So, you’ve recovered from an episode of depression, psychosis, or mania, and you never want to be unwell again. The good news is that spending some time and thought on relapse prevention planning can make that a reality. It is possible to set up a personalised plan to help you notice your early warning signs that an episode may be on it’s way, and any actions you want to take after noticing these signs.
It is important not to live in a constant state of vigilance, wondering if one night of poor sleep means you are about to have a relapse. All that stress can bring down your quality of life and may even trigger a relapse. But, burying your head in the sand and hoping for the best is equally unlikely to help you stay well.
If you have had a significant episode of depression, mania, or psychosis, I would recommend that you take the time to set up a relapse prevention plan. I would also recommend that you commit to attending mental health checkup appointments at set intervals – every three months generally seems manageable and productive. This checkup could be with a mental health nurse, psychologist, psychiatrist, or a GP with a special interest in mental health.
When I see people about relapse prevention planning, I have a process with three stages:
We meet for around an hour to identify your early warning signs and work out a personalised plan of actions you can take to stay well and also actions to take if you notice early warning signs. Taking action at the first signs of relapse can prevent a relapse or at least greatly reduce the length and severity of an episode.
I use a card sorting activity to help you identify your early warning signs. This involves sorting cards with statements such as “needing less sleep” or “feeling confused” into piles according to the stage at which they happen for you.
This activity is helpful for identifying early warning signs you hadn’t noticed before. Most people have noticed some of their early warning signs, such as wanting to go back to bed during the day as an early sign of depression. There are likely to be other signs that you’ve never noticed, such as talking less or withdrawing from friends and family.
It is very helpful if you can bring someone who knows you well to this appointment, as they may have noticed some early warning signs that you are unaware of. They can also provide ideas for how you can help yourself, and what support they are prepared to offer.
I type up a personalised relapse prevention plan, which includes the early warning signs you’ve identified, plus the actions you plan to take if you notice these signs. The plan includes contact details for any health professionals you see for your mental health, plus crisis numbers. If you have a history of an episode affecting your judgement and refusing to seek support, you may choose to specify that you give permission for a trusted friend or family member to contact treatment services on your behalf. This is reassuring for your loved ones, who often worry about upsetting you or damaging their relationship with you if they “put a foot wrong” when you are becoming unwell.
We review the plan and make sure it covers everything you need it to cover. I then give you a printed copy and an electronic (PDF) version for your records. You are welcome to contact me to review and change the plan whenever you need to in future.
Download a sample relapse prevention plan PDF: SAMPLE Relapse Prevention Plan.