Cycles of depression and maintaining hope

Depression often comes in cycles. This means there are periods when it feels absent or very mild, and other times when it feels much worse. The bad times with depression are sometimes classified by health professionals into categories such as minor (less severe) or major (more severe) “depressive episodes.”

Young adults we interviewed almost all described their depression as waxing and waning over time. Some said their cycle is predictable: for example, several people with a particular kind of depression called “Seasonal Affective Disorder” talked about regularly feeling more depressed in winter, and less depressed in the other seasons of the year. Others could describe specific triggers for depression such as life events, stress, or their menstrual cycle. A number of people said depression “just sort of feels like it comes in episodes,” but were unsure why it gets better or worse at particular times. Sophie captured the cyclical nature of her experience by saying depression is “…like a wave situation. I would be, I would be all right for maybe two or three weeks then something would happen and I would just sort of crash back down.” In contrast, though, a few people said their depression is constant rather than cyclical.

Ryan says he has experienced cycles of depression his entire life.
Interview Transcript

Yeah I would say it’s, it’s kind of like, it’s kind of like if you’re taking a drug, it’s like you relapse sometimes when you go back into depression after you’ve been happy for a while. That’s kind of how I’ve been dealing with it my entire life. It’s like I’ll go through a cycle, like I’m great for two weeks and the next week I can’t frickin’ sleep.

DEP Ryan
Profile Info
Age at interview: 19
Sex: M
Age at diagnosis: 13

Background: Ryan lives with his girlfriend and her family in a suburb but is looking to move. He works as a janitor. He is White.

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For Natasha, depression is constant rather than cyclical.
Interview Transcript

It’s sort of, I guess it’s just like I don’t think it’s really cyclical. It’s sort of a constant thing for me. And like back in high school it was a constant that I didn’t really recognize what it was so it was just like a feeling of like sadness but not knowing why. And like now it’s like still a sadness, a sort of a down-ness, but I know what it is and so it’s not, it’s like easier to get myself out of it.

DEP Natasha
Profile Info
Age at interview: 20
Sex: F
Age at diagnosis: 19

Background: Natasha is a student at a large university who lives in a dorm room on campus. She is African American.

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For those who experience them, depression’s cycles create both challenges and opportunities. As Kate put it, this means always being “…aware that the happiness… ends but so does the sadness.” The rest of this section of the website explores how people with cycles of depression live with this awareness.

Living in the shadow of depression

For some people, knowledge that depression comes and goes can undermine good feelings even when depressive symptoms are mild. As Julia put it, “I try not to get my hopes up because I feel like as soon as I do that I’m going to have a really bad phase… triggered by like totally random things.” Casey says he struggles not to have the way he deals with things when depressed become the frame he applies when he is feeling fine. Many people find that while they’re feeling good they have to spend a significant amount of energy trying to prevent or prepare for the next cycle of depression.

Shayne says managing depression is like managing diabetes: she has to constantly monitor multiple factors in order to keep on an even keel.
Interview Transcript

It means I have to constantly analyze my behavior and myself and my motivations and where they’re coming from and why am I thinking this way. I, it’s like diabetes. You have to watch what you eat. I have to watch what I eat too, but I also have to watch all of these other factors, like how much I’m sleeping, how much I’m exercising. You know, what am I eating. Like is it, is it good food, is it going to make me happy, is it healthy enough. Like, all these things. Like even what you eat affects your happiness. And like I am so sensitive that I have to watch all of these factors because they all play into my mental health. So like, if I skip a meal, I’m inordinately cranky, you know. Like I shouldn’t and like I just don’t want to be misbalanced in any way. I’m just, I’m so fragile at this point. So I have to, I have to take into account really closely everything in my life that is a factor into how I’m feeling. It’s a lot of work and I didn’t realize it was going to be that big of a deal when I was first diagnosed with it, I guess.

DEP Shayne
Profile Info
Age at interview: 27
Sex: F
Age at diagnosis: 13

Background: Shayne lives in a house with two roommates and three cats. She works in research, exercises regularly, and does art. She is White.

