I hope all my Canadian readers had a lovely Thanksgiving. Today, we’re talking more about relapses. I’ve talked before about my remission rules, and I posted just a few weeks ago about what to do when you are experiencing a relapse. Struggles with depression, anxiety, manic phases, and episodes are realities of long term mental illness. Having a few action plans in your toolbox can really help when those crises inevitably hit.
(1) Have a Safety Plan.
First of all, have a Safety Plan. If you struggle with self harm, suicidal thoughts, or addictions, this is a very important piece. Not every instance of these things requires hospitalization (although please don’t hesitate to seek it if you need it). Find someone you trust to work through the safety plan with you. I love this guideline from SFU, because I find it to be compassionate and thorough.
(2) Learn your symptoms and triggers.
Second, learn those things that get you railroaded. For example, I know that weeks without structure are catalysts for my depression. I try and tackle these weeks in advance by putting artificial structure in place. For some people, certain holidays or work interactions can trip them up. Here to Help has a great module about preventing a relapse here that includes learning your signs and symptoms.
If you struggle with anxiety, try to discover the root thoughts of your anxiety. Even if you can’t always unpack how to tackle it, knowing the core belief that is behind the anxiety can be helpful. This worksheet on automatic thoughts really helps uncover and challenge those core beliefs. This is a great exercise every day, because the more of these automatic thoughts you uncover, and the more you challenge them in a non-distressed state, the more likely you are to remember those challenges when you are in crisis.
(3) Remember your values.
Thirdly, know your values. This can be an ugly, shit-eating exercise, but it is important to do on a regular basis (it’s also important to do with your partner to make sure your family values line up). Try and do it in a good headspace, and try and balance how you ideally act and how you actually act. Therapist Aid has a few worksheets on discovering your values. When you have an idea of where your values stand, you will be better able to adjust where to put your focus when, for example, a depression episode makes nothing seem to matter.
(4) Plan to drop your productivity.
Sometimes you have to plan to be less productive. Remember, even on good days we can only expect to function at 70-90%! So in bad spells, expect to function at 50%. If there’s a certain time of year you always have trouble, try and build in less productivity that month (for me, it’s often been November and January).
(5) Remember your medication options.
Medication should be included as part of your planning for relapse. Nick and I are taking a trip soon, and I know that my safety anxiety comes up when we travel. I know some of it is unavoidable; but I don’t want it ruining my desire to explore. I will make sure my ativan prescription is filled, current, and with me at all times when we travel should my anxiety get out of hand.