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slipperyslope In Recognizing you need help

Tools for Preventing Relapse: How to Not Fall Down the Slippery Slope

In my last blog post, I discussed my own story of relapse and recovery. I had to hit hit rock bottom a second time before I accepted that I needed to be vigilant about managing my OCD and seeking help so that I never returned to that scary place. Now that I’ve been there twice, I know how much I have to lose and that’s what gives me the strength to fight my symptoms when they first re-surface instead of giving into them for momentary relief, which makes it that much harder to fight them the next time. I am now 33 and my OCD has not relapsed since I was sixteen, despite my parents being told I would have to be put away in an institution for life. There have been times as an adult when I came close, but I have always sought help for myself before things reached that tipping point. Further down in this post, I offer you some tools so that you never have to go through this hell again.

Mental illness is a slippery slope. When we are at the top of the hill (in remission or symptom-free), it’s easy to feel like we are on top of the world and have everything under control. We tend to forget that these conditions are chronic and symptoms come in waves. Sometimes I almost forget I have OCD and depression. Then something will happen in my life that makes my symptoms return and I am suddenly reminded that I do have these conditions for life and need to manage them. The good news is that if you remain vigilant about managing your symptoms and ask for help when you first notice you are sliding down the hill instead of waiting until you’re half way down, you can prevent a relapse. I can’t promise that you won’t start to slide down the slippery slope, but it’s much easier to get better when you don’t have to climb all the way back up the hill. If you seek help as soon as you start sliding, you won’t have to start at square one again. By admitting you need help before things get really bad, you will save yourself a lot of pain and suffering.

Below, are some general tools for preventing a relapse. This is a non-inclusive list based on my own experience with major depression because that’s the most common mental illness. Please note that I am NOT a doctor or therapist and nothing I’ve written is intended to replace medical advice. There may be other things you want to add to the list depending on your unique situation. If these tools speak to you, I encourage you to write them down somewhere you can see them regularly as a reminder that you are worth fighting for, you deserve to be happy, and managing your symptoms is key to that. With depression, some people shove their feelings in the back of the closet and don’t even realize they are depressed until they start to experience physical symptoms or things get so bad they can no longer ignore the pain. I don’t want that to happen to you again!

How to Recognize You are Falling Down the Slippery Slope:
(This list is specific to depression and includes items on my own list and from people I know who also have depression, but it can be applied to other conditions):

Ask yourself if any of the below statements apply to you right now. If you answer “yes” to any of these, it’s time to see a therapist. If you are having thoughts about ending your life, call the National Suicide Prevention Hotline: 1-800-273-8255.

  1. You have thoughts such as:
    1. “It would be easier to not be alive because then I wouldn’t be in so much pain.”
    2. “I am a terrible person for something I have done. I don’t deserve help.”
    3. “I’m worthless.”
    4. “I am too screwed up. I’m damaged goods. I’m beyond help.”
    5. “I know I need help, but it would be too painful to talk about what is bothering me.”
    6. “I just don’t care anymore.”
    7. “I will never be happy again. I will never have X (i.e. a successful relationship, a good job, etc). , I will always be like this. There is nothing I can do to fix this.
  2. You find yourself going through the motions of your life, but you don’t feel alive anymore.
  3. You can’t “snap yourself out of it.” You feel like you are heading back into that black hole and it’s getting harder to come out.
  4. You are fatigued. It takes an excessive amount of energy to just fulfill your obligations and get through the day.
  5. Getting to work or school on time is a challenge.
  6. You no longer have any interest in activities that once brought you pleasure.
  7. You have low sex drive.
  8. You have socially withdrawn and isolated yourself. You no longer enjoy spending time with people you care about.
  9. You feel like no one can possibly understand what you are going through right now.
  10. People are worried about you.
  11. You are sleeping too much or too little.
  12. You are over eating or not eating enough.
  13. You are slacking on your personal hygiene.
  14. You’ve started externalizing your symptoms: lashing out at people, have difficulty concentrating, feel a need to control everything, you see the negative in everything.
  15. You are self-medicating (i.e. with alcohol).
  16. You started feeling any of the above after a major life transition, a personal loss, the end of a relationship, or some other life stressor.
  17. You notice that your symptoms get worse when you ignore them and try to make them go away.

Also see the following resources:

If You Are Falling Down the Slippery Slope:

There is hope!

  1. The first step is to acknowledge that you are slipping. Don’t talk yourself out of getting help by saying “things could be worse.” That’s exactly right- things WILL be worse if you don’t take action now. Don’t wait.
  2. The second step is to seek help before things get worse. If reaching out to a therapist feels overwhelming, ask someone you trust to make the call for you. If no one is available to seek help on your behalf, take a deep breath and make the call yourself. You will be glad you did.
    (Once Voices for Health is fully launched, we will be able to connect people with therapists. In the meantime, I will offer tips in later posts on how to find a therapist).
  3. The third step is to make an appointment with the therapist and show up. Don’t give up after just one session. For a new therapist, give it at least three visits before you decide if you want to continue or if it’s time to try a different provider. Therapy is not easy. Just because you don’t feel great at the end of a session doesn’t mean the therapy isn’t working. It may mean you are finally addressing the root cause of your issues. The most important thing is finding a therapist who is well trained, who you trust and feel comfortable with.
  4. Don’t push away your support system when you need it most. Tell your friends and family what is going on. People can’t be there for you if they don’t know you are struggling. And remember, just because someone doesn’t understand or “get it,” that doesn’t mean they don’t care. They just don’t know what to say or how to help. When I was sick, some of the people I least expected to be there for me ended up being my greatest source of support and people I thought would be there for me looked the other way. You discover who your true friends are when you are at your lowest moments in life. Friendship isn’t always about who you have known the longest. It’s about who stays when everyone else walks away. If it’s too difficult to explain your situation, just say you are going through a hard time and you won’t be as available as you usually are. Your true friends will be there for you even if you can’t be a good friend yourself right now. When you are better, you can pay it forward.
  5. Force yourself to get out of the house and do activities you used to enjoy. Even if you don’t want to, do it anyway. Eventually, you will start to enjoy them again.
  6. Exercise! Physical activity helps you “get out of your head” and it increases serotonin levels in the brain. Yoga in particular is known for its anti-depressive effects. I try to go to yoga class three times a week and that does wonders for my depression.
  7. Get eight hours of sleep per night. Sleeping too much or too little can make your depression worse. Don’t sleep away the entire weekend and don’t stay up until 3:00 am either. If you have difficulty falling or staying asleep, see your doctor.
  8. Eat foods that are high in omega-3 (especially salmon). When you are depressed, it can be hard to find the energy to cook a healthy meal. You may need to cut out other things from your schedule to make time, but it’s worth it because food nourishes your body as well as your mind. Numerous studies, including some cited by com, The New York Times and Psychology Today have shown that the Mediterranean diet is great for fighting depression. Foods that are high in omega-3 (essential fatty acids), as well as fruits, nuts, vegetables, legumes, olive oil, and fish (especially salmon) can improve cognitive function and mood. Avocados are my favorite food and luckily they are packed with omega-3! Here are some easy recipes that follow the Mediterranean diet.

Photo credit: Andreas Levers

 

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