In this blog, I wanted to bring up the topic of relapse. Relapse is commonly thought of in connection to some form of addiction. However, relapse is a return to old unhealthy patterns, and it can apply to any mental health condition. For clients who are on their road to recovery from mental illness, it will typically look like an increase in symptoms of depression, anxiety, alcohol use, substance use, negative self-talk, lower self-esteem, or potentially experiencing things that aren’t happening in reality. Relapse can be very discouraging and disheartening, but it should actually be thought of as a normal part of the journey of self-improvement. There was an episode of Seinfeld, where Jerry was teasing Elaine that she was unable to end her relationship. He said, “Elaine, breaking up is like knocking over a Coke machine. You can’t do it all in one push; you’ve got to rock it back and forth a few times, and then it goes over.” I think of this whenever someone is struggling to make changes and has moments of falling back into past behavior.
The idea that relapse is normal doesn’t mean that everyone is doomed to experience relapse. Everyone’s journey is unique. Things that tend to minimize the chances of relapse are probably the very things that help a person find success in the first place: consistent counseling sessions, social supports, good self-care, medications, working on correcting unhealthy thinking patterns, and making positive changes to diet, sleep, and exercise. I’ve definitely noticed that when a client reports a relapse in their symptoms or behaviors, it usually coincides with a reduction in the very behaviors that were leading them down a healthy path.
According to Dr. Neel Burton in an article from Psychology today* some common signs of potential relapse are:
Changes in mood and lack of humor
Trouble concentrating
Becoming more easily frustrated
Isolating
Neglecting hygiene or care and not taking medications
Changes in eating or sleeping
Sensitivity to light or stimuli
Hearing or seeing things that others don’t seem to notice
Problem signs that your loved ones might notice:
Saying or doing strange or out of character things
Expressing odd ideas or acting suspicious
Dressing in a way that is out of character
If you have been improving your mental health and start to experience any of the signs on this list, be open and honest with your mental health professional.
There are a lot of different possible causes of relapse too. In his article, Dr. Burton also lists potential causes of relapse as lack of understanding about one’s disorder, not taking meds as prescribed, use of alcohol or drugs, poor sleep, increased stress, lack of support, poor health, and concerns about the stigma of mental health problems. Many clients speak in a self-deprecating manner about relapse, but when we break these reasons down we find that there isn’t necessarily a need to assign blame. Understanding mental health is not simple, and professionals may not always communicate conditions in a way that clients understand. Medication compliance can be affected by finances. Addiction is incredibly difficult to shake, especially without specialized treatment. Sleep can be affected by work. Stress isn’t always avoidable. Support isn’t always easy to find, especially for individuals who lose connection with their families. Health can be affected by a myriad of problems, and the stigma about mental health is a societal problem. I mention this to say that, while wellness has a lot to do with one’s choices, our choices are also impacted by a variety of things. Not all of these are within our control.
Having a setback or experiencing a relapse isn’t a reason to throw in the towel, and no, it doesn’t mean that you don’t have the ability to be successful in improving your mental health. If you’ve struggled and fought to improve your mental health and then fallen back into old habits, my recommendation is to first, give yourself some grace. You haven’t failed, and you haven’t lost what you’ve learned along the way. As a matter of fact, being able to notice that you have fallen back into old habits is actually a sign of growth. Beating up on yourself is very counter-productive, and it actually reduces your motivation to do the work. Understanding that unlearning habits of thought and behavior (that may have been in place for decades) takes time and patience. Rally the supports that you have, call your mental health professionals, and keep working.
*www.psychologytoday.com/us/blog/hide-and-seek/201210/mental-illness-preventing-relapse