Onika L. Dainty

Relapse looks different for everyone who experiences it. It may last days, weeks or months depending on the severity of the Bipolar episode. Similarly, recovery, remission or long-term stability has its own set of challenges that one must face on their wellness journey. In this article I will discuss how to plan for long-term stability after Bipolar relapse, how to overcome shame and rebuild confidence, the importance of a support system during challenging times and key ways of moving forward to create a life beyond Bipolar relapse.   

Building a Stronger Long-Term Stability Plan After Relapse

Building Your Crisis Plan

A mental health crisis plan is a proactive strategy developed before a crisis occurs which outlines the steps to take in a mental health emergency. Crisis plans include identification of early warning signs, a person’s coping mechanisms, emergency contacts, medical information including preferred hospitals or psychiatrists and resources for support. 

The goal of a crisis plan is to empower individuals when experiencing wellness to state how they would like to be treated in the future if a crisis occurs allowing them to maintain autonomy and dignity in navigating their own mental health crisis effectively and potentially minimizing harm to themselves or others.Unlike reactive measures that are often taken in a mental health crisis creating a plan allows an individual dealing with mental illness to have proactive involvement in how a crisis is handled as well as treatment outcomes where applicable. 

A typical crisis plan includes: 

• Early Warning Signs: a list of the early signs of potential crisis or distress symptoms that can help individuals identify if emergency services are needed.

• Coping Strategies: a list of specific techniques, like breathing or tapping, that help manage the overwhelming distress symptoms or reduce anxiety that can be invaluable to de-escalating a crisis. 

• Support Network: a list of trusted individuals who can be contacted to offer support during a mental health crisis. This list can be done in order of importance or trust. 

• Emergency Contacts: a list of contact information for crisis lines, preferred hospitals, wellness lines, mental health professionals or emergency services which ensure quick access.

• Medication List: a list of up-to-date medications and dosages an individual experiencing a crisis is taking. This can be useful for emergency service attendants if a crisis escalates and hospitalization is necessary. 

• Actions to Be Taken: an outline of the preferred steps to be taken in a crisis situation such as who to call first, if mental health professionals should be contacted, if a wellness check is necessary or which hospital an individual in crisis prefers. These action steps will be considered but not necessarily followed depending on the seriousness of the crisis.   

There are courses available through outpatient services such as Durham Mental Health Services (DMHS) or The Mood Disorder Association of Ontario (MDAO) which offer support in crisis planning. Wellness Recovery Action Plan (WRAP) is a personalized tool for managing mental health and well-being, developed through a structured process to help individuals identify triggers, wellness tools, and create plans for maintaining and enhancing their wellness, including crisis and post-crisis strategies. 

Medication Management 

After a Bipolar relapse a part of your rebuilding strategy may be revisiting your medication regime and the therapy you choose to participate in. When it comes to medication management it's important to note that the meds that were effective prior to your relapse may not have the same stabilizing result post-relapse. It has been my experience that an increase in dosage or a change to a different but recommended medication has been necessary for me to regain baseline mental health after an episode. This process of medication exploration by psychiatrists can take weeks before the correct cocktail is found and there is always the possibility of side effects occurring which can lead to further relapse. These are the risks that go hand-in-hand with medication management and adherence.

Therapeutic Strategies

Psychotherapy, counselling and group therapy after Bipolar relapse can be beneficial tools to maintaining remission or long-term stability. With the support of professionals it is possible to discover the root cause of the relapse especially if causes are related to life stress, specific triggers, loss of loved one or employment, adjustment to newness or change, anxiety, depression or substance use. Speak with your mental health network in your local community to find out how you can get connected to services that will lead to positive outcomes in your journey to long-term stability. Joining a peer support group can give you access to peers who have experienced relapse and can share tools and practices used to assist them on getting back on track. Online communities are a great and accessible resource for finding support after Bipolar relapse. It’s important to do your research in all cases to ensure you find professionals, groups and communities that fit your needs.      

Structure, Routine and Habit

Creating structure, routines and good habits after a Bipolar relapse goes a long way in finding balance in your daily life. Making small lifestyle changes like setting an alarm for waking you up or going to bed at the same time nightly will establish consistency and promote better sleep hygiene. Incorporating practices like daily exercise such as cardio or taking a walk are healthy habits that will have a positive effect on focus and stability. Tracking your mood in a journal or writing your thoughts down can help you manage your emotions and reflect on your feelings with the goal of long-term stability in mind. Staying connected with your support system of friends, family and mental health professionals is key during this time of transition. Knowing when to ask for help can be the difference between stability and further relapse. Through incorporating structure, routine and habit you can gain perspective into the practices that have a positive effect on your mental health, gain self-awareness and build a stronger long-term stability plan after relapse.   

Overcoming Shame and Rebuilding Confidence

It has been my experience that societal expectations as well as the expectations of those closest to you can add to the emotional burden of Bipolar relapse. It’s like looking into a mirror full of shattered glass, each piece representing the shame you feel inside, the broken trust of those around you and the assumption of a future full of relapse that society places on you. How do you overcome these burdens of belief and find a way to rebuild when all you see in front of you is a distorted view of who you used to be? How do you overcome all the challenges that Bipolar relapse brings and find the confidence you need to start again? It starts with self-forgiveness and challenging negative self-talk. 

To practice self-forgiveness, acknowledge your mistakes, accept responsibility, treat yourself with kindness, learn from the experience and move forward. This can be challenging especially when you have gone through a Bipolar relapse where the circumstances are a direct result of your illness rather than a particular action you took. The key to self-forgiveness with this type of relapse is acknowledging and accepting responsibility for the negative experiences that may have occurred as a result of the episode, practice self-kindness for the elements of your relapse that were out of your control, learn from your relapse and move forward armed with new found knowledge and understanding that will give you the confidence to rebuild a plan focused on long-term stability. When challenging the negative self-talk that may plague your mind after aBipolar relapse, start with questioning the thought’s validity, practice self-compassion, replace negative thoughts with positive affirmations while seeking the support of others in your care circle while also setting realistic goals for your future mental health outcomes. 

Final Thoughts

Bipolar relapse is not failure and it is not for others to judge as a failure. Picking up the pieces from that shattered mirror is a daily choice. Looking into your reflection and seeing someone worth fighting for rather than someone who feels shame or self-loathing is a step toward reframing your goals and rebuilding your future. Relapse is a setback and a stepping stone toward the actualization of who you can become regardless of your mental illness. Rebuilding stability can also mean reclaiming your joy, the hobbies or passions that previously brought happiness to your day or creating a self-care routine that helps you find your balance. Relapse is lessons learned from self-reflection leading you to the self-awareness that will determine your future long-term stability. 

Remember, every day is a new opportunity to do something you’ve never done before, so choose to move forward with confidence rather than shame looking beyond Bipolar relapse to a future filled with possibilities and long-term stability.