Chronic Illness · Chronic Pain · Grad School · Mental Health · Personal · Recovery

Keeping Red Flags from Building up to a Relapse

Note: “Relapse” in this article relates to falling back into pain behaviors related to chronic illness, maladaptive coping skills and bad habits that hurt rather than help recovery. I hope that, if you are struggling with any sort of relapse that looks different from that, this post still has a story you can relate to and some wisdom to apply to your own story.

“My worst days in recovery are better than the best days in relapse.” – Kate Le Page

It finally happened this week: I let my most important health habits slip out of my schedule for many days in a row because I thought I was too busy to do them. I had many friends who needed me in big ways, papers to be written, books to be read (there is a lot of this in seminary!), meetings to sit through, and so on. The questions were endless and the answer seemed obvious to each of them: When am I supposed to find time to exercise vigorously 5 times a week? Weight train 3 times a week? Sleep 8.5 hours a night? Eat 4-6 small meals that fit my dietary restrictions? Do cognitive behavioral therapy exercises to reduce my anxiety about my health, work, and life in general? Plan my days to make sure they don’t have too much in them? Switch up the kinds of activities I do back-to-back? Drink 10-12 cups of water? Walk a little bit each hour? Stretch? Breathe? Rest and rejuvenate in little moments before continuing the day? (These aren’t even all of the health habits I do; I am so excited to continue to share the Mayo Clinic lessons over time!) The answer to all of these questions was, “I just won’t for now. I’ll get through this week, then get back to it.”

Let me tell you: This week went about as well as the time that my sister, dad, and I decided to take a little detour on a walk in the woods and we ended up having to trudge through thigh-high, itchy grass for at least a mile before we found our way back.

[image description: me looking horrified while walking through the woods. My dad is in front of me, facing away from the camera, clearly trying to figure out what to do to get us out of our predicament].
By the time Thursday rolled around, I was mentally, spiritually, and physically exhausted. I was irritable and anxious about the littlest things, things that would usually just make me roll my eyes or laugh before moving on. My pain was so high that I was tempted to pop pills to take care of it in order to keep going at the frenetic pace I had taken on. I wanted to skip things so I could watch Netflix for hours. I could barely concentrate or attempt to be present. And finally, what really served as my wakeup call, I wasn’t able to stand and sing during chapel because of how bad my postural orthostatic tachycardia syndrome (POTS) symptoms were; I had to sit. When I exercise, weight train, sleep enough, drink enough water, stretch frequently, and so on, my POTS symptoms of light-headedness, fatigue, high heart rate, cognitive fogginess, and muscle weakness are barely noticeable (and if I do notice them, they don’t stop me). I haven’t experienced the unpleasantness of the inability to stand in weeks, maybe months at this point.

As I sat there, I decided that this would be the last moment that my health was my last priority.

Why, when there were so many things that legitimately did need my energy? Because I have come too damn far to lose my progress. I used to sleep 12 hours a day and then spend another 6 or so in bed, if not more. My big accomplishments from December 2015 to June 2016 were the days that I canceled less than 50% of my plans, got out of the house for a few hours in a row, walked more than 3,000 steps, didn’t cry because of the challenges I was facing, didn’t take as-needed pain meds, and so on. I barely recognize myself from that period. These behaviors now serve as red flags that warn me that I’m on my way to somewhere I don’t want to be.

Now, I’m out of the house 12-14 hours a day. I’m a full-time grad student. I only cancel plans if I literally would have to be in two places at once to make them happen. I have an exercise routine that I love. I am on 3 fewer daily meds and never take as-needed pain meds unless I tweaked a joint while exercising. I don’t spend any time in my bed except when I’m ready to sleep. I have more joy and purpose than I’ve had in a while. So, in response to the slips I was feeling this week, I set boundaries, decided what to let go of, and started my health behaviors again.

How do we let these wake-up call moments be the moment that we start to get back on track, rather than the moment we succumb to a relapse? How do we accept the inherent messiness of recovery?


[image description: a hand-drawn, black and white comparison of the expectations and reality of recovery. The picture is of two different arrows, one representing expectations and the other, reality. The expectation arrow is a straight trajectory upward, whereas the reality arrow is a messy arrow with a lot of circles and detours, but in the end is still pointing upwards. Source].
When you notice that you’re falling back into survival mode and there are red flags littered all around you:

  • Acknowledge your shortcomings, but acknowledge that they don’t define you. Because of black-and-white thinking, it’s all too easy to just think, “Well, I failed, and that makes me a failure. Why do I even bother trying?” That’s how we succumb to exactly what we don’t want: a relapse. That’s how we let bad moments slip into a pattern. You are in the best spot right now to say “no more” to this, rather than say “oh well.” Red flags don’t automatically mean you’re in a relapse. Do not let your thinking lead you to one.
  • See it as a bad day/week, not a bad life. See above.
  • Take yourself to a quiet place so that you can:
    • Decide what to let go of right away and over time.
    • Decide what to resume right away and over time. Some things will have to be left undone in order to make space for your self-care. What will they be? What can – and honestly, should – you let go of? Can you let your kitchen be a little messy? Can you let someone else step up on a task? Can you hand an imperfect paper in or skim rather than in-depth read that article? Can you turn off your phone for a few hours? Can you set clear boundaries with the people in your life? My guess is that you can.
  • Find your rhythm again. Daily and weekly schedules and daily routines (morning and evening) save so much time and effort, and they can help you find your ideal pace again. Give yourself space to figure out what works and what doesn’t. What do you need in your day? It’s not going to be perfect – you will very rarely do all of the things you want to in a day to take care of yourself, but know that you are trying – and that is far better than not.
  • Acknowledge – and relish in – the messiness of recovery and of your soul. It’s just never going to be a linear process to heal, but look at you – you’re giving it your all. You’re giving it your best each day, and your best will look different on each day, but you’re still here and you’re still trying. That is an amazing thing to celebrate. [Here are some more posts with tips and encouragement about the recovery process.]

“At a certain point, you have to kind of realize that greatness is a messy thing.” – James Gray

Your greatness will be messy. Your life will be messy. Your soul will be messy. That’s just how it is for everyone, no matter how much we try to deny it. Embrace it! Keep fighting the good fights you’re fighting right now, my friends. Self-care is not selfish; it’s necessary for survival and eventually, thriving.

2 thoughts on “Keeping Red Flags from Building up to a Relapse

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