Self Awareness + Relapse Prevention

Self awareness is the new relapse prevention.

Relapse prevention does not apply solely to alcohol and drug addiction.  Just like substance abuse, mental health disorders can have periods of exacerbation and periods of remission.  This means that there will be times of struggle, and times of feeling well.

Our challenge is to maintain the stretches of stable mood and minimal anxiety for as long as possible, and keep the stretches of illness as short, mild, and manageable as we can.

So how do we prevent relapses with illnesses such as Major Depressive Disorder, Bipolar Disorder, or Generalized Anxiety Disorder?  

The answer is:  It depends.

Each patient is different.  Each individual has a different need for, and response to, medications, psychotherapy, and integrative modalities such as mindfulness, meditation, exercise, nutrition, journaling, and yoga.  

One of my patients will be on medication for life, and she is perfectly okay with that.  She doesn’t have side effects, she is able to function well, and she is happy she has found a solution that works for her.  Another one of my patients has had only one episode of depression in response to a difficult loss. A brief course of medication, ongoing psychotherapy, and regular exercise is what allowed him to thrive.  

It is precisely because each person’s illness looks different, that their treatment and subsequent relapse prevention plan should also be individualized.  Self awareness is the first, fundamental step in knowing what works best for you. Ideally, your treatment team can support you by asking the questions that help you develop such self awareness, and in turn hold you accountable to sticking to your plan.

Here are some questions to consider reviewing with your team, and also discussing with your support system such as partner, family and friends:

What are my “red flag” signs and symptoms that signal a worsening of my condition?  Is it disrupted sleep?  An increased appetite? Lack of motivation at work?

What are my medication and therapy needs to maintain my mental health?

What are my non-negotiable tools to support myself?  Meditation?  A daily run? Time in nature?  A weekly lunch with friends?

Asking these questions, knowing the answers, and sharing them with those closest to you, are all critical steps in developing strategies to stay well.  Self awareness is what allows you to ask yourself the questions to begin with, and answer them with honesty. Self awareness is also how you will know when you find yourself struggling with your red flag symptoms, or straying from your treatment plan.

We all have different ways to practice self awareness.  Often therapy gives us the space and time to reflect meaningfully on who we are, and our relationship to our illness.  Other tools may include journaling, mindfulness practices, solo downtime, or spirituality.

Self awareness is the first step to understanding yourself, and how you in particular can stay well.  Take the time you need to understand what you need. Your health just may depend on it.

– Monisha Vasa, M.D. | The Collective’s Co-Founder + Clinical Advisor

Photo by: Mitul Shah

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