Reclaiming your mental wellness back from depression is difficult and energy-consuming. While it may take some time to find the right combination of treatments, activities, and therapeutic techniques that work, most people will eventually find relief. After reaching this stage, it may seem like depression is “cured.” For around 50 to 60% of people, it is. However, for many, depression is a recurrent disorder with periods of remission and relapse, similar to asthma, diabetes, or lupus [1]. This can be a difficult message to hear, but knowledge is power. By recognising and understanding the recurring nature of depression, you are in a much better position to manage your condition. Looking after your mental health will never be a one-and-done deal. Instead, it is a responsibility that you will have throughout your lifetime. It’s a tough path, but you never have to go down it alone. Depression treatments, support from loved ones, and guidance from medical professionals are resources that can support you along the way. What Is Depression Relapse? After going through several cycles of recurring depression, I finally understood my pattern. If I wanted to feel better, I would have to keep managing my stressors. Knowing that I can be healthy again motivates me when a relapse eventually happens. - Anonymous After treatment, depression symptoms can go away. Even going through a difficult period doesn’t bring them back. When this happens, depression is considered to be in remission. However, it is common for a depressive episode to reoccur, or relapse, after months or even years of being symptom free. The mental health community defines depression relapse as the re-emergence of symptoms, such as irritability, a sense of worthlessness, or pervasive low mood, after a period of emotional health. While people with recurrent depression can go through periods of emotional stability in between depressive episodes, this is not the same as the cycles associated with bipolar disorder. Although, in isolation, depressive episodes in the two conditions can look very similar. What Is the Difference Between Recurrent Depression and Bipolar Disorder? People with both recurrent depression and bipolar disorder can experience depressive episodes. The major difference is that people with bipolar disorder also experience at least one period of extreme emotional highs, known as mania or hypomania. Bipolar depressive episodes require different treatments than the depressive episodes of recurrent depression, so accurate diagnosis is key. Just one episode of hypomania or mania is enough to eliminate recurrent depression as a diagnosis. If you have ever experienced any combination of the following symptoms of bipolar disorder, consult your doctor: Sense of euphoria or invincibility An increase in risk-taking behaviours Incessant talking, pressured speech patterns Racing thoughts Insomnia and reduced need for sleep [2] Does Everyone Relapse and Why Does It Happen? While the causes of depression relapse aren’t clear, it is very common. Sometimes, relapse arises after facing a series of difficult situations. Other times, it occurs out of nowhere, right when everything seemed to be going so well. Half of people with major depressive disorder will experience more than one episode in their lifetime. After experiencing two episodes, the majority of people will have at least one more relapse. Episodes tend to occur several years apart but may last for weeks or months. Researchers are still uncovering the science behind depression relapses. There is some evidence that some personality traits, like neuroticism and dependency, can increase the likelihood of recurrence. Neuropsychologists are also investigating other possible factors, like hormonal fluctuations, genetics, and sleep quality. Sometimes, the triggers for relapse are easier to identify. A stressful life event, like a job loss, the death of a loved one, or an illness can increase the risk of relapse. Managing stress with less helpful coping mechanisms, such as alcohol or drugs, can also cause a relapse. Since the causes of relapse are both within and outside of our control, it is not easy to say what particular factor causes it. For many people with clinical depression, the chance of relapse is not a question of if, but when. It’s not because they have done anything wrong. It's just the nature of depression as a recurring disease. Even so, relapse can unleash complicated feelings of guilt and hopelessness. If you’ve noticed your depression is coming back, take it easy on yourself. Tough times are inevitable and difficult to predict. For this reason, relapse management is just as important as prevention. How Can We Manage and Prevent Relapse? Since relapse is so common, most psychologists recommend creating and following a relapse prevention plan immediately after depression treatment. How this looks will depend on several factors, including: How many previous relapses you’ve had Your response to antidepressant treatment Generally, people should continue any successful treatment approach for a minimum of 6 months after remission. In the case of selective serotonin reuptake inhibitors (SSRIs) and other