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When a Mental Health Diagnosis Returns

By Peggy Rice, Hope Coach Trainer for Fresh Hope

It began on a Thursday afternoon. This was my time—set aside for just me and whatever I wanted to do. It was a recent margin I’d built into my week—an afternoon alone, while my husband was gone volunteering, and the time was all mine to do as I pleased: read, crochet, listen to music.

I chose to lie on the couch with the blanket pulled over my head.

I recognized the behavior almost at once. This was old behavior—from 18 years ago.

So I called my psych nurse, the one who manages my meds, and through her assistant, got the message to and from her that my depression was returning, and I probably needed to increase my antidepressant.

It descended as a blanket of depression that afternoon. Or, as my husband described it later, it was as if I drove off a cliff. It happened that fast. Within four hours.

Or did it? Hadn’t it been building all year?

A year of making withdrawals from my emotional tank. I’d been trying in recent weeks to identify boundaries and margins and protect that emotional space, but I was already depleted, and each withdrawal was taking more, until there was just. none. left.

January–March: dealing with chronic pain.
April–June: helping aging parents who live far away.
July: vacation, but it was too long away from home, too hot, too much.
August: recognizing ongoing communication patterns in myself, my marriage, and my family—hard soul-searching efforts and discussions.
September: two particularly difficult days, and the last of my emotional reserves were all used up.

So maybe this afternoon of October 1st, curled up on the couch under the blanket, wasn’t really a surprise after all. I’d been calling it “emotional depletion,” but I knew enough to mention it to my psych nurse at my three-month check-in, so when I called 20 days later, she wasn’t completely surprised that it had gotten darker and deeper.

Thursday evening, I was irritable and crabby. It felt like I was looking at everything around me through sunglasses—everything had a darker shade to it.

Friday I increased my meds. But it’s gonna take a while for me to notice any effects. So a beautiful day in the mountains wasn’t complete joy—I had to really focus and practice staying in the moment, or my negative thinking would swoop in.

And perhaps that’s what surprised me the most—how quickly depression thoughts returned!

I’ve been practicing “thinking about what I’m thinking about” for years. Taking every thought captive unto Christ. Replacing negative self-talk with the truth of God’s Word. I’ve been practicing this, and teaching it to my Fresh Hope group, for years. I have charts and handouts with “not this thought—think this instead.”

But the thoughts that depression brings are their own monster.

I was thinking things on the e-bike ride in the mountains that never would have entered my mind two days prior! Like, as we rode behind the hospital, “Is there a psych ward there? If I checked in, could they make this go away in a day or two?” Or, “Here we go again. And it’s only going downhill from here. Might not go away this time.” Or, “I’m such a downer to anyone around me.” There were many such thoughts, just in an hour.

I remember my therapist from 18 years ago telling me that those weren’t my thoughts. That it was depression talking. And honestly, I accepted him at his word, but didn’t really believe it.

Until now.

Because these things I was thinking were so out of character for me. They were nothing I would have said to myself on Wednesday. And here on Friday, they entered my mind unbidden and sounded almost like truth.

Praise God that I had been practicing talking God’s truth to myself over these past several years, because I was able to recognize that the thoughts didn’t reflect what I actually believed. It was depression distorting the way I was seeing myself and my future—depression whispering in my ear. The thoughts still came, but I didn’t have to accept them as truth.

One of the hardest things about this is that I’ve been depression-free for eight years. Eighteen years ago, I went through a 10-year journey, in and out of depressive episodes. And with the exception of a brief hiccup last spring, when my psych nurse and I dropped my single antidepressant too low, I haven’t felt sad or down or depressed.

Even that brief situation with the lower dose only lasted a week, and it didn’t feel like this. Then, I was just sad—extremely sad. But this time, it’s all the old “feels.” All the familiar patterns and thoughts and emotions that plagued me for 10 years.

It’s almost like an old friend, in its familiarity and, dare I say, comfort?

No, it’s not comfortable.

More like putting on my old ratty sweatshirt with holes and stains and tears. Ugly, yet somehow comfortable.

I’m trying not to give in to the comfort. Because it’s not true—it’s a false comfort. It’s a lie. Again, it’s those whispers that depression is telling me:

“Come closer. Sit down. Remember what this feels like.”

Whispers of a Siren’s Song, luring me until I crash into the rocky shore.

No, I don’t want to remember.

I want to fight. I want to stay emotionally healthy. Mentally healthy.

But fighting looks different to me now than it did 18 years ago.

This time, I recognized what was happening. I made the phone call. I told my husband. I increased my medication as directed. I went to the mountains even though depression came along for the ride. And when the thoughts came, I noticed them. I named them. I challenged them with what I know to be true.

I don’t know how long this episode will last. I don’t know whether the medication change will be enough or whether there will be more steps ahead. And I’m trying very hard not to let depression answer those questions for me.

