaling a few times each week.

7. Don’t make any major life-changing decisions while you’re depressed.

Now is not the time to end a relationship, quit a job, or move. Wait until you feel better to make big decisions. Also, talk about any life-changing decisions with your family and friends.  

When to seek professional help

Self-care is important and necessary when dealing with MDD, but it isn’t always enough to solve your problems. See your doctor and mention that your depression seems to be getting worse. If you’re taking antidepressants, you may need a higher dose or a different drug. Adding an additional medication on a temporary basis can also bring relief.  

According to the National Institute of Mental Health, electroconvulsive therapy (ECT) may be helpful if medication isn’t effective enough. ECT is not painful and is often performed on an outpatient basis. Many advances over the years have made ECT a safer and more effective treatment. It can be useful if you’re not responding well to medication and therapy.

Always call your doctor immediately if you’re feeling suicidal. Treatment in a hospital is sometimes necessary and may even save your life.

The takeaway

Remember that all depressive episodes will eventually end. Commit to your own recovery and trust your medical support team. With patience and time, you have better days to come.