Relapse. Feels like a dirty word. A personal failure that happens when you thought you had your shit together. Statistically, it’s more likely than not that you will relapse at some point in time. Depressing thought but all is not lost, here’s a little more about how I stop the shit from hitting the fan.
Use a (free) sleep and mood tracker: There are many free trackers for logging mood and sleep patterns. Stepping on sleep problems early (for example being strict with bed times, using a short course of sleep medication as recommended by your doctor) can avert a full blown crisis. Secondly, having information about thoughts and feelings leading up to mood changes can help identify subtle negative thought patterns which can be challenged using techniques such as cognitive behavioural therapy to reduce their impact on mood.
I know my triggers: Extreme stress, too much alcohol, poor sleep. Day to day I cope with stressful events pretty well. We all have stress in our lives and living completely stress free can potentially hamper our creativity (anyone who has waited until a few days before an important deadline to start a project will know what I mean). I’m talking about major stressors. I can trace pretty much all of my depressive episodes back to specific life events (giving birth, a 2 week bout of being in bed with flu, grief). As for alcohol, if I have a few nights of 2 or 3 drinks each night it makes me depressed and anxious. Even at Christmas I try to moderate my alcohol intake as much as possible as the fun never seems to be worth the drop that happens afterwards.
Use healthy coping mechanisms: When you know what your triggers are you can utilise positive coping mechanisms to balance them out. I like to exercise, especially when I’m stressed. Out goes the negative energy and in come happy chemicals**. I also like to knit (the focus of making sure I don’t mess it up takes my mind off everything else), keep a journal and read. Find something you enjoy and deploy it often!
**This has backfired once during the early phase of a hypomanic episode. I did my usual zumba class and stayed awake until 1am that night. Lights, latin music and jumping around are not good for the overstimulated mind.
Accept that not every bad day or different emotion means that a relapse is going to happen: If you have kids, do you remember when they were born and you were obsessed with their toilet habits? Have they pooped today? What colour was it? What does green poo mean anyway? If they haven’t pooped should we talk to the doctor Before you had kids did you give any thought to other peoples bowel habits? Probably not. This is my way of saying that when we focus on one small thing we can become bogged down and miss the bigger picture. When I’ve one bad day (tired, hormonal, bad day at work), I often decide a relapse is coming. I’m on that downward spiral, I haven’t noticed and there’s nothing I can do. Then I wake up the next day, laugh that I had a bit of a shitty day yesterday and go about my business. One bad day does not make a relapse. Feeling elated because you had a great time with your family at the weekend does not mean hypomania is coming. Recognising and accepting the contrast between different thoughts and feelings can be hard if you’re prone to over-analysing but it’s important to know that everyone (regardless of mental illness) goes through a spectrum of emotions.
If the shit does hit the fan, remember that you’ve done this before. You can handle this. You can follow your plan to the letter but there’s no foolproof way of avoiding relapse. It’s going to take some time and effort but you can and will get through. Scale down your expectations, if showering and brushing your teeth is the only goal you can achieve then that’s okay. Lean on your support network and be kind to yourself. Slowly and steadily things will be rebuilt.