Because depression wants to tell me that I’m back where I was 18 years ago.

But I’m not.

Those eight years of emotional and mental health didn’t disappear on Thursday afternoon. Neither did everything I learned during the 10 difficult years that came before them. I’m not starting over. I’m starting from here—with experience, tools, people who know what’s happening, medical help, and a faith that has been tested before.

And maybe that’s what fighting looks like today.

Not pretending I’m okay. Not demanding that I feel better tomorrow. Not believing every thought that enters my mind.

Just doing the next healthy thing.

And then the next one.

If you’ve been doing well for a long time and suddenly find yourself facing familiar symptoms again, maybe you need to hear what I’m telling myself right now:

A recurrence does not erase your recovery.

Reach out. Tell someone. Call your doctor. Use the tools you’ve learned. And when your diagnosis starts whispering that everything you’ve gained is gone, remember: you are not standing where you stood the first time.

Neither am I.

And today, that gives me hope.

If you’re struggling, reach out to your doctor or a trusted person. In the US, you can call or text 988 to reach the Suicide & Crisis Lifeline.

About the Author: Peggy has been involved with Fresh Hope as a Group Facilitator for over 8 years and as the Hope Coach Trainer for over 6 years. She can be reached at peggy@freshhope.us.

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Saying Goodbye to Your Therapist

By Peggy Rice, Hope Coach Trainer for Fresh Hope

There are relationships in our lives that are difficult to explain to someone who hasn’t experienced them. I think the relationship with a good therapist can be one of those.A therapist knows things about us that many other people don’t. They have sat with us through some of our hardest moments. They may have watched us cry, wrestle, get angry, make progress, go backward two steps, and then move forward again. They know pieces of our story that we do not tell many people.

And then, sometimes, we have to say goodbye.

I recently had to say goodbye to a therapist I trusted deeply. The ending wasn’t because therapy had gone badly. In many ways, that made saying goodbye harder. She was leaving the practice where I had been seeing her, and I had to face the reality that this relationship, at least in the form I had known it, was ending.

There is grief for me in that. And the strange thing is, I can’t process my grief with her—which is exactly what I long to do. Because she knows me so well. She would be able to help me make sense of what I’m feeling and help me figure out what steps I might take next to get through it.

Except she is the person I am grieving.

We often think about therapy as something clinical: You make an appointment. You talk for an hour. Your insurance gets billed. You go home.

But when therapy is good, something much more profound happens in that room. Trust develops. Someone learns your story. They remember where you have been. They recognize your patterns. Sometimes they see growth in you before you can see it yourself.

And when that relationship ends, I think part of saying goodbye is looking back.

Who was I when I first walked into that therapist’s office? What was I carrying? What have I learned since then? What can I do now that I couldn’t do before? What truths have become part of me rather than something my therapist has to remind me of?
For me, I started seeing this therapist when I was experiencing chronic pain. She understood—she deals with chronic pain of her own. And I wanted a therapist who knew chronic pain AND knew the Lord, because my faith in Jesus is an integral part of who I am. I wanted a counselor who would intuitively understand that part of me without having to explain my faith, my worldview, or why those things affected the decisions I made. This therapist loves the Lord, too, so we had that in common.
Over time, we moved from discussing how to serve the Lord while dealing with pain to issues around aging, family, relationships, and communication patterns.

She taught me that “courage is doing something scared.” And her faith in me helped me push past some fears and have difficult conversations. I did them scared, with lots of prayer that God would be my courage and strength.

And He was. He is.

I was sharing with a friend recently that the two therapists I’ve had whom I consider really “good” had something important in common. I could spill all these jumbled pieces out in front of them, and somehow they could take those pieces, make sense of them, and give them back to me with some order and structure. Suddenly, I could understand myself a little better.

That is a remarkable gift.

And maybe that is why saying goodbye to a good therapist really does involve grief. You aren’t just losing an appointment on your calendar. You are losing a particular person who knew how to sit with the jumbled pieces of your life and help you make sense of them.

So that loss deserves to be acknowledged.

I think one of the things I am learning through this experience is that ending therapy well means allowing yourself to feel whatever the ending brings. Gratitude and sadness can exist at the same time. You can know that something has been very good and still grieve that it is changing.

But maybe there is another gift hidden in the goodbye.

It gives us an opportunity to recognize that the work we did in therapy doesn’t belong to the therapist.
It belongs to us.

The insights we gained are ours. The healthier patterns we practiced are ours. The boundaries we learned to set are ours. The hard truths we finally faced are ours. The courage we learned to practice is something we can keep practicing.
A good therapist may have helped us discover those things, but we get to carry them with us when we leave.
For those of us living with a mental health diagnosis—or loving someone who does—there can be another concern: What happens if I need help again?

