Emotional Instability in Depression: A Patient's Journey

Q: Emotional Instability in Depression: A Patient's Journey

Hello： Depression can improve significantly with regular treatment. <br>It is recommended to cooperate well with your outpatient physician; feel free to discuss any symptoms or concerns with them. <br>Take care of yourself and cherish yourself, as it is not only for your own sake

Mood instability in depression?

I am a patient with depression and have been on and off medication for over seven months.
I recently started taking medication again three weeks ago after a break of more than a month.
I want to know if this three-week period is considered real treatment, or if the previous treatment doesn't count.
In the past few weeks, there have been a few nights when my mood suddenly spikes for about half an hour.
My psychiatrist says I have made progress; previously, I would occasionally have suicidal thoughts and even acted on them, feeling completely out of control.
Now, during my episodes, I am filled with guilt, and it feels like a tug-of-war between living and dying.
I feel powerless and can only cry.
I am afraid that I won't be able to hold on and will disappoint those around me.
When I have an episode, it is truly painful, and I don't know how to help myself in those moments.
The episodes can occur without any apparent trigger, and although I manage to get through the half hour, I worry each time whether I will make it through safely.

Niming, 20~29 year old female. Ask Date: 2016/10/14

Dr. Liang Sunyuan reply Psychiatry

Hello: Depression can improve significantly with regular treatment.
It is recommended to cooperate well with your outpatient physician; feel free to discuss any symptoms or concerns with them.
Take care of yourself and cherish yourself, as it is not only for your own sake but also for those who care about and value you.
During episodes, it is advisable to soothe yourself, remembering from past experiences that this discomfort is temporary and will pass quickly.
Then, try to shift your focus to other activities.
If your condition is unstable, you can also schedule an earlier appointment with your physician to discuss coping strategies.

Reply Date: 2016/10/14

More Info

Understanding emotional instability during depression is a complex journey that many individuals face, and your experience reflects the struggles that come with this mental health condition. It’s important to recognize that depression can manifest in various ways, including sudden emotional surges, feelings of guilt, and thoughts of self-harm. Your journey over the past seven months, including the ups and downs of medication adherence, is not uncommon among those dealing with depression.

Firstly, regarding your question about the effectiveness of treatment after three weeks of medication: it’s essential to understand that while some individuals may experience improvements in their symptoms relatively quickly, for many, it can take several weeks to months for medications to reach their full therapeutic effect. Antidepressants often require time to adjust the brain's chemistry, and the initial weeks may involve side effects or fluctuations in mood before a more stable improvement is observed. Therefore, the previous treatments are not rendered invalid; they contribute to your overall treatment history and understanding of what works for you.

The emotional episodes you describe, where feelings surge unexpectedly and leave you feeling overwhelmed, can be particularly distressing. These episodes might be related to the underlying instability that often accompanies depression. It’s crucial to recognize that these feelings, while intense, are part of the illness and do not define your worth or your future. The fact that you have been able to endure these moments, even if they are painful, shows resilience.
When you experience these emotional surges, it may help to have a plan in place. Here are some strategies that could assist you during these challenging moments:
1. Grounding Techniques: When you feel overwhelmed, grounding techniques can help bring you back to the present moment. This can include focusing on your breathing, identifying objects around you, or using sensory experiences (like holding ice or listening to calming music) to distract your mind from distressing thoughts.

2. Journaling: Writing down your thoughts and feelings can be a powerful way to process emotions. It allows you to express what you’re going through and can help you identify patterns in your emotional responses.

3. Reach Out for Support: It’s vital to communicate with someone you trust during these episodes. Whether it’s a friend, family member, or therapist, sharing your feelings can alleviate some of the burdens you carry. You mentioned feeling guilty about burdening others, but remember that those who care about you want to support you.

4. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, yoga, or deep-breathing exercises can help reduce anxiety and improve emotional regulation. These techniques can create a sense of calm and help you manage your emotions more effectively.

5. Therapeutic Support: Continuing therapy alongside medication can provide a safe space to explore your feelings and develop coping strategies. Cognitive-behavioral therapy (CBT) is particularly effective for depression and can help you challenge negative thought patterns that contribute to emotional instability.

6. Emergency Plan: If you ever feel that your safety is at risk, it’s crucial to have a plan in place. This might include knowing who to call, where to go, or what steps to take to ensure your safety.

Lastly, it’s important to maintain open communication with your healthcare provider about your experiences. If you feel that your current treatment isn’t adequately addressing your symptoms, discussing this with your doctor can lead to adjustments in your medication or therapy approach.

In conclusion, your journey through depression is uniquely yours, filled with both challenges and opportunities for growth. While the road may feel daunting, remember that progress is often non-linear, and seeking help is a sign of strength. You are not alone in this, and with time, support, and the right strategies, it is possible to navigate through these emotional storms and find a path toward healing.

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