What is a mental health relapse?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.


Photo courtesy of Pixabay.com

Do people with depression, anxiety, or emotional problems relapse?

The term “Relapse” is increasingly being applied to mental illnesses and for good reasons.  Many people are familiar with the idea that people with a substance use disorder, alcoholics, and drug addicts can relapse. The idea that people with a mental illness can relapse is becoming a recognized part of the mental (or behavioral) health field.

Wellness and recovery.

We know more now than ever before about mental and emotional illness. Professionals no longer think of the mentally ill as somehow different from others. We now know that them is us. In their lifetime half of all Americans will experience the occurrence of an emotional or mental health problem that meets the criteria for a mental illness.

Looking at mental health issues as chronic conditions rather than once and forever problems has helped us to understand how someone with a mental health issue can “relapse.”

Mental health and illness lie on a continuum.

There are not two discrete groups, the well and the ill. People who appear to be emotionally and mentally well may gradually develop symptoms. Disorders can come on suddenly or slowly. People with mental health issues can and do recover. They get better.

Along this continuum, people can move from unwell (ill) to less unwell to well. Others can move from well to unwell. Across your lifespan, you will probably make many trips back and forth on the continuum. You get sad and depressed or anxious and then you get better.

People can have a mental illness and then get better.

For professional treatment, we have set the point at which people get diagnosed as mentally ill very far over on the continuum. Your condition needs to interfere with school or work, prevent you from having good relationships, upset you, or impair some important part of your life for it to be diagnosed as a mental illness.

Plenty of people get life problems that almost, but not quite reach the point of being mental illnesses. These people benefit from counseling also if they are able to get some. For milder issues (subclinical) self-help books, blogs like this one, religious and social activities, and so on can help them maintain their mental health.

Mental illnesses are often chronic conditions.

Mental and emotional issues are a lot like being overweight and developing type two diabetes. Once you have been diagnosed as a diabetic it is unlikely that this will come off your medical file. You may take medications, exercise, and watch your diet. All those things may get your blood sugar back under control.

With chronic conditions, and mental and emotional disorders fit this pattern well, even once you recover there will be things that you need to do to keep your condition under control.

Our understanding of the need to do things to maintain mental health recovery is informed by the stages of change model. See Stages of Change for a list of all the posts on this process.

In that model, we discovered that when someone recovers from a condition, excess weight, substance use, depression or just the normal problems of life, there are things that they will need to do to maintain those changes. We call that recovery the “Maintenance steps or Maintenance Stage of Change.

People with mental illnesses do relapse.

By relapse, I mean a return to symptoms or an increase in symptoms that were previously under control. Sometimes that relapse is a result of new life events. Someone with PTSD or complex trauma may experience another trauma or something that reminds them of past trauma.

Someone with depression or anxiety may have an experience that is sad or makes them anxious. As these levels of emotion rise, the person may become overwhelmed. If their support system is not being supportive or their coping skills are overwhelmed then the person moves to being less well, less able to cope and they may experience another episode of whatever we chose to call their mental or emotional issue.

This continuum of wellness and the possibility of recovery is easier to see when we talk about relatively well know conditions. Anxiety, the most common of all mental illness, and depression, that cousin of sadness, are good examples of how the journey from wellness to illness and back may occur.

We have all experienced some anxiety and can see how it may get better or worse. Depression is understandable. Sometimes in life, we get sad, if we get too sad or stuck there too long that might turn into Major Depressive Disorder.

What about really serious mental illnesses, the ones where it is harder to understand the symptoms. Do people with Borderline Personality Disorder, Schizophrenia or Dissociative Identify Disorder ever recover?

There sure do. There are treatments for all those conditions. Most of these treatments are skills-based. Someone who hears voices all the time, they can learn to listen to the police officers voice and not the one in their head. This is not easy, it takes lots of skill development and practice, but many people with even the most serious of emotional issues do recover.

Do you get the picture that I and other mental health professions are coming to be strong believers in wellness and recovery? Recovery happens. If recovery happens, sometimes there may be a return of symptoms. When that happens we expect a return to doing the things that helped the first time to help them recover even faster than the first time.

If there are other skills they need to learn, well during a relapse is a really great time to try out new skills and find a way to create your happy life, however, you define it.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

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