7 minute read
Relapse management
What is a relapse?
Can I really go it alone or will I become unwell again?
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I would like to keep working on feeling better Am I ready?
I feel so much better! But will it come back?
I don’t want to look back….I want to look forwards, how can this help me?
It is great news that you have completed your worry management treatment and feel better! Now it is time to think about staying well in the future. Next, we will learn more about everyday mood fluctuations. It is also important to know when you may be having a lapse or a relapse. You should know what the differences are between them. Using this relapse section will help you to manage your mood in the future. You can put your worry management skills back into action at any time you need them. Everyday mood changes It is normal for our mood to change day to day. Often more than once a day, depending on what happens to us! We all have times when we feel anxious for a few hours or even a few days at a time. We also have worries, a level of worrying is normal!. We just don’t pay so much attention to them as they pop back out of our minds again. What do you do when you have a day like this? Try not to let how you are feeling, or any worries affect what you do. That’s when that vicious cycle can take hold again. It is part of everyday life to feel this way from time to time. Be kind to yourself. Don’t put yourself under too much pressure that your mood has always got to be positive and you won’t worry – you will. This is OK, we all worry! They key is not to let it form a cycle again and affect what you do. You have the skills to manage it. What is a lapse? Sometimes, you can lapse back into old ways for a few days. For example, you may avoid things because of worrying. A lapse does not mean that you have relapsed. Spotting it means you can act to break the cycle before it takes hold. Recognise a lapse for what it is. Try not to worry that it is a sign that you have gone back to square one. It isn’t! If you spot this happening, it’s a sign to put your skills into action again.
What is a relapse? A relapse is when you start to feel the way you did before. Your physical symptoms and worries may return for several days in a row. If this should happen, you have the worry management skills to put back into action again. That should mean that the problem doesn’t get as bad or last as long. Completing this guide can help you to spot early warning signs before that vicious cycle has a chance to take hold again.
My early warning signs
Make a note of the things that you noticed first when you were becoming unwell. How did it affect you physically? What where you doing or not doing because of this? How did it affect your thoughts? Sometimes others around us noticed these things before we do. Ask those close to you what they noticed first. These are things to look out for as early warning signs in the future. Remember though, that you may have some of these symptoms as part of a normal mood pattern. If they are affecting how you are feeling and what you are doing more days than not, it is time to act.
My regular review
Write yourself a letter about how far you have come, how you are feeling and how you made that happen. Then, pop it into an envelope and address it to yourself. Put a reminder on your calendar or on your phone. This can remind you to open it and enjoy reading it again in 3, 6 and 9 months from today’s date. Once opened, reflect on how you are feeling. Also reflect on the impact that making the changes you have put into place has had on your life since. Then re-seal it and put it somewhere safe you will remember for next time! You should take out your letter and read this again if you notice any early warning signs. This will motivate you to put your worry management skills back into action. Remember, you have helped yourself before. You can do it again!
My regular review
Keeping check on my mood
How has my worry and anxiety been this month?
Have I had any of my early warning signs?
Am I feeling tense? Am I avoiding things because of how I am feeling? procrastinating or over-preparing? Am I having a high level of worries?, or doing things to feel better, that only work in the short term?
YES
For how many days?
NO
Reflect on the progress you have made since your last review and take a moment to think about what you would like to do in the next month to keep moving forwards
YES
If yes: Do I need to put my worry management skills back into action? If so what am I going to do and when am I going to do it?
NO
Move to the next question and use the worksheet to keep your GAD toolkit fresh
My GAD first aid tool kit
Think of your worry management skills as a first aid tool kit for your GAD. They are always there if you need them. You just need to remember how to use them and to keep your worry management skills fresh.
What are the key points of worry management and how you use it? Remember you can go back to the pages in this guide at any time to refresh your understanding. This is a great way to make sure you know what you need to do, if you need to put the skills into action again. Even if you are feeling well, a review day is helpful once a month to spot any early warning signs. Ideally, plan 6 months ahead of dates now and pop them in your calender or on your phone to remind you. Date of my next review day. Put this on your calendar or somewhere you will see it as a reminder.
Date of review 1:
Date of review 2:
Date of review 3:
Date of review 4:
Date of review 5:
Date of review 6:
What do I remember are the key points of the worry management techniques that I learnt? Take a few moments to read through your intervention booklet again and practice the technique. Even if you are feeling well, this is a great way to make sure you know what you need to do if you need the skill again in the future.
Do I feel confident enough to be able to use the techniques again if I needed to?
Date of my next review day. Put this in your calendar or somewhere you will see it as a reminder.
DATE:
“John: Remember to keep your skills fresh. Make sure you feel confident enough to be able to use the techniques again. This is important in case any of your early warning signs appear again. When I found I was starting to worry and avoid things again, I knew I could apply the techniques I had learnt in this booklet.”
Where to get more help
Emergency help
If you, or someone you are worried about, need support in an emergency situation, do not put off getting help. The following can be used in an emergency: • Emergencies: 999 • An Emergency appointment with your GP • Fast medical advice in a non-life threatening situation: 111 • Samaritans: 116 123 (24-hour service) • SHOUT Crisis support: Text 85258 (24hrs) • CONNECTION for Dorset 0300 123 5440 (24hrs)
Remember, do not be afraid to get help. Feeling this way doesn’t last forever and there are things that can be done to help! Below are some useful web links with good quality information for anxiety and depression and what treatments are recommended if you want to learn more: Useful websites on Generalised Anxiety Disorder and its treatment
• The NHS: https://www.nhs.uk/conditions/generalised-anxiety-disorder/ • The National Institute for Health & Care Excellence GAD information: https://www.nice.org. uk/guidance/cg11/ifp/chapter/About-this-information • The Royal College of Psychiatrists: https://www.rcpsych.ac.uk/mental-health/problemsdisorders/anxiety-panic-and-phobias • MIND The mental health charity: https://www.mind.org.uk • The Mental Health Foundation: https://www.mentalhealth.org.uk/a-to-z/a/anxiety
Other useful helplines:
• National Domestic Violence Helpline: 0808 200 0247 • Forced Marriages Unit: 0207 008151 • Support for Lesbian, Gay, Bisexual & Transgender (LGBT) Victims- Broken Rainbow: 0300 999 5428 or 0845 260 4460 • Support for Male Victims. Respect: 0808 801 0327 • Help for the Perpetrator. Respect: 0808 802 4040 • Childline: 0800 1111 • Debt helpline: 0808 808 4000 • Family lives (formerly Parentline): 0808 800 2222 • Citizen Advice Bureau: 0344 411 1444
