Given that more than 300 million people worldwide have had depression, we're all bound to have vastly different experiences living with it. But for many of us, depression isn't constant — there are good days and bad days. And on the really bad days, some people might go through a depressive episode, where they feel especially hopeless and like they can't get out of bed for days at a time.
According to the National Institute of Mental Health, a depressive episode can be defined as a period of two weeks or longer where a person is in a depressed mood or feels other symptoms that might reflect a change in their functioning, like trouble sleeping or eating, and thoughts of suicide. And, the NIMH estimates, about 16.2 million adults in the United States have had at least one major depressive episode.
A depressive episode, however, is more than a mental health issue. Susanne Babbel, PhD, a therapist based in San Francisco, says that there can be physical aspects to it, too.
"Symptoms can occur as deep sadness, withdrawal, hopelessness, change in eating patterns, severe constriction, and aches and pain," she says.
If you feel these symptoms come on, it's best to talk to a mental health professional and ask for help as soon as you can. Once you've had help from someone who can guide you through an episode, the most important thing to do is to continue to seek treatment (like going to therapy). But even as you recover and come out of a depressive spell, the transition can be difficult, and you might still find yourself exhausted and isolated.
And while support from a mental health professional is crucial, it's also important to have the support of your family and friends — though the nature of depression sometimes means that you distance yourself from those people during an episode. If that's the case, Dr. Babbel says that you can reach out to them and explain what you were going through.
"Be honest and educate them about what a depressive spell is and how they can be supportive," she says. "Reassure your friends that you care about them and that a depressive spell is not a reflection on your friendship with them."
Reassure your friends that you care about them and that a depressive spell is not a reflection on your friendship with them.
Susanne Babbel, PhD
You might, for instance, say something like, "Hey, I'm sorry I've been a little absent. I've been going through a lot mental health-wise, but I still really care about you and our friendship, and I'd love to get together sometime soon."
Because at least half of people who have had a major depressive episode are at risk for more episodes down the road, those positive relationships are key to getting help and recovering, and so is being patient with yourself.
"Practice supportive, compassionate, and calming self-talk such as, This will not last forever and you get through this," Dr. Babbel says. "Nurture yourself by doing something nice and send a loving message to yourself."
She adds that it's helpful to try to recognize what triggered this episode, and what helps you heal so that you can better prepare yourself if you go through another one in the future.
"Learn the warning signals of your spells so you can catch it before you spiral down too far," she says. "Make a list of what works for you during and after a depressive spell and go back to it when you need to."
If your depressive episodes are occurring on a regular enough basis to affect your relationships and work life, Dr. Babbel says, that's something you should definitely bring up with a doctor. In the meantime, remember that managing depression is an ongoing process — and it might take time.
If you are experiencing depression and need support, please call the National Depressive/Manic-Depressive Association Hotline at 1-800-826-3632 or the Crisis Call Center’s 24-hour hotline at 1-775-784-8090.