The Relapse Series: Recognising the signs.
Here she is. My poor girl doing her best Gollum impression. Olivia's not doing too great at the moment and as a result, I've been having a few 'moments' too. I’ve already written a post about relapsing, but I thought seeing as I'm going through one, I'll rewrite it so I can show you exactly what it is I do when feeling the clutches of OCD, depression, anxiety - or in my usual case, all three combined.
I hope that by doing this it allows you to see the process I use and consider how it might work for you too. I’m going to spread the main points over a series of shorter blogs, partly because I think it’ll be easier to read as it’ll break a lot of information into smaller bite-size chunks, and also because it's a good self-care choice for me.
Okay, so to start. A brief description of what's going on at the minute...
Feel very free to skip this bit, it's just here to help put everything in context. At the moment, our little family has a lot on it's plate and a lot of uncertainty surrounding it. To stop this becoming the next War and Peace, I’ll list the main issues:
Our son has come to the end of his time at nursery and sadly, he was the only one in his class not to receive a place for reception in his current school. Given the tough times we’ve been through as a family we had hoped to keep him with his friends. We had a long wait for an appeal and despite putting forward a strong case, it was denied. This, in particular, has been a huge trigger for me as it strikes straight into the heart of my current theme of OCD - the emotional well-being of my son.
We are considering buying my childhood family home. We moved in after the loss of my parents and I'm torn between whether we should start again somewhere new or stay here. It's a complicated one, involving many factors and it brings up some sad memories for me.
We are in the process of selling our flat. We have been having issues with our estate agents and this has led to quite a bit of anxiety.
Right, there’s the context of my situation. And whilst I like an adventure and am learning to deal with uncertainty, when it comes to things like schools and homes, especially at the same time, it sets me off.
I do realise, however, that these things happen to all of us, there's no avoiding it. We all go through stressful life events at one time or another and how we manage them and react to them makes a huge difference. On one of my particularly down days my twitter friend Nick posted this on line:
‘When you can't control what's happening, challenge yourself to control the way you respond to what's happening. That’s where your power is.’
It really hit home. So I need to thank him for posting something that kicked my butt into gear.
So here I go with attempting to change the way I respond to what's happening...
A word about the word 'relapse'
The first thing I’m going to do is re-frame my thinking around the word relapse. It brings back images of being stuck in bed without an appetite, going through a crisis which will eventually see me hit rock bottom and beg for help. No thank you!
The word relapse also contains the word lapse and I’ve never heard that used in a positive way. If I think of my daily recovery journey as the steady climb up a hill of varying gradients, the word relapse makes me think of myself crashing to the bottom and landing in a broken heap, waiting to recover enough to start the climb from scratch again. I recognise this is not helpful thinking, so I'm going to challenge it and change it.
I prefer 'set back', or 'bump in the road' or 'Olivia's kicking off at the minute!'. None of these underplay the importance of self-care but they help me to see the situation as something that can vary in intensity and length. Something that can happen even when still travelling in the right direction along the road of recovery.
I'm not going to fear a relapse, that gives it too much power. I'm changing my thinking from a panicked 'Oh my goodness, I think I'm relapsing' to 'Okay, I'm not feeling too great, let's accept this is happening and get on it!'.
Now that I've re-framed my thinking about relapses I don't fear them so much, but I do have to acknowledge that I need to keep an eye out for triggers, dips in mood and an increase in symptoms. For this I use the blueprint I created in my cognitive behavioural therapy sessions.
Relapse Prevention Blueprint
This is basically a tailor-made plan designed to help individuals stay healthy. It helps to identify symptoms of a relapse and lists strategies that help to address the symptoms. There are loads of examples on the internet and I used these to create a type of hybrid of my own.
If you're not too distracted by my fancy paper-weights, this is an example of it here:
***Hmmm, for some reason I can't enlarge this image any further, but it doesn't really matter because the intention here is to show how I display my support information. I like it presented clearly and interconnected! I'll expand and talk about the individual sections later. You may find some images easier to read on tablet or laptop.***
It’s like a safety net that I use to help me catch myself before I dip too far. Don’t be overwhelmed by the size of this, I’ve got it written on lined A4 paper in a folder too, but this way allows me to link my sections together which I’ll show you in a minute. It’s also an excuse to get the lining paper and felt tips out 😊.
Right so I'll focus in on the first two sections:
1) Times when I may be more vulnerable
2) Early warning signs.
Here they are...
Straight away in the green I can see that I am currently in a situation where I am naturally more vulnerable to an increase in symptoms. In fact, if I look at the green section, all three areas apply to me at the minute so I need to be mindful.
In the blue, I've listed the symptoms I experience when beginning to have a dip. Having my early warning signs listed in this way means I can almost immediately see what’s going on. It gives me a snapshot of how my symptoms are presenting.
Whether I think the symptoms will pass on their own or not, I like to address them with a few strategies and if I expand the picture like this (and this is where you'll see why I like doing it in poster form) you can see that I’ve written strategy suggestions that help me with each symptom. I’ll talk about the strategies over my next few blogs.
So to sum up, if I'm having a few low days, I always start with an assessment of how I'm doing. I assess my triggers, my symptoms and the impact they are having on me and my day-to-day life. Your version of this may look completely different. Different things work for different people and that's totally okay. But what is important is having this information somewhere handy and clearly presented to allow for easy reference. When we feel rough, we don't always want to go through hundreds of therapy notes or homework sheets. Having it all in front of us gives us easy access and an immediate helicopter view of how we can help ourselves when we feel most vulnerable.
I really hope this helps and if you are having a setback please remember it will pass. We've got through this before and will do again!
All the best
Just an added note:
I am a qualified teacher which means I am able to talk about teaching and learning strategies until the cows come home and I use my knowledge of these to help me explain the processes I go through when dealing with my mental health conditions in the hope it makes it really clear for others to see. I am not a qualified doctor, therapist, psychiatrist or any other medical professional. I know these strategies because I attended therapy sessions with a professional. If you are struggling please, please seek professional help. I hate the fact this sounds like a 'get out of being sued' disclaimer but I wouldn't be doing right by anyone if I didn't encourage those suffering to get help. I share this because I know how I felt when I was really low and would have given anything to see the kind of examples I'm providing now and to know that I wasn't alone. So please, if you need support, ask for it. For ways of asking for help please see here.
For the full disclaimer please see the website.