Navigating Your Depression Relapse

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Like many other common medical conditions, such as high blood pressure, depression is highly treatable, but there is also a risk that the symptoms will return. According to Dr. William Marchand, a clinical associate professor of psychiatry at the University of Utah School of Medicine, the risk of recurrence, or a relapse after a full remission, for a person who has had one episode is 50%. For a person who has had two episodes, the risk is about 70%. For someone with three episodes or more, the risk rises to around 90%. This is why having a prevention plan in place is critical. “Depression is often a chronic illness, but with a good prevention plan in place, it is often possible to prevent recurrences entirely or limit the severity and duration if depression does return.” A prevention plan must include maintenance treatment, which is “treatment that is continued after symptoms are in remission to prevent recurrence.” It is also important to understand what might be triggering a possible relapse, and how you can prevent or minimize the influence of those triggers. Here are three common triggers that could cause a relapse:

  • Not Following Treatment: “The biggest issue regarding relapse has to do with children and adults not following through on their treatment plan,” said Deborah Serani, Psy.D, a clinical psychologist. This can include anything from skipping therapy sessions to missing doses of your medications to ending your therapy too soon.
  • Ruminating: Those who suffer from depression tend to dwell on their supposed flaws and failures. These negative self-referential ruminations play a major role in relapse.
  • Not Knowing Your Personal Vulnerabilities: Since we are all unique, triggers can be specific to each individual’s situation. To identify your triggers, learn how to recognize the who, what, whys and whens of your emotional and physical life,” Serani said.

Sometimes it is not possible to prevent yourself from a relapse. However, by knowing the early signs and getting treatment right away, you can prevent a full blown episode or lessen its severity and length.



Coping with Depression Setbacks

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As you are on your way to overcoming your depression, it is not uncommon for your depression symptoms to flare up again. You might experience a few bad days, sometimes referred to as setbacks, which are common hurdles in depression treatment that can slow a patient’s progress, says David Blackburn, PhD, a psychologist at Scott & White Hospital in Temple, Texas. Setbacks can unfortunately cause a vicious cycle, since they can often worsen a person’s depression symptoms. “They might get even more discouraged than they already are,” Blackburn explains.“  Try some of these strategies when you feel yourself slipping back into your depression:

  • Use Coping Techniques: Try to remember the strategies that you learned during your treatment of depression, such as avoiding thoughts that tend toward the absolute- “I can never do anything right.” Blackburn says that people who suffer from depression should try to take stressful events in stride and stop fixating on situations they have no influence over. “It’s important to recognize that you, as an individual, cannot control a situation or people in it,” Blackburn says. “The only thing you can control is how you respond.”
  • Improve Dietary and Exercise Habits: If you take care of your body, you will feel better, both mentally and physically. Even just a small amount of physical activity will improve your outlook. Try to eat plenty of fruits and vegetable per day, as well as plenty of whole grains and low-fat dairy products.
  • Ask About Adjusting Your Medication: If you are taking medicine for your depression, setbacks can occur if the medication becomes less effective. Sometimes a simple switch is all that is needed to move forward. If you feel that your medicine is causing your setbacks, speak with your doctor.
  • Consider Psychotherapy: If you have been managing your depression with medication alone, you might find that adding psychotherapy to your treatment regimen might be beneficial. “Medication can improve your mood to the point where psychotherapy can be more successful,” Blackburn says.



Get the Facts: Bipolar Disorder

Bipolar disorder affects approximately 5.7 million American adults—roughly 3% of the adult population in the United States.  This mental disorder has gained visibility recently as several prominent public figures have candidly discussed their struggles with bipolar disorder.  However, despite this current publicity, most of the US population does not truly understand what it means to suffer from bipolar disorder.

Bipolar disorder (sometimes referred to as manic-depressive disorder) is a serious mental illness characterized by extreme moods ranging from mania to depression.  Individuals with may experience quickly changing, highly varied moods, as well as increased risk-taking tendencies.  Bipolar disorder is divided into three subtypes based upon specific symptomologies.

