[Article updated on 11 September 2017]
Relapses can have devastating consequences for people with mental disorders such as schizophrenia, bipolar disorder, depression, or an anxiety disorder. After every relapse, it may become increasingly difficult to regain control over the symptoms. For this reason, it is especially important for people with a mental disorder to do all that is possible to reduce the risk of a relapse.
Early signs of a relapse
People with a mental disorder and their relatives, friends, and carers should learn to recognize the early signs and symptoms of a relapse. These signs and symptoms may differ from one person to another and from one mental disorder to another, but common ones include:
- Suffering changes in mood.
- Losing your sense of humour.
- Becoming tense, irritable, or agitated.
- Finding it difficult to concentrate.
- Retreating from social situations and neglecting outside activities and social relationships.
- Saying or doing irrational or inappropriate things.
- Developing ideas that other people find unusual, strange, or unbelievable.
- Neglecting your personal care.
- Neglecting to take your medication.
- Dressing in unusual clothes or unusual combinations of clothes.
- Sleeping excessively or hardly at all.
- Eating excessively or hardly at all.
- Becoming increasingly suspicious or hostile.
- Becoming especially sensitive to noise or light.
- Hearing voices or seeing things that other people cannot see or hear.
If you notice or suspect any of these signs and symptoms in yourself, contact your family doctor, psychiatrist, or key worker as soon as possible for support and advice, as this may help to avert a full-scale relapse. Before problems arise, it is a good idea to have an action plan in place, and to have discussed this action plan with your carer. You can also keep a diary to help you identify the signs and symptoms of a possible relapse. Remember that a relapse may impair your thinking, and thereby prevent you from recognizing those signs and symptoms: you may need to rely on family, friends, and carers, and to trust in their judgement.
Common causes of a relapse
Try to identify any factors that may have caused or contributed to your signs and symptoms, because addressing these factors may help you to avert a full-scale relapse. Common ones include:
- Poor understanding of your mental disorder in general, and of the symptoms of a relapse in particular
- Non-compliance with medication or decreased dose of medication
- Drug and alcohol misuse
- Lack of sleep or irregular pattern of sleep
- Lack of social relationships and support
- Felt stigma
- Poor physical health
I have blogged about many of these relapse factors. Minimizing them can help you to prevent relapses, and so significantly improve your chances of making a durable recovery.
The role of medication
Scientific research suggests that, in many cases, long-term treatment with medication can substantially reduce the risk of relapse. If you are reluctant to take your medication because the schedule is too complicated or because you are suffering from intolerable adverse effects, speak to your family doctor or psychiatrist about this. He or she may be able to simplify the schedule, decrease the dose, or change you to another medication that suits you better. Do not simply stop taking your medication without having first discussed and planned this. Unfortunately, taking your medication at the dose prescribed by your doctor is often the single most important thing that you can do to prevent a relapse.
All the best,
Neel Burton is the author of The Meaning of Madness, Growing from Depression, and other books.