Navigating Life When Depression Lifts
Today, we're talking about something critically important, yet often unspoken: what happens after a major depressive episode starts to lift?
We focus so much on getting out of depression, on finding that spark again. And when it happens, it's often a moment of immense relief, sometimes even elation. But then, reality hits. You might find yourself standing amidst the wreckage depression left behind: fractured friendships, strained relationships, a mountain of neglected responsibilities, a to do list that’s expanded by a power of 10, and perhaps the most insidious challenge of all – a deeply ingrained negative mindset, a “depressive mindset” that still anticipates catastrophe, even when your mood has improved.
This phase, the aftermath, is incredibly difficult, often isolating, and frankly, it's where many people lose momentum and start to slide back into old patterns. My goal today is to illuminate this often-dark and undiscussed path and provide you with a roadmap to not just survive it, but to truly rebuild and thrive.
The hell of depression doesn't just make you feel bad; it actively dismantles your life. When the fog clears, you're often left with a stark inventory of what's been lost or neglected. This isn't a sign of personal failure; it's the collateral damage of a serious illness. Ignoring this reality sets you up for disappointment.
When you start feeling better, you can still have a loss of relationships and friendships because of social isolation and withdrawal, the inability to connect with people during an episode, or people step away because they don’t understand, you haven’t been comfortable sharing with them, or they simply get tired of you not calling or texting back. In a lot of ways, you might feel like you've alienated everyone, and the thought of repairing everything feels overwhelming.
First things first: understand that not all relationships are salvageable, and that's okay. Focus on a few key relationships that you value. Apologize sincerely, if you’re comfortable, briefly explain (without over-explaining or excusing), and ask for understanding, not forgiveness. An example of this might look like "I know I was distant, and I regret that. I was in a very dark place. I'm working to get better, and I'd love to reconnect whenever you're ready."
The next slog on the uphill climb is the mountain of work and responsibilities your depression allowed to pile up on you. From piled-up emails, neglected chores, professional deadlines, to financial arrears. The sheer volume can feel paralyzing, making you want to retreat back into the familiar comfort of inaction. Even when your mood improves, it can put you right back down into the dumps of thinking you’re under the mountain instead of trying to climb it.
Instead of the “all-or-nothing” mentality that is common in depressed individuals, let’s break it down into a bite-sized strategy. Seriously. Think “micro-tasks.” Don't look at the whole mountain; focus on picking up one pebble. One email. One bill. One small chore. Celebrate each tiny accomplishment. Perfection is the enemy of progress here.
But not only has your to-do list been impacted, your very identity and sense of self can feel different. You might feel like a different person. Your routines are shattered. You might not even know what you enjoy anymore. Again, take it in bite-sized chunks. Start small with re-establishing a routine. Even just consistent wake-up/ and go to sleep times. Re-explore interests, one hobby or meeting at a time. Give yourself the grace to rediscover who you are outside of the illness overshadowing everything you do. Don’t let it win. Don’t let it make the decisions for you, even in a passive realm.
Instead of wallowing in “what-ifs” and “OMG I couldn’t possibly ever catch up” make a list. Seriously. Do it now. A realistic, brutal list, of what needs attention. Like everything that needs attention. Don't judge it; just document it. Then, arrange it by priority in terms of either timeframe it’s due (or overdue) or acuity. Pick one small, manageable item off that list to tackle this week. Just one. And celebrate the win when you accomplish it. Move to the next task.
I frequently tell people that, believe it or not, helping get people out of a neurochemical depression is actually the EASY part! Your mood can lift, but your mind might still be stuck in depressive patterns. This is the “depressive mindset” – the automatic assumption that everything will go wrong, that you're a failure, that joy won't last, that as we talked about earlier, if you can’t get it all done it’s going to go to hell in a handbasket. It's a deep neural pathway forged by months or years 0r even decades of negative thinking, and it won't magically disappear with a lifted mood. It will actively try to drag you back down because your brain will return to the comfort and safety of what it knows (whether or not that was the healthy place to be or not!)
We all have an inner voice, whether or not we realize it. If you’ve been living in a traumatized or depressive state for eons, you may not know your inner voice is putting you down or barking at you. You may just feel “ok” until you have an argument with your boss, then you start spiraling. “Worthless, dumbass, idiot” all start coming to the forefront of your mind. I cover some of this in my podcast episode “when your inner voice is an @sshole.” So you feel ok, something you perceive as “bad” happens, then whether or not you consciously realize it, your depressed brain is kicking you while you’re already down.
You need to learn to recognize that insidious, critical inner voice. It's not your truth; it's only the echo of depression. The whole “This good feeling won't last,” and “You're going to mess it all up again,” and “No one really cares” commentary. Name it. Externalize it. “Ah, there's the depression talking again.” IF YOU ARE ABLE to recognize it as the depression talking and actually not your actual identity. One of the ways you can better recognize that negative running monologue or inner critic is to check in with yourself more frequently. You don’t need an hour-long meditation to do it. A few seconds will do. Ask yourself how you’re feeling, on a scale of 1-10. One means I should probably be hospitalized. Ten means I’m so good I’m pooping unicorns and rainbows. The number doesn’t really have any meaning except for what you assign it. The CHANGE is what matters in a relative sense. Like, “I woke up today feeling like a 5 because I didn’t get great sleep but man I’m a 7 after lunch because I had a surprise visit by my favorite UPS guy.” Note the changes. Sometimes you can decipher why there was a change; sometimes you can’t. That’s ok because you will get better with practice.
