- Psychological Issues
After recovering from an episode of your illness, there is a chance that you may not have any further symptoms. There is also a chance that you may have a relapse.
It is important to be prepared for another episode of illness, even if it never happens. Preparing does not mean you are being pessimistic or assuming that you will become ill again. It means knowing what to do just in case, so that you can get on with the rest of your life.
A relapse is said to occur when the symptoms of your illness worsen or when previous symptoms return. Many people have experienced one or more relapses of their illness. These relapses are exacerbations of their illness, particularly in their positive symptoms. A relapse may or may not require hospitalisation. After a relapse you may still experience persistent symptoms. Persistent symptoms are experienced more or less constantly, and do not indicate that you are about to become very unwell.
However, before a relapse happens people often experience changes in their symptoms or in some aspect of their behaviour, thoughts or feelings. These changes are called warning signs, they are indications that a relapse may be imminent.
Some warning signs are common and include feeling suspicious or irritable, feeling very tired or unusually energetic, and sleep changes. Other warning signs are highly individualised and include all sorts of changes to your behaviour, mood and thoughts. If you can identify your warning signs as early as possible, you may be able to take action such as reducing your stress levels, consulting your mental health worker or doctor earlier than you had intended, or increasing your medication temporarily- either or all of these may avert the relapse or reduce its severity.
It is particularly important for you to learn to distinguish warning signs from any persistent symptoms, and from any medication side effects you may experience.
People often experience a fairly specific and individualised series of changes in their behaviour, thoughts and mood before a relapse. This series of changes has been called a relapse signature. Identifying that relapse signature in as much detail as possible is important for relapse prevention.
Many people have their own individual early warning signs that they and their family can learn to recognise.
Some common early warning signs of relapse are:
These signs are different for everyone. It is important to work out which signs may be relevant to you. It is useful to do this with someone who knows you well, like a family member or a mental health worker. It is also important to have a plan of what to do should any of these signs appear.
Remember that these warning signs may be a normal sign that you are affected by something stressful. They do not always mean that you are becoming unwell. By recognising the stress and acting to reduce its impact you may be reducing the likelihood of a relapse.
Sometimes another person notices that you are becoming unwell and may mention their concerns to you, before you have realised yourself that you are becoming unwell. Thinking back on your past relapses, you may be able to identify warning signs that you did not recognise as warning signs at the time. In other words sometimes it is difficult to identify all your early warning signs yourself. Remember the earlier your warning signs are detected, the greater the likelihood that you can prevent a relapse, or reduce its severity.
Factors that may be important in selecting a suitable “helper” to assist you to identify your warning signs.
Issues for consideration
Someone who is:
This helper may assist you in three ways,
There are a range of strategies you may find helpful in dealing with warning signs or relapse symptoms. They may involve doing something or not doing something, they involve using stress management techniques and distraction activities.
It is important to develop an action plan. You may like to work this out with your mental health worker. Decide which strategies have worked for you and which you are willing to try. Remember that some coping strategies work sometimes and some don’t always have a backup as part of your plan.