prescription antidepressants, a psychiatrist may adapt the dose by tapering it over time [3]. Mental health self-care activities like a daily mindfulness meditation practice and a sleep hygiene routine can also reduce the risk of relapse. The relapse prevention plan includes monitoring therapeutic activities to help identify depressive symptoms in the early stages. For example, writing down any worrisome behaviour changes, such as sudden changes to sleeping or eating patterns, and tracking their duration. If symptoms like loss of interest, low mood, and intense feelings of worthlessness or guilt persist for more than 14 days, it could indicate a relapse. Relapse prevention plans include steps to take should depressive symptoms return [4]. Here are a few common actions: Schedule a therapy/ psychiatry appointment Lower stressors by delegating tasks, scaling down projects, or delaying significant changes if possible Call/meet up with a friend or loved one Cut back on alcohol and overprocessed foods Try a few evidence-based journaling prompts[5] What emotion did I feel most today? Where in my body do I feel my emotions? What actions have I done in the past that improved my mood? Can I do any of these actions today? Re-introduce effective depression treatments into your daily routine. Keep evidence-based treatments on-hand, such as a therapy lamp in the case of seasonal depression. Start daily tDCS sessions with the Flow headset. Flow is a medically approved brain stimulation device that you can safely use at home under the supervision of a qualified Health Practitioner to reduce depressive symptoms. You can order the Flow headset and have it delivered directly to your door. If you always have a Flow headset on hand, you can start treatment sessions as soon as depressive symptoms re-emerge [6]. Relapse isn’t a personal failure, but rather an inevitable part of the recovery journey. Having a robust relapse prevention plan in place is the best way to keep depression in check. [1] Burcusa SL, Iacono WG. Risk for recurrence in depression. Clin Psychol Rev. 2007 Dec;27(8):959-85. [2] Altaweel N, Upthegrove R, Surtees A, Durdurak B, Marwaha S. Personality traits as risk factors for relapse or recurrence in major depression: a systematic review. Front Psychiatry. 2023 May 5;14:1176355. [3] Nuggerud-Galeas S, Sáez-Benito Suescun L, Berenguer Torrijo N, Sáez-Benito Suescun A, Aguilar-Latorre A, Magallón Botaya R, Oliván Blázquez B. Analysis of depressive episodes, their recurrence and pharmacologic treatment in primary care patients: A retrospective descriptive study. PLoS One. 2020 May 21;15(5):e0233454. [4] Kang S-G, Cho S-E. Neuroimaging Biomarkers for Predicting Treatment Response and Recurrence of Major Depressive Disorder. International Journal of Molecular Sciences. 2020; 21(6):2148. [5] https://www.choosingtherapy.com/journal-prompts-for-depression/ [6] https://www.heretohelp.bc.ca/infosheet/preventing-relapse-of-depression

Caring for yourself, both physically and emotionally, during cancer treatment is vital to your recovery and can often feel overwhelming. The effects of treatment, combined with everyday pressures, can leave little energy for your own self-care. Prioritising self-care will help you maintain strength, manage symptoms and support in your recovery.  In this post, we’ll explore three key areas to self-care, mindfulness, nutrition and exercise, offering practical ways to nurture your body and mind throughout your cancer journey. Mindfulness and Mental Health Cancer can bring a range of emotional challenges and distress, from anxiety about treatment to trouble sleeping. Mindfulness practices can ease these pressures and improve quality of life. Mindfulness involves your ability to be fully present in a moment and can involve practices such as meditation[1]. Meditation, for example, has been shown to help reduce pain, fatigue, high blood pressure and insomnia, while promoting relaxation and mental clarity[2]. Just a few minutes each day focusing on your breath can make a difference. Journaling is another simple tool that is easy to implement into your routine. Writing down thoughts and feelings can reduce stress, track moods and provide perspective during treatment. Pair this with basic breathing exercises to calm the nervous system and lower tension. These practices can be done anywhere, making them easy to incorporate into your life. Nutrition for Strength and Energy Further, a balanced diet is essential for maintaining your body's strength and supporting recovery, and it is an integral part of self-care. Adequate protein is especially important to maintain muscle mass and energy as cancer takes a large toll on your body. Aim to include lean meats, fish, eggs, dairy and healthy fats in your meals. Cancer Council Australia provides nourishing recipe ideas such as chicken satay curry, salmon risotto and protein pancakes to help you meet your needs [3]. Hydration is equally critical. Aim to drink around two litres of fluids a day, more if your doctor recommends it. Water, herbal teas, and clear broths are all adequate forms of hydration. If treatment affects your appetite or ability to absorb nutrients, ask your