Bipolar Disorder: Coping with Relapse

Updated: Jan 28

This has been a hard couple of weeks.

I don’t like to not be good at things. I am naturally a perfectionist and a high achiever and I find it really hard to tolerate not doing well at something.

One thing I have become very good at is managing my mental illness. I can talk about it passionately but from a distance. I can go about my life living with it as a diagnosis, but sometimes only remembering it exists when I take my medication at night. I have a full time job which at times is stressful and busy, and have been able to easily brush it off at the end of the day and use the same coping mechanisms ‘normal’ people do. I maintain a healthy and stable relationship. I am close with my friends and see them as often as possible.

I was good at recovery.

Recently I relapsed – I’ve written about that here. I didn’t see it coming until it happened – but I did at least notice when it had happened. It was too late to do anything about it alone – I couldn’t bring myself back. But I knew I needed to be brought back.

I did everything right. I took sick leave from work. I went to my GP. I took antipsychotics again even though I hate them. I engaged with the crisis team and saw a psychiatrist. I wrote a thorough crisis plan and let others be a part of it, something I’ve historically shied away from. Everyone has consistently told me how well I have done.

So why do I still feel shit?

I appreciate people saying that, I really do. I recognise it myself – although I do wish I had noticed earlier. The nurse told me I’d done well to recognise my early warning signs, but in hindsight the really early signs were in the background for at least two or three weeks before, if not a little longer. They are things that are innocent and normal in isolation, but together clearly mean for me that something isn’t quite right and I guess I will just need to remember that for next time.

That’s one of the worst things about relapse. It just reminds me that there is always a next time. I will never be free from this. I can be free from it for many years, as I have been until now, but it will still be there.

How do I feel about relapsing again and being aware of this inevitability?

Honestly, I mostly just feel sad. I usually have a crash after mania, whether that is chemical, pure exhaustion, or whether it is for the reasons above I don’t know. This sadness will pass quickly, I’m sure of it. The disappointment in myself might last longer. The anxiety around becoming unwell again will be there for months.

I’m frustrated that not only will I have to pay extra attention to everything I do now, other people will be doing this too. I want to be able to say I’ve not slept well and it not raise alarm bells. I want to go shopping and not have it questioned. I want to have days where I wear pyjamas and sit under a duvet without doubting my motives. I want to behave like a normal human being and not second guess – or have other people second guess – everything I’m doing.

I also get frustrated with my frustrations. I feel ungrateful. I have never in my life been surrounded by so many incredible, wonderful and supportive people who love me and care for me. It’s not reasonable for me to expect them all to move on from this immediately, and it’s not reasonable for me to either. As much as it frustrates me, I do need to be aware of how I am doing in these fragile few months that follow.

I’ve rambled a bit. The point of this post was about how to cope with relapse. Despite ranting about my frustrations above, I know that I have and will come out of this with more skills and knowledge in my arsenal.

What I have ultimately learnt from this experience is that the way to truly cope with relapse is to forgive yourself. I’ve said previously that I look after myself pretty well generally. I really don’t feel like there was anything I could have done to prevent this. No matter how I live my life, this illness doesn’t go away; and actually, that’s not my fault.

I was kind to myself. I was vocal. I asked for what I needed, regardless of my anxieties. I averted a more significant crisis and I’m proud of that. It’s not enough to be kind to myself at the time though. I have to be kind to myself after.

There’s no use in beating myself up about this; I can’t turn back time and it is what it is. It’s not my fault and I did my best.

Those should be the only two things that matter.

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