When you carry a mental health diagnosis, you are in almost constant fear of relapsing. Whether you have a chronic long-standing condition or are suffering from a new diagnosis, the fear of symptoms re-activating, or worsening, is a real problem for those of us that suffer from mental illness.
Most of us ask ourselves every day: ‘Will I always be like this?’ ‘What if this happens again?’ or even: ‘How do I know I am truly recovered?’ These are all totally normal questions to ask ourselves, wonder about, and feel scared if our worst fears should become a reality.
The truth is though, we are in just about complete control over our mental health. Despite what some people believe, our mental health is in our own hands. What I am saying is that surely there are some environmental, biological, genetic, and parental contributing factors to how we feel and what we think, but are these markers the only indicators which tell how we measure our own health?
The answer is, probably not. In fact, these contributing factors are just that. So, in the event of your life circumstances being particularly limited and if you feel restricted in your capacity to maintain good mental health, think again.
Self-determination, our drive, and the very mobility needed to work on ourselves and harbour enough self-awareness to realise our own strengths, as well as limitations, comes from within. Sure, some of us are put in impossible situations, born into poverty, victimised, abused, and maltreated. But even in these circumstances, there are those that rediscover resilience and make it, despite the seemingly desperate nature of their problems.
So, why do we fear relapsing so much if it is in our means to stay, or get, healthy? The answer is, because people, regardless of the successes they experience and the positive aspects of displaying certain behaviours which serve us well, often lose sight of the bigger picture.
For people in recovery, the road ahead can seem long, especially with more seemingly chronic diagnoses, and often believe they cannot persist over the long haul or, in some cases, lifespan. The rest of our lives for many of us, especially young and even middle-aged people, can seem like a lot of work, or too much of an effort to sustain for the long-term or across the lifespan.
Maintaining good health, especially our mental health, will only make living easier in the long term, create and allow for more solutions during difficult situations, and make everything more manageable.
Aside from remembering this totally reasonable explanation for why people lose sight of their recovery plan, people continue to rationalise stopping or discontinuing behaviours which promote healthier decision-making. They stop putting into action self-management techniques consistently during their everyday routines, and self-care measures during the tenure of their illness.
This can be due to several reasons. Sometimes we deem ourselves cured. Other times, we encounter a seemingly insurmountable situation created by our negative behaviours as a result of playing out symptoms of a disorder.
There is no question that these negative, maladaptive, and self-defeating behaviours can and need to be stopped when they first trigger us to stop doing what we all need to do for ourselves. Like most thoughts surrounding fear, paranoia, and anxious thinking, they all snowball, combine and multiply our worst thoughts.
Following our self-care plan across the lifespan will mean living a life free of this fear or at least regulated, as best as possible, to reduce the likelihood and chances of paranoia, and the fear that we will one day relapse or become sick without warning.
Thus, this concern of relapse is truly our own doing, and ultimately, when left to our own devices, we set its limits and create the solution for disarming its paralysing force, which can make life seem like we are on a ride or are just a passenger in our lives. The truth is, we are driving our own health forward at a rate, speed, and course of our own choosing.
I recommend allying with your therapist, treatment team, and close peers with a vested interest in your mental health. Establishing a deep trust with those who have close personal contact with you every day. In doing so, if these collaterals begin to detect an extreme and toxic abnormality in your health, you can feel safe in taking their advice and concern very seriously. Sure, no clinician or friend can get a perfect read on our health.
But for those of us without a great deal of self-awareness or drive to look after ourselves, there are still options and strategies to stay healthy without relying completely on your own devices. Indeed, not everyone cares enough about their health to self-monitor all the time.
In other cases, the priority of the day will capture our attention, such as paying the rent, housing, employment, or even just showing up to work on time. All of which, if not also addressed in our lives, would disrupt our mental health and even put our lives in jeopardy, regardless of our diagnosis.
In the end, anyway you want to manage your mental health, do at least that much. Have a plan, and have a reserve plan when the original road map to better health becomes unworkable. Ultimately, whether you have a chronic condition or an acute diagnosis, relapse is only something to be feared when you aren’t doing what you need to do to work towards better health and healing.
Relapse is real. Relapse is awful. But it isn’t the end of the world. Relapsing and experiencing the renewal of old symptoms can still be a reminder to get back on track with your recovery. Keep going and don’t stop. When you stop taking care of yourself, be prepared for your worst fears to not just haunt you, but become the grim reality you feared so vehemently, instead of investing the same mental energy in health and healing.
Max E. Guttman, LCSW is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.