How do you get "back on track"? Could use advice.

I'll be fascinated to hear other's responses to this as I also struggle with similar issues. For me, I'm at a stage where I've come to accept the swings rather than keep trying to prevent them. I guess I'm old enough and been through so many that I've realised that I always come through them sooner or later.

The big things that have made all the difference for me are:

• A really understanding husband. It's been hard on him but we've come through some really tough times together stronger at the other side. When he sees me slipping he's able to give me space to let it pass.
• A flexible work situation. I take more sick leave than I'd like and frankly a normal employer wouldn't tolerate it. So I am self employed and give myself the time when I need it to rest and retreat from the world.
• A basic, non negotiable set of habits. Essentially this boils down to no matter how bad I'm feeling I always take my medication, have a shower and brush my teeth. After that, if I need to go back to bed that's fine.
• When I'm feeling good I am a much better house keeper than I ever used to be. Living in a clean and tidy home has reduced my tolerance for what could be described as squalor which I have lived in in the past. This has helped my mental health in general and also serves as an early warning system - if I come home and realised I didn't make the bed for example I watch myself for other signs of a dip and try to increase my self care - going for a walk outdoors, a massage, chocolate - but also increase my vigilance with my routines to not start slipping without being mindful of what's going on. That way I go through my low on my terms, knowing what's happening and knowing it will pass rather than trying to ignore it or 'soldier on' which never ends well for me.

So my advice, for what it's worth, is to try to be kind to yourself. You're not behind, you're just going on your journey.

My heart goes out to you, rogue_cricket. I've always loved your presence here on the site, so it hurts to know that you're hurting.

I see a lot of myself in your words. I was diagnosed with major depressive disorder a long time ago, and I now live my life with that label mostly in the rear view mirror. Most days are good, happy, fulfilled days for me.

Every so often though, the tide of depression comes back up and I have to deal with it until it subsides. I'm not in therapy or on any related medications anymore. I mostly get through these periods by acknowledging that they are temporary, they're distortions, and that I only have to do what I can during those times, not what I should. I intentionally lower my expectations for myself because my throughput is so reduced.

Here's an excerpt from something I wrote as I went through a low point a few weeks ago. I initially intended it as a blog post but, like most of what I write, never posted it anywhere (that's another tip: sometimes writing things helps get them out of your head and lets them live somewhere else -- and that's especially true for things no one else will ever read). I share it here less as advice and more as commiseration:

Occasionally, the depression returns.

I'm much better equipped to handle it now. I recognize it immediately. I know its texture -- the way it sits in my brain. I know that pressure-in-your-eyeballs feeling, where you feel like you might cry but you're not all the way there.

I know my baseline and range of emotions under normal circumstances, so I can recognize when depression shifts that. I know that this shift is temporary, and that I'll get back to my baseline soon enough, but probably not as soon as I'd like. I know there's not a quick fix or even a direct fix on its own. I also know that my lows tend to be relatively shallow ones. Having explored the deepest depths of depression myself earlier in life, when my depression returns it comes in the form of dips rather than trenches.

Having this awareness is genuinely helpful.

---

One time, I smoked too much weed and got severely disoriented. The whole world was swimming and shifting around me and I was severely nauseous. I thought lying down would help, but it felt like my bed was moving. I had no equilibrium -- no sense of center.

I put my foot over the edge of the bed and put it flat on the floor.

This floor, I told myself, is what flat is. It is unmoving and it is horizontal and it is level.

Your foot, I continued the conversation, is flat on the floor. It too, is horizontal and unmoving.

Your body, I went on, is lying the same way as your foot. It is on a flat bed. That bed is not moving.

The conversation with myself acted as a sort of logical proof for my body. In the unnerving spinning of my uncomfortable high, I created a frame of reference for myself -- an anchor point that I could use to find some calm in the storm.

It genuinely did help me in that moment, by the way, but I share it here not because it's a story worth telling on its own but because it's a weirdly accurate analogy for what I experience with depression.

When my depression returns, it is emotionally disorienting. It is an overwhelming feeling that sets me spinning.

Knowledge of my emotional baseline is my foot on the floor. It's what lets me reconstruct a sense of "normal" admist a period of very obvious not-normalcy.

I know, intellectually, that the depression is there. I know, intellectually, exactly what it does. I can reconstruct a logical anchor for myself so that I'm less swayed by depression's strong winds.

But every time it returns, I'm always caught off-guard anyway, because I forget how powerful it is.

---

I'm a career teacher. I've done it for many years now, having taught thousands of students.

I try to have a positive impact on my students. It's something that gives me genuine joy and makes me feel like I'm doing something meaningful with my life. I'm not a very proud person, but I do take pride in some of the specific students I've helped over the years -- the kind that I've gone above and beyond for.

