Kahlil Gibran on Pain

12 Strategies to Help You Recover From a Relapse

It’s a dreadful place.

Relapse.

Maybe you had hoped you’d never go there. Or maybe you stay awake fearing you will. It doesn’t matter. You don’t have to stay there for long. You’ll be on your way shortly.

I prefer to use the term “set back” when I get sucked back into the Black Hole–bam!–stuck inside a brain that covets relief, any form of relief, and will do just about anything to get it. Because it’s certainly not the end of recovery. From depression or any addiction. A relapse merely gives you a new starting place.
Since I struggle with this time in and time out in my own life, I’ve laid out a dozen strategies to get unstuck … to recover from a relapse.

1. Listen to the right people.

If you’re like me, you’re convinced that you are lazy, ugly, stupid, weak, pathetic, and self-absorbed when you are depressed or have given into an addiction. Unconsciously you seek people, places, and things that will confirm those opinions. So, for example, when my self-esteem has plummeted to below-seawater status, I can’t stop thinking about the relative who asked me, after I had just returned from the psych ward and was doing everything I possibly could to recover from depression: “Do you WANT to feel better?” Indicating that I was somehow willing myself to stay sick in order to get attention or maybe because fantasizing about death is so much fun. I can’t get her and that question out of my mind when I’m pedaling backward. SO I draw a picture of her, with her question inside a bubble. Then I draw me with a bubble that says “HELL YES, DIMWIT!” Then I get out my self-esteem file and read a few of the affirmations of why I’m not lazy, ugly, stupid, weak, pathetic, and self-absorbed.

2. Make time to cry.

I’ve listed the healing faculties of tears in my piece “7 Good Reasons to Cry Your Eyes Out.” Your body essentially purges toxins when you weep. It’s as if all your emotions are bubbling to the surface, and when you cry, you release them, which is why it is so cathartic. Lately I’ve been allowing myself 10 to 15 minutes in the morning to have a good cry, to say whatever I want without cognitive adjustments, to let it all out, and not to judge it.

3. Ditch the self-help.

As I wrote in my piece “Use Caution with Positive Thinking,” cognitive-behavioral adjustments can be extremely helpful for persons struggling with mild to moderate depression, or struggling with an addition that isn’t destroying them. With severe depression or a crippling addiction, though, positive thinking can sometimes make matters worse. I was so relieved the other day when my psychiatrist told me to put the self-help books away. Because I do think they were contributing to my self-battery.

Right now, when I start to think “I can’t take it anymore,” I try not to fret. I don’t worry about how I can adjust those thoughts. I simply consider the thoughts as symptoms of my bipolar disorder, and say to myself, “It’s okay. You won’t feel that way when you’re better. The thoughts are like a drop in insulin to a diabetic … a symptom of your illness, and a sign you need to be especially gentle with yourself.”

4. Distract yourself.

Instead of sitting down with some self-help books, you would be better off doing whatever you can to distract yourself. I remember this from my former therapist who told me, during the months of my severe breakdown, to do mindless things … like word puzzles and reading trashy novels. Recently, I’ve been going to Navy football games, which does take my mind off of my thoughts for a few hours on Saturdays. Not that I understand football … but there is a lot to watch besides the cheerleaders. Like my children trying to score all kinds of junk food.

5. Look for signs of hope.

The little, unexpected signs of hope kept me alive during my mega-breakdown, and they are the gas for my sorry-performing engine during a fragile time like this. Yesterday a saw a rose bloom on our rose bush out front. In October! Since roses symbolize healing for me, I took it as a sign of hope … that I won’t plummet too far … there are things in this life that I’m meant to do.

6. Put family and friends on notice.

The first five weeks of my setback I tried to act like nothing was wrong. I didn’t want to burden Eric with anything else. By the eighth week, however, I knew I needed to fill him in, because it was becoming increasingly difficult to act as if all was peachy. A few nights ago I finally burst into tears and expressed to him how difficult it was to have to work and take care of the kids when I’m combating such intrusive and destructive thoughts. He didn’t say anything. He just rubbed my back. And I felt a whole lot better having opened up to him. Good, solid support is vital for any type of recovery, whether it be giving up cigarettes or booze or, for a manic depressive, trying like hell to temper your moods.

7. Make necessary adjustments.

Sometimes a relapse can signal that you need to make an adjustment in your life. Looking back, I know that mine was partly caused by my summer schedule. Eric and I were very short on cash last summer, so I wrote all of my summer blogs in five weeks. That way I didn’t have to hire a babysitter for the other seven weeks. Moreover, I planned out the summer like a mathematician, blanking on one detail: I’m not built like other people. I am a fragile creature who has an illness called bipolar disorder. Because of that, I can’t expect myself to work at a manic rate and not suffer some consequences.

The adjustments? Eric and I recently sat down with the budget for 2010. I told him that I absolutely needed to put my health first, that we were going to have to come up with the income to hire a sitter next summer. “I’d gladly move into a small apartment, or take a second mortgage on the house,” I said, “but I cannot repeat that mistake because I’m still recovering from the damage done in June and July.” I’m also beginning to interview sitters for next summer right now, so that I am prepared come May of 2010.

8. Say yes anyway.

In her book “Solace: Finding Your Way Through Grief and Learning to Live Again,” author Roberta Temes suggests a policy whereby you always say yes to an invitation out. That keeps you from isolating, which is so easy to do when you’re grieving or stuck in a depression or off the wagon in a big way. I’ve been following this piece of advice. When a friend asks me to have coffee (and I really hope she doesn’t!), I have to say yes. It’s non-negotiable. Until I feel better and get back my brain.

9. Break your day into moments.

Most depressives and addicts would agree that “a day at a time” simply doesn’t cut it. That’s WAY too long. Especially first thing in the morning. I have to get to bedtime? Are you kidding me? So when rear-ended in the depression tunnel or fighting one of my many addictions, I break the day into about 850 moments. Each minute has a few moments. Right now it’s 11:00. I only have to worry about what I’m doing now, until, say 11:02.

10. Remember your mantras.

Yep. Time to pull out those babies, and try to believe them as you’re saying them. Here are some that I’m using now: “I’m okay.” “It’s okay.” “I am enough.” “I have enough.” “I am loved.” “I am good enough.” “I will feel better.” “This too shall pass.” “Let it pass.” “Hello???? Anyone there?????”

11. Get involved.

A Beyond Blue reader commented a few weeks ago that what helps her more than anything when she is depressed is getting involved. I second this. I think that I’ve been able to buffer myself from a full breakdown this autumn by my efforts to stay involved: swimming with the masters program at the Naval Academy at least twice a week, participating in some of the parents’ programs at the kids’ school, and tutoring the midshipmen in writing once a week. Getting involved when you’re depressed or disabled by addiction always feels counter-intuitive. Most of us want to isolate. But when you’re with people, you don’t ruminate as much. You can’t. You’re supposed to be paying attention.

12. Enjoy the small things.

This one sounds like one of those fruity affirmations you’d get with your palm reading. But if you can pull it off, you’ll be well on your way out of a relapse. Here’s an example: Yesterday, Katherine baked an apple pie in her cooking class. When I went to the school cafeteria to fetch her, the site of my kindergartener making her own apple pie was very sweet. So was the pie with vanilla ice-cream, which we enjoyed as an afterschool treat. I hung onto that moment for as long as I could. Just tasting the pie, and the fact that my daughter is healthy enough to bake one. It made me happy for like seven minutes. Progress, right?