healthcare team whether vitamin or mineral supplements are appropriate. Key nutrients for many people with cancer include vitamins A, C, D and E, zinc, calcium and magnesium [4]. Your doctor or dietitian can guide you on the right amounts and safe combinations. Exercise for Body and Mind Physical activity supports both your mental well-being and physical strength. Before starting or changing any routine, speak with your doctor to determine what level of activity is safe for you during your treatment and recovery. Gentle movements, such as stretching, standing and light household tasks, can help reduce stiffness and improve circulation. For those cleared for moderate exercise, options like walking, water aerobics or dancing can help boost mood and stamina. If you’re already active and your doctor greenlights it, more vigorous activities such as running, swimming or hiking may be possible [5]. Even small bursts of movement throughout the day can ease fatigue, strengthen muscles and enhance your overall quality of life [6]. It is best to ask your doctor about which exercises are the most beneficial for you.  Mindfulness, nutritious eating and regular exercise each play a crucial role in supporting your wellbeing during cancer treatment. These self-care practices help manage side effects, maintain energy and foster a sense of control. Start small and listen to your body to tailor these suggestions to your individual needs. [1] https://www.headspace.com/mindfulness/mindfulness-101 [2] https://www.cancerresearchuk.org/about-cancer/treatment/complementary-alternative-therapies/individual-therapies/meditation [3] https://www.cancer.org.au/cancer-information/causes-and-prevention/diet-and-exercise/food-and-nutrition/healthy-recipes [4] https://www.cancerresearchuk.org/about-cancer/treatment/complementary-alternative-therapies/individual-therapies/vitamins-diet-supplements [5] https://www.cancer.gov/rare-brain-spine-tumor/living/self-care/physical-health [6] https://www.cancersa.org.au/support/living-with-cancer/exercise-for-people-living-with-cancer/about-this-information/  

After being diagnosed with depression, it is normal to wonder, what can I do to feel better? Treatments come in many forms - from lifestyle changes to prescription medicines. However, there isn’t a treatment type that is suitable - or even works - for everyone. More than 60% of people taking prescription antidepressants experience at least 10 side effects, and some of them are pretty severe [1]. At the same time, psychotherapy is not always accessible, or desirable. Even if a depression treatment does have a positive effect, it probably won’t treat all symptoms. Most likely, it will take a mixture of several approaches to fully recover from depression. Finding the combination of treatments that will produce the best results for you takes a bit of trial and error. If the treatments you’ve tried haven’t been effective or right for you, there’s still hope. While medication and psychotherapy are the most common treatments, they are far from the only ones available. One option that stands out has: No severe side effects No waiting lists And are as effective as other antidepressant treatments This evidence-based treatment is known as transcranial Direct Current Stimulation, or simply, tDCS. tDCS is a versatile treatment option. It can be used alone or in combination with other treatment approaches. If you haven’t heard of tDCS before, it’s probably because for many years it was only available in a clinical setting. Today, there is a medically approved tDCS device for home use. You simply need to talk to your appropriately qualified health practitioner and ask them to authorise supervising you and your use of Flow. In order to purchase and use the Flow tDCS you will need your health practitioner to supervise your ongoing treatment and progress. Before we go further into that, let’s back up and talk about the technology behind tDCS. tDCS: The History tDCS is a type of depression treatment known as brain stimulation. This means that it interacts with brain cells and nerves through a very mild electric current. While this wouldn’t be out of place in a sci-fi movie, tDCS is actually quite an old technology. Ancient Romans used the currents emitted by electric fish to treat nerve pain, and tDCS was first used as an effective depression treatment way back in the 19th century. tDCS headsets have been used by psychologists and mental health clinicians since the 1970s. And in 2019, Flow Neuroscience had created the first medically approved tDCS headset for at-home use in the UK. The Flow tDCS headset has undergone rigorous IEC compliance and European Union CE-mark testing and is TGA and Medsafe approved in Australia and New Zealand. The device also has important safety features that eliminate the risk of adverse side effects. Anyone with a clinical diagnosis of Major Depressive Disorder (depression) could try Flow — you can talk to your health practitioner to see if Flow is right for you. tDCS vs TMS vs ECT: What’s the Difference? Besides tDCS, there are other treatment protocols that relieve depressive symptoms through brain stimulation. The best-known are: