ON MENTAL ILLNESS: Stages of a Relapse

Jack Bragen
Thursday July 13, 2017 - 04:50:00 PM

The following will not be universally applicable to all who suffer from psychiatric illness. It primarily describes what happens, or perhaps what used to happen, with me. However, it may be applicable to a good number of others who've had similar experiences.  

In the first stages of a relapse, I am doing well, I am gaining confidence; and my symptoms are not preventing me from enjoying life. I am accomplishing things, and interacting with others.  

In the ensuing stage, my confidence is becoming overconfidence. I might feel ready to handle anything. I may have forgotten how bad it was, perhaps years before, when I had gone off medication. I may feel confident to the extent that I ask to have my medications lowered. A psychiatrist might go along with this request, since it may seem as though I am doing well. However, this could be a mistake.  

Later, in what I will call, "Third Stage of Relapse," I may have begun to develop one or more delusional systems, my behavior could be starting to get obnoxious, and perhaps strange, at times. I may believe at this point that I am capable of "riding out" the withdrawal from psychiatric medications. I may believe I am not sick at all or perhaps that I have cured myself with cognitive and other techniques. One problem with this stage is that I might be able to fool others into believing that I'm "cured," or, "in remission."  

At some point around the "Third Stage," a traumatic event often seems to happen. While this may be purely coincidental, the aftermath of it includes that I could begin to go downhill faster.  

In "Stage Four" of a psychotic relapse, I've become completely disconnected from reality, and I am interpreting my senses in a bizarre, delusional, and unreal manner. I am no longer capable of caring for myself, and I could be unintentionally doing a number of dangerous stunts. This stage is a threat to my physical well-being and to that of others. Also in this stage, brain damage could occur.  

If I survive "Stage Four" and make it to "Stage Five," this is where I've been put into involuntary treatment, medication is reinstated, and I wake up one morning and realize I am in a psych hospital -- again.  

There you have it, what it is like to be in the revolving door of mental health hospitalizations. The last time this happened to me was in the year 1996, and I hope that it doesn't happen to me again in my lifetime. Yet it could.  

Prevention of repeat psychotic episodes is the best thing we can do to improve brain health, as opposed to following a twisted ethic that psych medications are unnatural and that we are better off free of all prescription drugs. This is medicine, and people who have Schizophrenia need medicine.  

In "Stage Five," which is the hospitalization stage, we have an opportunity to make a lifetime commitment to keeping the condition treated.  

It is important to note that not all relapses are a result of noncompliance. Many people become ill despite every effort at cooperating with treatment professionals. In these instances, perhaps something could have been done, such as temporarily raising medications, if there is a period of worse symptoms. In other cases, the illness, sometimes in combination with life circumstances, has simply become worse, and not much could've been done to prevent that.  

Not all mentally ill people are alike. The stages of relapse are applicable to me, and probably to some other mental health consumers. Therefore, I recommend that you give this some thought, and figure out what your own particular pattern is, and what the predictors might be.  

A psychiatrist, in my past, would ask if I was eating and sleeping okay. This was his effort to look for early warning signs. Yet, by the time I've become ill to the extent that I'm not eating and sleeping, I've probably reached an acute level of being ill.  

The point is this: I suggest you look at your past, figure out what led to past relapses, and try not to repeat past mistakes, if there were any.  

If we can walk away from a relapse alive and intact, and having learned something from it, we can consider ourselves fortunate.  

However, if equipped with enough knowledge about ourselves, we may be able to recognize early warning signs, and redirect our path to avoid going into relapse. This can sometimes entail getting medication raised, getting more counseling, or reducing stress.  

In some instances, delusions can sneak up, without being detected--impairing our ability to judge, and the relapse has begun much earlier than the decision to reduce or go off medication. This is significant also because blame, if there is any, could be directed at the illness and not at ourselves.  

However, there should never be blame connected to psychiatric illness. It is not caused by us doing something wrong, and it is not caused by bad parenting. Mental illnesses are neurologically caused, and having a mental illness is not a sign of bad character.