This past year I got a letter from a student on the last day of school. She gave it to me in an envelope, and I asked her if I should read it now, in front of her, or later, on my own. She said it was fine to read it now, and after I opened it up to find kind and heartfelt words about how much she appreciated having me as a teacher, I openly wept in front of her. She cried too.

Moments like these are truly beautiful, and I consider myself lucky that I get to experience them.

But I don't share this story to pat myself on the back or even celebrate that moment. I share this story because it helps capture just how powerful depression is.

In my current low, I have spent the last two nights unable to sleep. As my brain jumps from thought to thought underneath a tidal wave of sadness and the ever-present sensation of feeling like I need to cry but not being able to, my brain genuinely believes that my career is empty; my life's work meaningless; my impact on the world negligible or, worse, negative.

It feels honestly silly to type it out, because I am fully aware that it's not true. I have direct proof of it, after all. I can re-read that student's letter -- or several others like it I have received over the years.

But proof and what I know are all damned in those moments, because when the depression hits, its sadness and its emptiness feel more true than anything has ever felt. It completely hollows me out.

I know, intellectually, that it's not real, but it doesn't feel that way at all.

My journaling ended there, at a low point, because I was in a low place. The good news is that I'm no longer there, and I'm back to my baseline: generally happy, fulfilled in what I do, sharing in my students' joy, etc.

A lot of getting through the dark periods is simply trusting that I'll return to my normal baseline, which, thus far, I always have. The other part is, weirdly enough, not trying to fight the depression head-on. Instead, I almost invite it in -- like an unwelcome houseguest. Yes, they're going to make a bit of a mess of things and take over my schedule and overstay their welcome, but I always make sure I'm viewing them as a visitor and not a cohabitant. Those things I wish I could do or want to make happen get scheduled for after they decide to leave.

I give myself permission to not be optimal, efficient, and productive. I give myself permission to sit in sadness without fighting it. I give myself permission to not need a reason for what I'm feeling or how I'm thinking. I visualize all of this as a sort of polite listening to my houseguest, letting them talk on because it's easier than trying to interrupt or argue with them. It takes up time and energy, yes, but, eventually, they'll stop talking and I'll be able to leave the conversation, and, eventually, they'll head out and I'll get to clean up after them.

I'm no therapist, and I don't even know if my way of dealing with it is healthy or maladaptive. Maybe some people with depression are able to fully escape it and I'm actually sicker than I think I am? So, don't necessarily look at what I'm saying as any sort of prescription or fix or even sound advice.

Just know that I'm hoping for the best for you. One of the other things that grounds me, when I'm in my depths, is that other people care about me, even when I don't. It's one of the "feet on the floor" I use to try to keep my baseline in sight and in memory.

Know that I genuinely care for you, rogue_cricket, and I wish you peace.

A combination of medication and therapy tends to be the best option. As someone with severe depression, PTSD and to a small extent ADHD, I sympathize with the emotional rollercoaster. Many days I let dishes and other chores pile up because I just don't care. It can be hard to want to do anything. Sometimes you have to just force yourself to do things; even just doing a single task as simple as sweeping the floor, washing a few dishes or organizing stuff gives me a bit of satisfaction that I managed to at least accomplish something.

The biggest thing for me is having what my therapist likes to call “a lot of tools in the toolbox”. Targeting the real reason I’m disinterested in something means more successful strategies to navigate. Something that works really well for a while can wane in efficacy, so I try something else out. Dani Donovan’s Anti Planner has been a godsend in that way; as an ADHD artist and designer she wrote it specifically for ADHD people. Pomodoro timer working? Great, I’ll use it until it doesn’t. If it’s not working I’ll flip through the book to see what else I can be doing instead. I HIGHLY recommend, even if it’s kinda pricey.

Another thing I do is a “good enough” job. Meaning, the dishes don’t have to be perfectly done, they just have to be put in the dishwasher. I don’t have to put away ALL of the groceries, just the stuff for the fridge/freezer. I didn’t put my clothes away, but they’re washed. I won’t clean the bathroom, I’ll just wipe out the sink. Usually doing a small part of a task is enough to break the hurdle of inertia and get me farther than my intended goal: just the sink turns into just the sink and the toilet turns into just the sink and the toilet and the tub, then the bathroom is clean. Putting the spoons away from the dishwasher turns into emptying the dishwasher.

It’s not a perfect system, and sometimes I offload the task to outside help. I reach out to friends and family, ask them to FaceTime while I do dishes or something, or set challenges for myself. The goal is not perfection, it’s working with yourself to move through life.

