Everyone gets down once in a while. Everyone can feel sad, emotionally unbalanced, tired or anxious. But if you find yourself repeatedly in these states, often for no discernible reason or for unbelievably petty reasons, then you may have a depressive cycle condition.
1: Is this you?
One day you’re on top of the world, or at least feeling fine. You break your shoe, but march into a store and get a new pair. It cost a bit, but they would have needed replacing some time or another and you really like your new shoes anyway. You get to your lunch date a bit late but after explaining and showing the offending shoe all is well. You enjoy the date knowing that they aren’t too upset by your lateness, part on friendly terms and agree to have a second date.
The next morning you wake up suddenly at four am feeling incredibly anxious. You’re not sure if your date was actually OK with your reasoning. Maybe they think you’re the sort of person who carries around broken shoes just so you can excuse your lateness? And now you’re not sure you like those shoes any more anyway. You preferred the old ones. You can’t get back to sleep and drink some coffee to calm a strange shakiness and ache that has appeared in your fingers, probably from the stress. Trying to make breakfast a few minutes later, you drop a whole egg in the pan and, frustrated, throw all of it away. Making a new omelet feels like an incredibly difficult task and you feel suddenly very tired, despite just having had a coffee. You sit down and try and put the TV on, but can’t focus on it. It feels pointless and dumb to be watching TV and nothing is interesting on it. You feel helpless and break down crying.
After crying you feel more steady. Your hands aren’t shaking and you have a little more energy. You still feel strangely empty and your joints have started hurting a bit again, but at least now you feel like making another omelet.
That is a fairly normal depressive episode following what may have been a normal mood or may have been very mild mania. Because you’ve lived with it most of your life, most people with this sort of cycle don’t really notice it as something that may be a problem.
2: Ups, downs or steady?
In terms of the type of cycle, there are three defining characteristics: what moods there are in the cycle, how long the cycle is and how intense the moods are.
Firstly we’ll look at the moods we have. There are three stages to a cycle. Most people will only experience two for any length of time and the other may not feature or may be very brief and mild.
-Depressive stage. The one we’re focusing on for this guide and the one that causes most people the biggest problem. You feel sad, angry or temperamental for no reason. You feel tired, lethargic, but also anxious and jumpy at once, you may have a very hard time sleeping despite feeling exhausted. You lose motivation and start having negative thought cycles.
-Manic stage. Can be a problem to some people but provides a welcome break for those with very mild mania. You feel on top of the world, excited and brimming with energy. Your outlook is optimistic and the silver linings seem very clear. You want to do everything at once and have a hard time stopping yourself from filling the calendar too much. You have a hard time focusing on any task at hand.
-Normal or flat stage. Not a problem in and of itself, but can make some people with depressive cycles feel worse about the depression.
If you have depressive and manic as your primary cycle, you could have: cyclothymia, bipolar I, borderline.
If you have depressive and flat as your primary cycle, you could have: dysthymia, bipolar II.
People with depressive and manic may find their lives are in more of a mess and others are more often hurt by their actions. People with depressive and flat may find themselves very alone and be at risk of self harm.
3: Serious or inconvenient?
The severity of the disorder depends on two things. Firstly, how intense the moods are. Depression can range from feeling a bit flat and sad to suicidal rage. Mania can range from feeling a bit lively and unfocused to impulsively buying an entire store and then burning it. The more destructive and hard to control the mood is, the more intense it is.
The second thing is how fast the cycle is. When the cycle is slow you can predict the buildup and get ready. When it’s fast your moods can flip uncomfortably.
In terms of severity, the mood disorders scale like this:
Borderline. Very sudden, unpredictable mood switches between full mania and clinical depression.
Bipolar I. Gradual, predictable mood switches between full mania and clinical depression.
Bipolar II. Gradual, predictable mood switches between hypomania and clinical depression.
Cyclothymia. Very sudden, predictable mood switches between hypomania and subclinical depression.
Dysthymia. Gradual, predictable mood switches between normal mood and subclinical depression.
Of course all of them vary a little from person to person, but in general that is the simplest way of explaining each of them.
And the main way of treating these episodes is to work out what exactly is going on. Not all depression is alike, so pinpointing the cause of an exact problem can help fix it.
One cause of depression is when serotonin reuptake inhibitors stop working. Serotonin is a neurotransmitter that helps relay messages around the brain. SRIs stop your body from absorbing too much serotonin. When they aren’t working we may end up with too little serotonin, which destabilizes our mood. On its own, this won’t always cause depression, but it leaves us vulnerable. Symptoms include:
-Sudden urges to cry, laugh or crush things.
-Sensitivity to pain, normal touch feels uncomfortable.
-Isolating yourself from others for a while.
-Engaging in calm and pleasurable activities, like watching TV, reading or listening to music.
-Asking your doctor about 5-HTP and SSRIs.
GABA’s main role is helping us get into a nice deep sleep. When this sleep process is interrupted, for example by alcohol, REM sleep is worsened which can cause a downward spiral as though we weren’t sleeping at all. If you have poor GABA receptors you may suffer the same way someone suffers with a hangover. Symptoms include:
-Suddenly vivid and very memorable dreams.
-Anxious, edgy, twitchy.
-Panic and sickness at night.
-Turning to alcohol or drugs to get some sleep.
-Meditation before bed to unwind.
-A mild sleeping pill to promote REM sleep.
Dopamine is the reward driver. Whenever you do something that results in a pleasant sensation, like eating good food, relaxing, having sex or playing, dopamine fires out to tell you what a good job you’re doing and to remind you to do that more often. When your dopamine receptors aren’t working properly there is nothing in your body to tell you that you did well at being a human. Symptoms include:
-No lust for life.
-Nothing feels rewarding, everything feels like it’s draining you, even things you used to like seem pointless.
-Low or absent concern even for people you loved.
-Things genuinely start looking dull, grey and uninviting.
-Going somewhere new and exciting.
-Overwhelming the senses.
Norepinephrine is a neurotransmitter that is produced in response to stress. It is also a stress hormone, like cortisol or adrenaline. It increases the oxygen going to our brain, speeds up our heartrate and shuts down basic processes like digestion until the stress is gone. It helps send us into fight or flight. When the receptors aren’t working anxiety can build up, but the body becomes overwhelmed and has no energy to fight the stress. Symptoms include:
-Low energy for no reason.
-Poor motivation, persistence and focus.
-A desire to sleep for a long time.
-Boredom regardless of what you’re doing.
-Sudden spikes of anxiety, a feeling your existence is threatened.
-A mild herbal antianxiety pill like valerian root.
-Caffeine to raise your energy through the day.
-Ask your doctor about SSRIs.
Many people with depression actually have a smaller than average hippocampus and long periods of depression can shrink it further. The hippocampus processes all your new memories and might play a role in deciding which ones are important to keep and which ones are for the short term. It also works with your spacial memory, helping you map your location and even remember what size your body is and what it’s doing. If your hippocampus is too small, it may become overwhelmed, causing poor memory function and proprioception. Symptoms include:
-Forgetting your daily plans.
-Forgetting what day it was, or things that happened in the past few days.
-Accidentally dropping or crushing things because you lost track of your hands.
-Keeping lists when you notice it happening.
9: The start and end.
Finally, you want to learn to predict when depression is creeping up on you, what type of depression it is and what the cycle usually involves. Keep a diary to find out what starts and ends your depressive cycles, what triggers an episode and what helps calm them preemptively.
And that’s how I manage depressive cycles. I hope that helps, or was at least informative if you don’t have depression.
TTFN and Happy Hunting!