Bipolar I disorder involves serious mood swings and periods of mania that can be dangerous and extremely disruptive.  Bipolar II disorder is less severe and is characterized by more gradual mood swings that are less likely to impair functioning.  With bipolar II disorder, individuals may experience hypomania (a less severe form of mania) and longer-lasting periods of depression.  Cyclothymic disorder is another mild form of bipolar disorder.  Although the mood swings can be disruptive, the highs and lows are not as severe as with other subtypes.

All three forms of bipolar disorder may require lifelong treatment.  Common treatments include medication, counseling, and education or support groups.  Individuals living with bipolar disorder can work with a physician to determine a course of management that is best for their unique needs.  Sharing knowledge about this disorder is an important part of increasing awareness.

Depression and the Holidays: Tips for Coping

As the holiday season approaches, feelings of festive cheer can be accompanied by feelings of stress and depression.  The stress of holiday demands—parties, gifts, decorating, cooking, yikes!—coupled with the pressure to spend the holidays with loved ones, can be overwhelming.

The coping tips listed below can help lessen the potential impact of holiday depression.

Especially if you have experienced depression in the past, be aware of signs of depression and seek help if necessary.

Coping Tips:

  • Acknowledge your feelings.  It’s okay to take time to be sad, cry, and express your sadness.  Forcing yourself to be happy won’t help, and ignoring depression may even prolong its symptoms.
  • Reach out. If you’re feeling lonely or isolated, don’t hesitate to seek help through community, religious, social, or medical resources.  Volunteering can be a great way to spend time with others and help a good cause.
  • Be realistic.  The holidays aren’t perfect.  Focusing on perfection can lead to disappointment.  Instead, enjoy the happy moments and celebrate the accomplishments of the past year.
  • Compromise.  Spending holidays with the family can often lead to disputes and arguments.  Try to accept your family and friends for who they are and enjoy their compan
    y.  Set aside past or ongoing disagreements.
  • Budget.  Financial stressors can play a big role in creating and/or building upon holiday depression.  While there certainly is a lot of pressure to spend, sticking to a budget will help you manage your stress and ensure that you don’t end up in debt come January 1st!
  • Say no!  It can be hard to turn down solicitations for help or invitations to parties, but agreeing to too much can leave you feeling resentful and overwhelmed.  Be sure to allow yourself time to decompress.
  • Keep your health in mind.  Holiday desserts, cocktails, and candy can be tempting to say the least.  Sticking to your healthy eating and exercise habits will benefit both your mental and physical health.
  • Seek professional help.  If you’re feeling persistent depression, talk to your doctor or a mental health professional.

These tips can help combat and manage holiday depression and better allow you to enjoy this time of year.  As the holidays approach, keep these helpful hints in mind.  The Segal Institute for Clinical Research wishes you a happy and healthy holiday season!

In Honor of Suicide Prevention Day

Each day, almost 3,000 people across the globe commit suicide.  For every one of these 3,000, an additional 20 people attempt to end their lives.  In an effort to reverse these staggering numbers, the International Association for Suicide Prevention has dedicated September 10 of each year as World Suicide Prevention Day.

Suicide is a major preventable cause of premature death.  International awareness needs to be raised, national prevention policies and frameworks need to be implemented, and support programs to help at-risk individuals need to be accessible through local communities.  On the 10th of September, the world paused in observance of World Suicide Prevention Day.  Over 40 countries held awareness events to mark the occasion, focusing on this year’s theme: “Suicide Prevention across the Globe: Strengthening Protective Factors and Instilling Hope.”

Instilling hope and strengthening protective factors are not goals that can be accomplished through a one-day observance, but rather must be cultivated and reinforced each and every day.  Understanding protective factors against suicide is the first step toward suicide prevention.  These factors include:

  • Resilience in coping with adverse life events
  • A sense of personal worth and confidence
  • Effective coping and problem-solving skills
  • Adaptive help-seeking behaviors
  • Strong spiritual and social ties through supportive relationships
  • Healthy lifestyle choices

These protective factors, combined with an earnest hope for a better tomorrow, are essential to the reduction in international suicide rates.  If you see a loved one struggling with depression, mental health, or thoughts of suicide, helping this person fortify these factors and seek professional help can be the difference that saves a life.

