A Relapse Isn't a Start-Over

[David Baxter PhD]

Mindful Monday: A Relapse Isn't a Start-Over
Therese J. Borchard
June 14, 2010

Spiritual author Henry Nouwen writes:

"When suddenly you seem to lose all you thought you had gained, do not despair. Your healing is not a straight line. You must expect setbacks and regressions. Don't say to yourself, "All is lost. I have to start all over again." This is not true. What you have gained, you have gained.

Sometimes little things build up and make you lose ground for a moment. Fatigue, a seemingly cold remark, someone's inability to hear you, someone's innocent forgetfulness, which feels like rejection--when all these come together, they can make you feel as if you are right back where you started. But try to think about it instead as being pulled off the road for awhile. When you return to the road, you return to the place where you left it, not to where you started."
​

That's so important to remember: Whenever we start to slip and lose ground, we aren't sent back to the starting line. No way. We've made too much progress to be dumped back there in the garbage pit. We've just lost a few inches.

I struggle with this often, especially as I'm surfacing from a depressive cycle. I have two good days followed by a day where I'm back to counting the hours until bedtime, repeating four of my favorite mantras: "I am okay." "I am enough." "Peace." "I wish I hadn't stopped drinking."

I can clearly see the progress in my friends when something like a relapse happens. Like the one who lost her husband a year and a half again. The other day she felt the same heart pangs or intensity of grief as she did those first days as a widow.

"I'm back at the beginning," she said to me.

"No you're not," I said. "You haven't called me in tears for over four months. Do you realize that? Frankly, I'm surprised you haven't had more bad days like this. You just feel like it's the beginning because, compared to how good you've been feeling for the last few months, it is a huge disappointment. But you're not at the starting line. Nowhere even close."

Today I'm reminding myself of the same thing.

All of my boundaries have ditched me for a party somewhere I'm not invited. My discipline applied for a foreign-exchange program abroad and has been gone for the last month. And my happy cap got eaten by the dog, with all the other clothes he's managed to chew up.

But I have to remember in this backslide that I've only taken two steps back, not 1,000 meters. Even though, to my mind, it feels the same.

 

[David Baxter PhD]

How to Come Back After a Relapse

How to Come Back After a Relapse Therese J. Borchard
June 14, 2010

It's a dreadful place.

Relapse.

Maybe you had hoped you'd never go there. Or maybe you stay awake at night fearing you will. Maybe you’ve just realized you’re already there.

I prefer to use the term "setback" when I get sucked back into the Black Hole of depression--bam!--stuck inside a brain that covets relief, any form of relief, and will do just about anything to get it. I call it "setback" not "relapse" because such times are certainly not the end of recovery. From depression or any addiction, a relapse merely gives you a new starting place for healing.

Since I've been struggling with this recently in my own life, I've laid out a dozen strategies to get unstuck, or to recover from a relapse.

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?" The insinuation was that I was somehow willing myself to stay sick in order to get attention, 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, complete with her question inside a comic-strip bubble. Then I draw me with my own 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.

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.

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."

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.

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

The first five weeks of my recent depression setback, I tried to act like nothing was wrong. I didn't want to burden my husband with anything more than our everyday "stuff." 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, though, 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.

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.

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.

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.

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?????"

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.

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?