Ending with one therapist doesn’t mean we will never need therapy again. It doesn’t mean we’ve graduated from needing support. It simply means that this particular season and this particular therapeutic relationship have come to an end.
And perhaps part of ending well is knowing that asking for help again someday will not erase the progress we have made.
But I also know I am not walking into whatever comes next alone. The therapist who has walked beside me may no longer be there in the same role, but God is. He was with me before I walked into her office, He was present in the work we did together, and He will be with me in whatever comes next.

And there are other kinds of support along the way, too. Therapy is one important part of the mental health journey, but it doesn’t have to be the only one. Peer support, like what we find in Fresh Hope groups, gives us a place to be known, encouraged, and reminded that we don’t have to navigate our mental health journeys alone.

So if you are approaching your last appointment with a therapist who has mattered to you, don’t feel as though you have to treat it like just another appointment.

Talk about the ending.

Say what the relationship has meant to you. Talk about what you have learned. Ask what your therapist has seen change in you. Talk about what you want to carry forward. And if you’re sad, let yourself be sad.
Goodbyes are sometimes painful precisely because something has been good.
And maybe the goal isn’t to leave without sadness.

Maybe the goal is to leave knowing that what happened in that room mattered—that we carry what we learned with us, and that the God who met us there will be with us in whatever comes next.

Peggy has been involved with Fresh Hope as a Group Facilitator for over 8 years and as the Hope Coach Trainer for over 6 years. She can be reached at peggy@freshhope.us.

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This is my first article as a guest writer for Fresh Hope, so I would like to introduce myself, share a little of my story, and say how I first encountered Fresh Hope.

I am grateful to the Lord that He has brought me to a good place where I enjoy a happy and fulfilling life. I have a mental health diagnosis and have been on a long journey of recovery. I was first diagnosed and hospitalized in 1992. I struggle like all of us, but the difference between then and now is stark. I first found Fresh Hope in 2024 during an online search for resources to help folks like me. I explored the site and found it to be an amazing ministry for people with mental health conditions and their loved ones to find the hope and help they need as they navigate life.

God has been instrumental in my recovery. When I was 10 years old, my mother was hospitalized for the first time with a mental health condition. We had a babysitter, Betty, who told my siblings and me about Jesus and how we could know Him as Lord. That was the beginning of my relationship with Jesus. Even though I drifted away from Him later, that served as an anchor for my life. God was so gracious to send Betty to tell us about Him amid our tumultuous childhood.

God brought me to Texas from Ohio in 1999 where He placed my feet on a path of healing. It was there that I found a church where the elders prayed for me on a regular basis and a particular couple ministered to me throughout a chaotic period of 10 years where I battled with a bi-polar 1 condition. I was hospitalized more times than I can remember. But Lois and Bill stuck with me through it all!

In 2010, I came to a cross-roads through a crisis. Just prior to that He used Christian television to communicate to me that I needed to act on my mustard seed-sized faith, surrender to Him and trust Him with my life. One evening, I hit rock bottom and told God, “I cannot do this life anymore! I surrender to You and I ask You to teach me how to trust You, because I do not know how.” I felt the load from my whole life on my shoulders lifted from me. This decision changed the trajectory of my life from that point forward. I grew in my faith rapidly.

Psalm 34:4-7 “I sought the LORD, and He heard me, and delivered me from all my fears. They looked to Him and were radiant, and their faces were not ashamed. This poor man cried out, and the LORD heard him, and saved him out of all his troubles. The angel of the LORD encamps all around those who fear Him and delivers them.”

I began meditating on passages in the Bible. Because I was so depressed for 2 years, I had only enough energy to meditate on one verse at a time. I wrote verses on notecards. I began getting up every day and creating structure, as I could not work then. My father passed away and I joined a grief support group. Volunteering at the hospice where my support group was gave me purpose. I found great hope in God and promised Him I would never again consider suicide as a viable option. I could not do that to Him, my family, or my church. I had once been in a church where Scripture was taught in depth. The Spirit of God brought some of them to mind. I found that doing what the Bible told me to do was extremely helpful. When I was overcome with fear, I meditated on 1 Timothy 1:7 and other verses about fear. I verbalized them aloud. I found peace that I would not have otherwise.

2 Timothy 1:7 (NKJV) “For God has not given us a spirit of fear, but of power, and of love, and of a sound mind.”

My therapist suggested I record what had been working for me. I wrote a list of what I called: “Biblical Principles for Change and Growth” as a result.” I will elaborate on some of those in a series of blog posts to follow. Amazingly, much of what God led me to do toward recovery is like what Pastor Brad and his doctor has developed in the 7 Principles of Recovery for Fresh Hope.

Laura Smith lives in Texas and enjoys time spent with family and friends, painting, and outdoor activities. She is a new group facilitator for Fresh Hope for Mental Health. For questions or comments, or to reach her, please email info@freshhope.us.

 

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