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Mara works hard to enjoy things during good periods, but still finds herself wondering when depression will return.
Interview Transcript

So yeah, I sort of had these ebbs and flows like throughout my childhood and I think a lot people can relate to that. Where there would be like, a bad few months and then a good few months, and then maybe a bad year and then maybe a good couple weeks, but I think sort of what I spent a lot of those good periods in was just kind of like, this petrification like this feeling like, yeah things are good now but I can’t really truly enjoy them because I’m still just waiting for the other foot to fall. So, since, since moving out and since having a lot better outlook on a lot of the things happening to me I’ve had a lot of an easier time enjoying things and enjoying people, the people that I’m around and building new relationships but it’s still kind of hard not falling back into the mentality of, well when is this all going to stop like, when is the movie going to end, when are the credits going to roll like, when do I have to come back and face reality.

DEP Mara
Profile Info
Age at interview: 18
Sex: F
Age at diagnosis: 14

Background: Mara is a student at a large university. She lives in a dorm room on campus. She is Vietnamese and White.

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Coping with transition

Several people talked about how transitions in their lives (like moving or changing schools) played a role in their cycles of depression. Most often, transition seemed to promise a new lease on life, corresponding with a “high” in the mood cycle — but then proved disappointing, difficult or even traumatic, triggering a terrible “low.” Meghan, for example, felt “all stresses in life were over” after high school, because that was her goal for the summer, but really things were “just getting worse and worse” and her depression became worse than ever once at college.(See ‘Depression and transitions to adulthood’ for more on depression.)

Jacob thought each milestone would bring welcome change to his life, but altered circumstances had little effect on his depression.
Interview Transcript

Yeah I think milestones like at first I thought college would make me a real person. And then after I got to college, I thought well once I’m self-sufficient, I have a job or a steady income and things like that and then my real life would start. And then after that as well and maybe once I find a serious relationship, long term relationship then that would be the thing. I have all those things now and I’m still in the same situation of “okay what’s next, now what do I do?”

DEP Jacob
Profile Info
Age at interview: 25
Sex: M
Age at diagnosis: 18

Background: Jacob is a software engineer at a large company. He lives with his girlfriend and a cat. He is White.

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Crystal kept vowing to start over, but cycles of harder and easier persisted.
Interview Transcript

So when I graduated from high school, summer after high school I was trying, I was convinced you know I was going to start over. This always happens you know elementary school to middle school, middle school to high school, high school going on to college, I was convinced you know. I know I, the thing is, I have a journal and I keep one and I write in it often I started in high school just to cope with my depression, and I found it helpful but looking back at my journal it’s interesting because I do say some of the same things after a while, like during my transition periods I would always say, “Ok I’m going to start all over,” And then every year for my new year’s resolution would be I’m going to try something differently. But every year there are some setbacks and there are some cycles and there’s some, and there’s some difficulties and I end up, I ended up going back right to where I started. So in between high school and college I was trying to see if it was possible for me to even move my, adjust my thinking.

DEP Crystal
Profile Info
Age at interview: 20
Sex: F
Age at diagnosis: 15

Background: Crystal is an African American college student. She works campus jobs during the year and internships in the summers.

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Maintaining hope

Many people we interviewed yearned for the capacity to remember, even during their darkest times, that bouts of depression are temporary. Even while acknowledging that it might sound “cheesy,” several people emphasized the importance of being able to see “the silver lining behind every cloud.” Others focused on repeating reminders to themselves in the form of little phrases such as “there is a way to get through this,” or “it will get better,” or “hard days will go away.” As Elizabeth put it, “… sometimes you have to literally tell yourself it’s going to be ok, even if you don’t believe it, even if you don’t think it’s going to happen, and that really does… reframe my thinking.” Colin says it’s helpful to remember that “the only constant is change”; even if he is feeling severely depressed now, in the future he will again have energy, motivation and desire.

Nadina says that the first step in maintaining a hopeful attitude is learning not to give up, and remembering that bad times have come and gone in the past.
Interview Transcript

When I was younger I thought depression would be the end of me, um, but now that I’m older I feel that it is a challenge that many people deal with and it’s an ongoing battle and like life is kind of just an ongoing battle, and that you know, if you can make it through one day you can make it through so many more. And just to not give up, I know that’s such an overused thing, you know, not giving up, but sometimes that’s all you have to resort to is just to like keep staying strong, to really fight through your demons and, and other people sometimes and realize you may not have control over everything but you have control over how you perceive things and how you feel about things. And sometimes it gets really hard to where you may not feel like you can deal with these things, but if you’ve dealt with horrible things in the past and you’ve made it through it, I’m positive you can make it through the next round of things that [laughs] may not be particularly positive. But you know, that’s just kind of how life is. And I know it’s a struggle, but everybody feels that struggle to some extent.

