One year without a depressive episode – a cautious celebration! SHORTS edition

It’s been twelve months now since I have experienced a depressed period. Achieving this has been a long sought-after target after around 8-9 years of cycling through up and down periods, with the predominant and longer spells being depressed ones. So, why has this brought uncertainty and consternation rather than pure celebration?

I should be celebrating, but it’s not that straightforward.

This should, I feel, be a time of celebration and relief. A time to acknowledge all the work I have put into managing my mental health more effectively. Breaking this cycle has been a big aim of mine, and honestly, I didn’t think I would achieve it this year.

Not experiencing depression for a year now has been a blessed relief. However, the longer the stability remained over this autumn and winter, the more unsettled I became. My usual anchors and rhythms of life have been disrupted - in a good way, but it still requires processing and management.

The reality of living with recurrent depressive episodes

The impact of a depressed spell for me tends to be:

• Loss of words and thoughts
• Loss of connection to others
• Loss of confidence
• Struggle to plan anything and make decisions
• Loss of motivation and energy
• Loss of hope for the future

Cumulative effect

Experiencing the above impacts just once is hard enough, but experiencing it recurrently adds to the effects of each episode. Whilst I have gained the knowledge and ability to cope with the extreme lows, each time, there remains a question mark as to whether I can pull myself out of the latest dark, depressed hole. There's the ever-present fear of depression consuming me once again.

Adjusting to the familiar pattern being disrupted

Whilst these depressed spells were horrible to live through, they had been a recurrent part of my life for nearly a decade. The recognisable pattern of my moods and experiences was suddenly broken, and I found this destabilising and unsettling, whilst also being thankful that I had avoided the depression thus far. 

This is the reality of living with a long-term mental health condition like bipolar. It’s possible to live well and manage symptoms, but the fear of depression returning never really goes away.

What has helped me avoid depression this autumn/winter?

Many variables have changed between and within the last two autumn/winter periods, making it difficult to draw specific conclusions about cause and effect. I have, though, been able to identify several interlinking factors which I believe have helped me avoid depression this time around. 

• A change in anti-depressant medication early last year, and I started HRT in December.
• Ongoing regular therapy sessions and more regular input from a psychiatrist.
• A better understanding of how being autistic impacts me and how it interacts with being bipolar.
• I have a much better understanding of bipolar disorder.
• Focused on Seasonal Affective Disorder (SAD) and how to mitigate its impact (see my earlier newsletter about my Strategies for coping with SAD).
• I have maintained a good connection with my husband, children, and close family.
• I have maintained engagement on social media and written these newsletters.
• Regular exercise.
• Peer support for both the bipolar and the SEND parenting side of things.
• Being self-employed and having the opportunity and flexibility to do volunteer work alongside paid freelance work in my areas of interest. This has undoubtedly given me the time to put all the above in place.

What do I need to do now to maintain this stability in the long term?

One of the most problematic aspects of living with bipolar is the contrast between the highs of hypomania and the lows of depression. I have said on numerous occasions that I enjoy the periods of hypomania. I find the boost in energy, the lack of need to sleep for as long, my brain operating at multiple times the speed it does when depressed, the ideas and connections my brain makes during those periods, and the confidence it gives me, a real benefit. It is tangibly and noticeably different. 

However, one of the most important realisations I have had is recognising that whilst hypomania is enjoyable and arguably productive initially, the consequences, both during periods and for the months following, can be severe. They can negatively impact my relationships with others. I also tend to take on too much, leading to burnout if left unchecked. 

This is where I believe my bipolar and autistic needs have interacted most noticeably in the past. Hypomanic episodes in recent years have increased in intensity and led to me becoming dysregulated and exhausted physically and mentally. What I have managed to achieve within the last twelve months, which seems to have helped, is to recognise when I am veering towards hypomania and to keep a lid on activity levels as far as possible.

Previously, I would have continued to push on through when starting to feel like my energy levels and mood were dipping because I would assume that what I was experiencing was the onset of depression. However, recognising that what I am, in fact, experiencing is autistic burnout means that resting and withdrawing for a few hours, days, or a week even seems to have enabled me to reset and then reengage without depression occurring. 

From now on, I will be trying to do more of the same. Evening out the edges of my bipolar symptoms whilst not expecting myself to stay at a constant mood level and recognising the needs I have as an autistic person. Maintaining connections to others is incredibly important, both in person and virtually. I need interactions, feedback, informed debates and discussions, and I need to feel understood without overexplaining myself. 

Valuing and nurturing my most important relationships is essential to me, and my husband, children, and close family and friends will always come first. But I’ve recognised that to be there for them, I also need time for myself, to pursue my interests and hobbies, to have time for friendships and more professional relationships to build and nurture. I must be clear and comfortable with my identity, beliefs, and values. 

I haven’t figured this out conclusively yet and probably never will; it is a constant learning curve, and life never stands still. It’s hard work and takes considerable time and effort, but I hope it is starting to pay dividends.

About the author

I am Joanne (Jo) Feaster, a late-identified autistic and bipolar woman. I started self-identifying as autistic in May 2023 and was diagnosed with bipolar type 2 in July 2023. I am married and live in Leeds with my husband, John, and my two exceptional children, both of whom were diagnosed in late 2023 and early 2024 as autistic and with ADHD. 

I write to aid my mental health and to share my lived experiences as an autistic and bipolar woman and parent-carer of my neurodivergent children. I subscribe to the social model of disability and the neurodiversity paradigm. I see our strengths, positive qualities, and spiky profiles just as much as I recognise the barriers we face from society.