A Relapse Prevention Plan

I read the chapter "Developing a Relapse Prevention Plan" by Kim T. Mueser, PhD, and Susan Gingerich, MSW, in their book The Complete Family Guide to Schizophrenia I found some interesting information on how to prevent a relapse.

First, the early warning signs of a relapse vary, and sometimes some relapses do not have any warnings. However here are some common early warning signs to watch out for:

• Social Withdraw
• Suspicious of Others


• Irritability
  
• Depression


• Appetite Changes


• Sleeping Too Much or Too Little


• Change in Routine or Unusual Behavior


• Concentration Problems


• Feeling Anxious or Nervous

Social withdraw could be an indication that psychotic symptoms are returning, and the individual feels that people are either against them or they are hearing voices. Feeling irritable could mean feeling annoyed by things that don't usually annoy you, or feeling impatient and on the edge. Some people may feel depressed or worthless and not carry an interest in things that used to preoccupy their time. Depression also includes feeling suicidal. A change in appetite is a warning sign of a relapse. You may eat a lot or not eat much at all. Sleep disturbances is a sign of a relapse. Some people change their sleeping pattern by either sleeping too much or not getting enough sleep. Unusual behavior could be anything like not answering the phone or dressing in all black. Concentration problems could mean having difficulty completing a task or following a conversation. Feeling anxious or nervous is a feeling that usually comes before a relapse.

To prevent a relapse you should (http://www.rethink.org/):

• Continue to take prescribed anti-psychotic medication
• Learn how to identify, reduce, and cope with stressful situations
• Avoid using street drugs
• Maintain close relationships with family and friends
• Develop a lifestyle that maintains your well being
• Know your early warning signs and put in place a relapse prevention plan

Second, you should schedule a family meeting to come up with a relapse prevention plan. Determine who should participate in the meeting. In the meeting discuss relapses and their signs Find out what triggered your relapse such as a move, new job, and financial stress. Then determine whether you have been taking your medication. Stopping treatment is usually followed by a relapse. If you have discontinued medication, discuss the reasons why and talk to your doctor. Then discuss whether you have abused drugs or alcohol with your family, these substances make the illness worse. Finally, set a date to do a follow up meeting, and review the relapse prevention plan every six months.

Third, reduce your level of stress. People with schizophrenia can be affected by arguments, criticism, and sudden increased responsibilities. Have you started a new job or had a problem with a relationship, if so these could trigger stress. Come up with some ways to alleviate stress. For example, working less hours at work, participating in more leisure activities, and communicating concerns with a friend or treatment team member.

Lastly, talk to your doctor about possibly increasing your dose of medication or changing your medication to prevent a relapse. Make a list of treatment providers to contact if early warning signs persist for more than a few days (list their name and phone number):

1. Psychiatrist:
2. Nurse:
3. Case Manager:
4. Social Worker:
5. Therapist or Counselor:
6. Other:

Was this relapse prevention plan helpful to you?