Electroconvulsive Therapy (ECT) Transcranial Magnetic Stimulation (TMS) While both ECT and TMS are used for depression, they are very distinct treatments that are recommended under very different circumstances. ECT is reserved for the most severe cases of treatment-resistant depression. It can only be performed in a clinical setting and under the direct supervision of a medical professional. ECT is helpful and highly effective but has significant side effects such as memory loss. For this reason, it is usually only used as a last-resort treatment. TMS is a much milder treatment than ECT and uses magnetic fields rather than electricity to stimulate the brain. TMS is effective, non-invasive, and well-tolerated (although there is a minuscule chance of serious side effects). However, it can only be done in a medical setting. Most people will need at least 30 once-per-day sessions to see a change in their symptoms. tDCS, like TMS, is also mild and non-invasive. However, tDCS has no severe side effects. While most tDCS treatments are designed for clinical use, the Flow tDCS device is portable and battery-powered, making it possible to undergo treatment at home. How Does Flow tDCS Treat Depression? The Flow tDCS device resembles a headset or small headband with two electrodes. During a session, these electrodes will go on either side of your forehead and send out a minor electric current. This passes through the dorsolateral prefrontal cortex (DLPFC) – a brain area that often under functions in patients with depression (specifically the left side of the DLPFC) [2]. The current helps neurons in that region to “fire up” and make them more active. A more active DLPFC can raise your mood and reduce your depressive symptoms. This effect is so strong in fact, that research shows that tDCS is as effective as other types of antidepressant treatments. In some studies, tDCS have made SSRIs (a common type of antidepressant) even more effective [3]. What Is It Like To Use a Flow tDCS Headset? The Flow headset can be delivered to your door, you can take the device right out of the box, charge it, and follow the steps included with your headset to potentially use it within the same day. Before you begin your first session, download the Flow app. When you look at the headset, you will see two holder rings, which fit two circular sponges. These holder rings are electrodes and will fit on either side of your forehead. In the app, you will find a helpful instruction video that walks you through the process of placing the headset correctly. Once you press the start button on the app, you’re all set. The electrodes will start to emit a very low voltage current. This may sound intense but don’t worry, tDCS sessions are typically painless. You might feel a slight tingling or warming sensation on your skin. This is normal and will stop as soon as you are done with your session. Also, you will probably notice that this reaction will fade as you get used to the device. During the session, you can do any of your usual activities. Some people like to draw, knit, watch T.V., read, or just relax. A typical session lasts around 30 minutes, and the headset will shut off by itself. When you’re done, you might notice a boost in your mood or energy right away. Following your first session, you will need to continue tDCS sessions 5 times a week for 3 weeks. After that, you can scale back and do sessions a couple of times a week. If you’d like, you can combine the headset with the Flow in-app treatment program, which will help you make important lifestyle changes, like improving your sleep quality and nutrition. The in-app treatment program also contains meditation exercises and suggestions for incorporating more movement into your life. Like the headset, you can use the Flow in-app treatment program on its own, or in combination with other treatments. You can do whatever works for you and your lifestyle. So, tDCS is an approach that can help you tip the scales when it comes to managing your depression. If you are thinking of trying tDCS, the Flow headset talk to your qualified health practitioner to see if Flow is right for you. [1] Read, J., Cartwright, C., & Gibson, K. (2018). Adverse effects of antidepressants reported by a large international cohort: Emotional blunting, suicidality, and withdrawal effects. Journal of Affective Disorders, 227, 75-84. https://pubmed.ncbi.nlm.nih.gov/29866014/ [2] Ahmadizadeh, M. J., Rezaei, M., & Fitzgerald, P. B. (2019). Transcranial direct current stimulation (tDCS) of the DLPFC for treatment of neuropsychiatric disorders. Brain Network and Modulation, 2025 [3] Brunoni, A. R., Valiengo, L., Baccaro, A., Zanão, T. A., de Oliveira, J. F., Goulart, A., Boggio, P. S., Lotufo, P. A., Benseñor, I. M., & Fregni, F. (2013). The sertraline versus electrical current therapy for treating depression clinical study: Results from a factorial, randomized, controlled trial. JAMA Psychiatry, 70(4), 383–391. https://doi.org/10.1001/2013.jamapsychiatry.32

Discover Flow Neuroscience, a breakthrough tDCS headset and therapy app for managing depression. Learn how this non-invasive, home-based treatment works, its benefits, and if it’s right for you.