I will say the sleep disregulation is probably playing a bigger part on you than you think. I notice my adhd is worse on days I’m tired: I need a second dose of afternoon meds those days, or I need to be more strict with myself on daydreaming/time wasting. I’d say to try and get your sleep back on a schedule. Even if you can’t fall asleep i recommend listening to podcasts (Sleep With Me is fantastic for getting me to doze back off) rather than getting up and reading or scrolling on your phone. Meditating is also fantastic for me to settle myself and calm my mind.

Best of luck, buddy. You’re not alone and it’s not hopeless.

I struggled with addiction, which was related to my underlying depression and probably some other trauma. I only got a diagnosis for the former. I still get these swings, where I'm down and slightly depressed for several months. Thankfully, it now seems to happen one time per year, on average.

The biggest help for me is thinking that nothing is permanent. Both the good periods and the bad ones will pass, eventually. I think that this helps me not stress out too much - when I'm in a good state, I'm not anxious about what's to come. When I'm in a bad state, I'm not pressuring myself into trying to feel better.

But sometimes I go through these phases, generally 1-3 months long, where my ability to function on a normal level slips dramatically.

If you have "swingy" mental health, or phases, or waves - what do YOU do about it, if anything? Therapy? Do you change your medication?

As someone with a bipolar diagnosis (among others), the pendular nature of your mental health makes me think there may be something to explore in regard to your diagnosis. A conversation with your doctor may be worthwhile. Bipolar disorder, cyclothymia, and seasonal affective disorder are possibilities that come to mind.

Speaking from experience, mood stabilizers are aptly named and highly effective.

Good luck! :)

This post reverberates a lot.

I am diagnosed with BPD, not ADHD, but I sometimes think I have CPTSD too. But yeah BPD is one of the very swingy/wavy/phase-y diagnoses, however it's way shorter term than the month-long time frame you're talking about. I do get the longer lasting ups and downs too, but that's probably a generally human type of thing.

I have ruined my life multiple times because of these mood swings. Even if the episode it has only been for a single day or a week, that's enough to quit your job, leave school, blow up at a friend and lose them forever... I have learned to see the signs as I've gotten older though (30) - but as a teenager I was wildly unpredictable to everyone, including myself.

I guess I don't really have much to add, certainly not an answer to your questions aside from some generic "we'll figure it out" advice. But I really do believe we'll be fine eventually.

I really relate with your experience and will be following the thread

A lot of good suggestions and advice in here; however, I'd add that I think it's good to ask yourself what your social support system looks like. A partner, friends, a therapist, a psychiatrist, a mental health peer support group, a hobby group, etc. Having at least a few of those would be a good start to help keep you on track.

It also might be helpful to reconsider your perspective on therapy. While it may not be as necessary as it once was in the past, it might be good to revisit. It can be good just to check in rather than seeking treatment for a specific diagnosis.

So for people who have OP’s issue or similar, what do other people do for you that helps?

I've been dealing with periods of pretty bad depression for a while, and the best trick I have to follow to help climbing back up the hill rather than falling in deeper: set one reasonable, somewhat simple goal for the day, and if you do that goal, it was a good day.

"If I do 15 minutes on the Elliptical, today was a good day."

Getting that little win can really matter. For me, it would often trickle through into other parts of your day. It lets you give yourself a break -- you can actually pause and do something for yourself without feeling guilty, if you've already met the "today was a good day" goal you set earlier.

Also, exercise is incredibly important. Most of my 'little goals' are exercise based, because I know damn well if I exercise, I'll do more with the rest of the day too.

One thing I'm practicing is write out all the things that annoy you or all the boundaries you're not setting or enforcing with people in your life and slowly start to speak out (with empathy and politely) about certain things so people know in no uncertain terms that you're not accepting whatever anymore and that they need to work with you to help start falling in line with these boundaries.

Make sure the boundaries are appropriate and that you have a right to expect them and that there needs to be a gradual acceptance and acting within them in order for that relationship to continue being enjoyable and productive or even just sustainable.

You'd be surprised how resentful you can become aware of feeling with people who constantly undermine or refuse to accept basic rules of decency or things that you value that they are perhaps unintentionally flouting and continuing to do so on an ongoing basis and how disempowering that is when you aren't being respected in the way(s) you need.

Break down things you see as more helpful or aspirational and then break those actions into smaller steps. Like, exercise can be a one kilometer run or a five minute walk, which can just be a two minute sit outside, which can just be a plan to go outside tomorrow and deciding to relax today. Relaxing and enjoying yourself can also be an accomplishment. Enjoy your accomplishments and find your limits, so you know what to expect of yourself, rather than following perhaps arbitrary societal ideas of what you're supposed to be doing.

Once you slip, focus on the basics, whatever those are for you, and reset. Consider putting a name to patterns or setbacks and try to identify them, eventually trying to predict and head them off at the pass.