By Tamra Wade
May 1992 – Inpatient hospital recovery plan
Dear support people –
This is a letter to inform you of the work I have done and the help I may need. I have been in the hospital for depression and to work through my alcoholic family members and my childhood sexually abuse.
My memories have been slowly coming to surface. As they do there is the chance I may slip back into my depression.
(See my warning signs and triggers)
I give you permission to confront me if you see me slipping. If I get defensive don’t be afraid or back off. This is a warning sign.
My health and happiness depend on your support.
I love you.
The above is a letter I wrote to my loved ones – my support people – while I was inpatient in a hospital working on my depression and trauma recovery. I had had a breakdown – a split in my soul of sorts – that prompted me to check myself in. I stayed in the hospital for two weeks working to find myself in the middle of my horror and suffering.
It was one of the best decisions of my life to better my life on my own terms.
One of the tools I learned while in the hospital was how to create and share a relapse prevention plan.
So many of us have faced depression and a myriad of other mental health issues brought by abuse, trauma, neglect, chemical dependency, imbalance and/or temporary situations. Each of our individual experience with depression can span a wide spectrum of symptoms from sadness and loneliness to victories, achievement and even joy.
While it is hard to describe these variations of experience, there are a few things that are similar.
There is a profound sense of loneliness even amongst loved ones and friends. My thirst for joy can be replaced with apathy and a deep sense of doom seemingly without notices. Life goes dark and I can loose my sense of life and desire to live.
There are people in my life, perhaps yours too, that have never known depression. It is hard for them to understand what depression is or how to assist when it attempts to takes over.
Using a relapse prevention plan, I am able to enlist the help of my friends and family in a tangible way. I give them permission to lean in to the discomfort of talking about my depression. It gives them tools to help me get back on track.
What is a relapse prevention plan?
A relapse prevention plan is a written plan that will help you organize warning signs, triggers and the tools you use to get back on track.
Warning signs are what will alert you and your support people that you are in risk of relapse. These are actions or behaviors that are less productive and can feed a downward spiral. Examples of warning signs can include and are not limited to:
- Perfectionism – unrealistic goals
- Letting up on recovery disciplines
- Judging others
- Calling in sick to work often
- Not going to therapy or support groups
- Canceling appointments, meetings and/or get togethers
- Saying yes when wanting to say no – including sexual interactions
- Reckless behavior
Triggers are specific activities, behaviors, food, people, places and things that the past have precipitated depression and behaviors associated with depression and or anxiety. Think of a trigger as the things that start an episode. Examples of trigger behaviors can include and are not limited to:
- Loud noise or voices
- An argument
- Sound of a gunshot
- Specific sent
- Certain song
- Feelings of shame
- Alcohol use or smell
- Watching too much television
- Movies or television with violence or sexual abuse
- Being around people who derail you
Recovery tools are a little more self-explanatory. These are a list of specific things that you use to keep yourself in recovery. This list should be as specific as possible. This list can include and is not limited to:
- Support group
- Therapy sessions
- 12-step meetings
- Getting together with your safe support people
- Challenge irrational thoughts
- Not talking with people who derail you
- Abstain from bad behaviors such as purging, restricting, recklessness
- Follow exercise plan
- Follow meal plan
- Set boundaries with family members
- Make time for fun – keep a list of fun activities to choose from
- Select to be around healthy people
- Ask for help
Your recovery tools can also be broken out into things that you wish to do daily, weekly, monthly etc. Setting up appointments with your recovery tools will keep positive activities actively on your schedule. Share your recovery schedule with your support people.
Lastly, write a letter to your support people similarly to the one I shared at the beginning of this post. Start by sharing briefly about your situation. Ask your support people for their active assistance. Include a copy of your written warning signs. Additionally, give them permission to confront you on your list of warning signs.
If you are in therapy, talk with your therapist about creating a relapse prevention plan. It helps to have the help of a trained professional. I am not a credentialed professional, I can only offer you these tactics from my own arsenal of tools and experiences.
Keep in mind that if you have worked through this type of exercise before, it is important to visit it regularly. Things change; our fears and anxiety grow and shrink.
One of my recovery tools is music. Select music that feeds your soul in a positive way. It’s easy to listen to music that feeds our current state of mine. This is not always healthy and in fact is on some people’s warning signs list.
My most favorite recovery tool presently is hiking. Being outdoors with my dearest friend exploring Mother Nature fills my soul with so much happiness. Sometimes we hike easier nature hikes. Other times will crush it hiking one of the most difficult climbs in our area. It took me six months to hike to the top of this summit and doing so changed me profoundly. I will save more of this for another posts specific about the benefit of endurance.
Sending love to all of you who, like me, have a life long relationship with depression or are the support system for those of us who are depressed.
We are not alone. You can work to live in recovery. I am actively working to stay in recovery after thirty years of discovery. I think a relapse prevention plan is a good plan.