Relapse prevention for your peace of mind
by David Pollak
(Sydney, NSW, Australia)
This article is about mental health relapse prevention. We will first look at exactly what relapse prevention is. Then we’ll talk about strategies such as social support, counselling and monitoring symptoms, as well as medication, general wellbeing and managing stress. You will gain a deeper understanding of how to make these strategies can work for you.
What is relapse prevention?
It’s common to re-experience illness after recovering from such things as depression. Subsequent episodes are known as ‘relapses’. Lapses; however, are far more common than relapses. A ‘lapse’ occurs when only one or two symptoms come back for a brief period rather than the return of a full blown episode. Since a lapse can lead to a relapse, one or two mild symptoms can be a warning signal to keep an eye on the symptoms.
A ‘prolapse’ refers to improved health. To put this in perspective, a lapse is a brief experience of only one or two symptoms which can lead either to a relapse (e.g., another episode occurs) or a prolapse (e.g., health improves). A prolapse is more likely to occur when using our relapse prevention skills. Relapse prevention refers to an effective set of skills and actions for maintaining recovery following an episode of mental illness.
There are various ways you can prevent a relapse. Some of these are social support, psychological therapies, medication, symptom monitoring, general wellbeing, and managing stress.
• Social support
When it comes to our mental health research consistently shows ‘Social Support’ reduces the likelihood of relapse. As the name suggests, social support refers to having a network of family, friends and others. It means spending time with people instead of being alone, isolated and by our self.
A typical example is it’s the weekend and a few negative thoughts creep up, such as, ‘I’m a failure’ and ‘I’m no good.’ These and similar thoughts could go on all day while spending time alone with nothing to do. Then a friend comes over after arranging it in advance and the conversation completely takes your focus away from the negative thoughts. This is one example of how social support in healthy reciprocated relationships works. It’s a useful strategy in reducing the chance of having a relapse.
• Psychological therapies
We often learn during the recovery process. We can learn, for instance, to identify how poor sleep patterns and insomnia are symptoms of depression. We can then learn how to improve our sleeping patterns to overcome insomnia. This shows how we gain insight, knowledge and skills when working with our Psychologist.
One reason for reduced rates of relapse when working with our Psychologist is the knowledge and skills gained during the recovery process. Researchers compared three groups: groups receiving medication alone, groups receiving only a psychological therapy, and groups receiving medication combined with psychological therapy. Researchers keep finding the same result: a greater likelihood of having a relapse for groups only receiving medication. The groups who receive talking-type therapy have lower relapse rates. The knowledge and skills gained during the recovery process with our Psychologist reduces our chances of having a relapse.
Medical practitioners (e.g., Psychiatrists, GP’s, etc.) watch us stabilise on medication during our recovery. Research shows medication can help in cases of more severe episodes of depression. While medication is usually a temporary treatment, it is sometimes prescribed for a year or even many years after we have recovered.
Health professionals commonly see a relapse after we stop taking our medication. There are many possible reasons for this, such as poor coping skills, a physiological need for medication, etc. Our doctor (e.g., Psychiatrist, GP, etc.) specialises in treating us with medicine and our doctor is the right professional to talk to about medication. Some doctors believe in long-term medication while others believe in short-term medication use. Finding the right doctor to help really is essential.
• Symptom monitoring
One thing doctors (e.g., Psychiatrists, GP’s) and Psychologists do during our recovery is monitor our symptoms. Symptom identification and symptom monitoring is a learnable skill; however, this can be difficult when we are depressed and we don’t know how to identify or monitor our own symptoms.
Once we practice identifying what our symptoms actually are, we get better at monitoring our symptoms for ourselves. Insight into symptoms, what to do when we have symptoms, and how to maintain mental healthiness is part of most relapse prevention programs. Keeping symptoms in check help us to gain control of our own health. Since our mental health is just as important as our physical health, monitoring symptoms can mean the difference between a relapse and a prolapse.
• General wellbeing
An essential element of preventing relapse is general wellbeing. This involves looking after ourselves through such things as eating healthy foods and sometimes multivitamins, as well as regular exercise and getting enough sleep.
Sleep is crucial for managing energy levels. In the same way a battery needs recharging to supply energy, not enough sleep can leave us feeling run down. Regular exercise helps too. Interestingly, exercise is often used in programs to reduce insomnia. Exercise can feel good and increase fitness. Getting the right amount of vitamins and minerals can also improve energy levels. Since having less energy is a common symptom of depression, good nutrition, regular exercise and sleeping well are excellent ways to prevent a relapse.
• Managing stress
Stressful life events are associated with the development of mental illness. Adjusting to changes such as moving house, changing jobs/roles, the loss of a relationship or passing of a loved one, etc. can be stressful. Being regularly stressed over long periods of time is linked with worry, anxiety, negative thinking and depression.
Stress can be managed by first becoming aware we are stressed and understanding its impact on us. Strategies include looking after our general wellbeing, such as nutrition, exercise and sleep. Social support also helps as do relaxation strategies. Rather than limiting our time and energy to stressful activities, finding a balance enables us to engage in relaxing and enjoyable activities too.
Relapse prevention and your Psychologist
Psychologists these days usually include sessions on relapse prevention in therapy and can help us come up with individually tailored prevention plans. Typically, we’d work with our Psychologist exploring what strategies work best. We may find our nutrition is good, but we spend too much time alone and could benefit from social support and symptom monitoring. It’s up to us how specific our program will be.
An active approach to your health can make a real difference to your life whether you’ve experienced depression or not. Proactively using relapse prevention strategies can help prevent further episodes, and can literally positively enhance your life whether you have experienced mental illness or not. You can achieve personal growth.
We’ve taken a look at some great strategies to help prevent a relapse. Social support, counselling, medication, symptom monitoring, taking care of our wellbeing and managing stress are well-researched strategies we can utilise every day. Psychologists can help you explore which strategies work best for you. You can start using strategies that work best for you today… to significantly reduce relapse.
David Pollak is a Senior Psychologist at Australian Psychology Solutions. David practices in the Eastern Suburbs of Sydney, Australia and has worked as a Psychologist since 1999.
0407 676 192