DEP Nadina
Profile Info
Age at interview: 23
Sex: F
Age at diagnosis: N/A

Background: Nadina lives with her parents in a suburb near a small city. She completed college and works as a freelance illustrator. She is Caucasian.

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Brendan has learned that periods of hopelessness are temporary, and that if you wait them out you will find new solutions.
Interview Transcript

There have been times when it’s been really bad and it felt kind of hopeless. But what I’ve learned when I was young in my first depressed, my first suicidal depressive episode at 10 years old, is that periods of hopelessness are temporary. And that if you wait them out, you normally see a solution that you haven’t thought of before. So sometimes, it is that. Other times, it’s, you know, like things are really good right now. And things are going really good for me, I feel optimistic about the future, but there are still even today, there are certain days where like, I know that things are good but I’m just tired, I’m just sad, I just feel a little awkward. It’s something that you live with. It’s something that you make adjustments to, you know, it’s,- I’ve tried to think of it as like you know having like a sore shoulder or something. You want to be careful with heavy, lifting heavy objects. You don’t want to hurt yourself but it’s an annoyance, it’s not something that’s taking you out of the game. And that’s what I try to remind myself is that no matter, no matter how bad I feel, it’s almost never actually that bad and if I just keep on doing what I’m doing then I normally turn out OK.

DEP Brendan
Profile Info
Age at interview: 21
Sex: M
Age at diagnosis: 15

Background: Brendan has three jobs and is a fulltime college student and musician. He lives in an apartment with a roommate. Ethnic background is White.

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Specific strategies people described for maintaining hope during dark times include reconnecting with other people; remembering high points from the past; focusing on gratitude; or doing something uplifting like gardening or sitting in the sun. Natasha says she has come to think of her depression as a journey with “ups and downs” that with time gets “easier to navigate.” For Kate, it is important to remember that “there is always a light there at the end of the tunnel. You might just not see it ‘cause there’s a curve. So you have to just keep on trucking and just kind of muscle through the worst of it.”

During a tough period of unemployment, Elizabeth felt severe depression threatening to descend. She headed it off by drawing on coping skills such as taking decisive action, persisting, and speaking positively to herself.
Interview Transcript

At that point, I did really know that it was going to be ok, but there was something that just stopped me in that moment and really getting through was with support and help and reminders and really using the skills that I had worked on for so long. Igniting those coping skills and the problem solving skills to think, ok, instead of you know thinking negatively or crying I can just go apply to another job and see if that works out. So the persistence really got me through as well.

Are the primary coping and problem solving skills around persistence, are there other aspects of those?

A lot of them are around persistence. A lot of it too, as simple as this sounds, is just trying to speak positively to myself. When I was very deeply depressed a lot of my thinking was negative, “I’m never going to amount to anything. I’m never going to be happy. Who would want to be with me? Who wants to be around me?”

DEP Elizabeth
Profile Info
Age at interview: 28
Sex: F
Age at diagnosis: 17

Background: Elizabeth lives in a house with her husband. She works as a parent educator. She is White/Italian.

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Sam has learned that depression can always be made better by using one of several specific coping mechanisms.
Interview Transcript

I would absolutely want to give the message that, not that it gets better because that’s not a thing that magically happens, but there is almost always the means with which a situation can be made better. Sometimes that involves extricating yourself from situation that are unsalvageable. Sometimes that involves taking an honest and sometimes painful, look at your own self and your own behavior and making a determined effort to change it. Sometimes it involves trying to unlearn very painful but powerful ways of looking at the world that are not the most healthy and trying to relearn new ones in their place. Sometimes it involves just eating an ice cream cone. There is almost always the possibility of a situation being made better it involves a lot of work, but it can be done.

DEP Sam
Profile Info
Age at interview: 23
Sex: M
Age at diagnosis: 19

Background: Sam works as a young professional to earn money to resume his university studies. He lives in an apartment with a roommate. He is White.

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See also ‘How depression feels’, ‘Depression and identity’, ‘Depression and healing’, ‘Depression and strategies for everyday life’, and ‘Having a purpose in life’.

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