Relapse Awareness and Management
People who live with schizophrenia and other serious mental health conditions, like all people, tend to have good times and difficult times throughout their lives. Most people who have schizophrenia experience times of remission, when symptoms are under control, and times of relapse, when symptoms return or even get worse.
Relapse can happen quickly, within days. But it’s most common for a relapse to develop gradually. Knowing the triggers and noticing the signs of relapse as early as possible can help prevent the relapse from occurring—or reduce its severity. Early intervention may help avoid hospitalization—or make it possible for a person to have a shorter hospital stay and get back to his or her life and recovery.
Noticing the early signs
It’s impossible to predict exactly what each person’s early signs of relapse will be. But over time, it may be possible to notice a pattern of similar early warning signs. It is usually very subtle at first—people may not notice anything different unless they know the person with a mental health condition very well. Sometimes, it can just be the sound of the person’s voice. Or it may be that the person is being quiet when he or she normally would not be.
Some of the common early signs of relapse include:
- Restless or unsettled sleep
- Feelings of tension or nervousness
- Having a hard time concentrating
- Not wanting to spend time with others; staying isolated
- Feeling irritable or having a short temper
- Having trouble taking care of routine things
- Feeling a lack of energy
- Feeling sad or depressed
- Feeling confused
- A change in appetite
For bipolar disorder:
- Disturbed (or lack of) sleep; feeling extremely excited
- Talking quickly and talking more than usual
- Making big plans without thinking them through
- Acting reckless
- Feeling very tired
- Feeling very depressed
- While every relapse experience is unique, a person’s early warning signs tend to be similar each time.
The Relapse Prevention Worksheet may be helpful to keep a list of early warning signs.
Some common relapse triggers:
Not taking medication regularly or correctly as prescribed is the most common cause of relapse. This can occur if the person with a mental health condition has stopped taking medication altogether or stopped taking it regularly, but it can also happen because the body’s need for medication may have changed, or the doctor may have changed the dose. The amount of medication needed can change with time. This is why it is important to have regular doctor visits and to check in with the doctor about how the medication is working–so that the medication plan can be adjusted if needed.
Too much stress. There is good stress–like starting a new job that was wanted, and bad stress–like having a serious argument with someone. Any big change can cause stress.
Use of street drugs/illicit drugs or alcohol. This can trigger a relapse in many people.
Not sticking with a healthy routine. If the person with a mental health condition has drifted away from some of the healthy habits, the recovery team may be enlisted to help get things back on track.