Celebrate Women’s Health This Month

August is National Women’s Month, and to celebrate we want to give women the knowledge and education needed to stay healthy and happy.  Below, we discuss some of the signs, symptoms, and treatments of medical conditions affecting women.  Share this information with the important women in your life.


While depression affects both men and women, it does so in very different ways.  Women experience depression twice as often as men, and women with depression are more likely to feel guilty, sad, and helpless.  Signs of depression often include changes in sleep patterns, changes in appetite, and/or changes in weight.  Since 40% of women with depression will not seek professional help, it’s important to be aware of these signs, and offer support if you think a friend or loved one may be depressed.


Endometriosis typically occurs during a woman’s reproductive years, and affects an estimated 6%-10% of all women.  In women with this condition, cells of the uterine lining are found outside of the uterine cavity, causing pain, cramping, constipation, and chronic fatigue.   See a gynecologist if you have been experiencing these symptoms, or have a family history of endometriosis.

Bacterial Vaginosis(BV).

Bacterial vaginosis is the most common vaginal infection in women of childbearing age.  While its causes are not yet fully understood, BV is related to an imbalance of bacteria in the vagina.  Having multiple sexual partners or douching can increase a women’s chance of having BV.  Diagnosis can be accomplished with a medical examination and laboratory test.  Having BV can make women more susceptible to other STDs, and since BV can sometimes carry no noticeable symptoms, it’s important to schedule routine gynecological exams to stay healthy.

Yeast Infections.

Up to 75% of women have been diagnosed with a yeast infection.  These infections are caused by an overgrowth of the fungus Candida albicans.  Many factors can raise your susceptibility to yeast infections, including stress, fatigue, some medicines, and diet.  Yeast infections can be diagnosed with a pelvic exam.  Symptoms can be similar to those of more serious conditions, so it’s important to see a doctor right away if you think you may have an infection.

Anemia Due to Uterine Fibroids.

It is possible that up to 80% of women have uterine fibroids.  Uterine fibroids are noncancerous tumors of the uterus.  In some women, uterine fibroids may cause heavy bleeding, pelvic discomfort and pain, or create pressure on other organs.  The excessive bleeding that can accompany uterine fibroids can cause anemia—a decrease in red blood cells that can cause fatigue or headaches among other symptoms.   Regular gynecological exams can help identify the existence of uterine fibroids, and routine blood tests can check for iron levels that indicate anemia.


Stay healthy, ladies!  Seeing a doctor regularly is essential to preventing, diagnosing, and treating medical conditions such as those discussed above.  Happy National Women’s Month from Segal Institute for Clinical Research!

Depression Symptoms and Your Health

When is it more than just a bad mood?

It’s common to go through emotional ups and downs. Feeling sadness is a normal part of life – however the constant sadness characterized by depression is not normal. When sadness, apathy and lack of motivation engulf your everyday it may be symptoms of clinical depression.

Are you depressed? If several of these symptoms are persistent in your life, it may be clinical depression:

  • Feeling hopeless or helpless
  • Acting more aggressive, irritable or short-tempered than usual
  •  Sleeping too much or too little
  •  Lack of concentration, tasks that were once simple now are difficult
  • Change in appetite: eating too littler or too much
  •  Difficulty controlling negative thoughts
  •  Consuming more alcohol or engaging in reckless behavior
  • Aches or pains, headaches, cramps or digestive problems that do not ease even with treatment.
  • Thoughts of suicide or that life is not worth living (seek help IMMEDIATELY if this is the case)

Symptoms of depression can vary for each person, however it is important to recognize your depression symptoms – many people with a depressive illness never seek treatment. The good news is that even those with the most severe depression can get better with treatment. Treatment options vary for each person, however medication, psychotherapies and other combinations of methods can be effective for people dealing with depression

If you or someone you know is experiencing symptoms of depression, it’s important to seek professional help. Finding a doctor and developing a personalized treatment plan offer the best opportunity to overcome your depression symptoms.

Looking to learn more about depression? The National Institute of Mental Health offers a detailed overview here. Other resources include: Mental Health America’s depression screenerThe American Psychological Association.