The other thing you can do outside of checking in with yourself is challenging “ANTS” as Dr. Amen puts it, or automatic negative thoughts. When you say, “I’m going to fail at this task.” Ask yourself as if you were in a courtroom: What’s the evidence for this? Past failures don’t predict future ones as 1) you’re different now and 2) when you feel better you behave differently and you choose differently. Also, instead of assuming the worst, as yourself: “is there another way to look at this scenario?” Instead of “I ruined my friendship,” try “our relationship was definitely challenged by my depression, but now I’m in a better place to mend it and to tend to it on an ongoing basis.” Another way you can look at things is this: it was life-changing for me to challenge my negative inner voice when my own therapist asked, “wow, that was a really harsh statement you made about yourself! Would you talk to your niece like that?” Yikes! I totally wouldn’t. I would tell her that everyone makes mistakes, that it’s not the end of the world, and that there isn’t anything we can’t figure out together. Ummmm….so why is it ok to talk to others like in that positive validating and affirming, helpful tone, but not that way to myself? Whoops.
Outside of medications, ketamine treatments and PrTMS, CBT or cognitive behavioral therapy helps to retrain the brain. It just requires practice like training any muscle.
There’s also behavioral activation, which tells you: Even when your brain is telling you “don't bother,” do it anyway. Engage in small activities that used to bring you joy, or productive tasks. The action can precede the feeling of motivation, not the other way around.
There’s also mindfulness, self-compassion, and meditation where you observe your thoughts without judgment. Don't fight them, just notice them and let them pass. And be kind to yourself. You've fought a battle. This rebuilding phase is tough and most certainly is not for the faint of heart, and you deserve compassion.
For the next 24 hours, I want you to become a detective of your own thoughts. Every time you catch yourself having a negative or a “depressive-mindset-type” thought about the future or your capabilities, simply label it: “That's the depressive mindset trying to trick me.” Don't argue with it, just identify it. This awareness will become your superpower in identifying and tracking down thoughts that will derail the future you’re trying to build.
Relapse in depression is a real threat if you don't actively build resilience. That takes time, repetition, and the willingness to make missteps along the way. Recovery never happens in a straight line. And, recovery isn't about avoiding all future sadness; it's about developing the tools to navigate it without falling back into the abyss. This requires ongoing effort, vigilance, and support.
You can make it LESS likely to happen by counteracting it with some basic mental housekeeping routines:
1) Sleep Hygiene: get a consistent sleep schedule back in order. Lack of sleep is a fast-track back to instability.
2) Nutrition: Fuel your brain and body with nutrient-dense foods, especially all the colors of the rainbow and anything containing B vitamins and Omega 3’s. If you’re not eating well, you’re not producing neurotransmitters well either.
3) Hydration: If your brain is dehydrated, it’s overheating and enzymes won’t work properly. Make sure your neurons are nice and plump so they can metabolize and send signals appropriately.
4) Movement: Even 15 minutes of walking daily can make a significant difference. It's not about being an athlete; it’s not even about losing weight, it's about consistency. Do 30” a day and you’re increasing the thickness or your cortical gray matter, the thinking part of your brain. You also increase the release of endogenous opioids that make you feel better than sitting on the couch.
5) Build (or rebuild) Your Support Network (Strategically):Identify the people who truly understand and support you. Lean on them. Also consider support groups – they can be invaluable.
6) Boundaries: Learn to set boundaries with those who drain you or are unsupportive. Protecting your peace is paramount.
7) Consider Professional Support (Ongoing):
§ Therapy: Regular therapy, even when you feel better, can provide tools, accountability, and a safe space to process ongoing challenges.
§ Medication Management: If you're on medication, continue to work closely with your psychiatrist or prescriber. Don't abruptly stop when you feel better; that's a recipe for relapse.
§ Make a Relapse Prevention Plan: Work with a professional to create a personalized plan: identify your triggers, early warning signs, and concrete steps to take if you feel yourself slipping.
This week, I want you to identify one consistent, small, healthy habit you will commit to daily. Just one. And if you don't already have one, schedule a follow-up with your therapist or psychiatrist, or reach out to The Anderson Clinic, to discuss building a robust relapse prevention plan. Your future self will thank you for the effort you put into your mental health TODAY.
Coming out of depression is a testament to your incredible strength and resilience. It's a challenging next chapter, but it's one you don't have to face alone. Remember, recovery is a long process, not a singular event, and every step forward is a victory.
At The Anderson Clinic, we are here to walk with you on this journey, providing compassionate, evidence-based care without judgment. Visit www.andersonclinic.net or call us at (513) 321-1753 to take that courageous first step.