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Authors: Susan J. Noonan
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of self. Remembering your baseline self, or healthier state of mind, will help you keep each episode in context, and you will feel more in control of your life. You are not your depression.
Having a clear image of your baseline healthy self to draw on during your recovery will help you know what you are working toward. You may need to ask people who know you well to help you. Ask your friends or family to remind you honestly of your strengths and unique personal qualities, then write them down. Review that list periodically. See chapter 3 for an exercise on how to do this.
Identify and Monitor Your Triggers
Triggers are events or circumstances that may cause you distress and lead to an increase in your symptoms. Being aware of what can worsen your symptoms is crucial to avoiding relapse (see page 74 ). You may not be able to change the Trigger itself, but you can learn to modify how you respond to it so that you do not feel as much distress. Work with your therapist to identify, monitor, and modify your response to your Triggers.
Identify and Monitor Your Early Warning Signs and Symptoms
Warning Signs are distinct changes from your baseline that precede an episode of depression or mania (see page 75 ). Each person has a characteristic pattern of Warning Signs. These are changes in your thoughts, feelings, behaviors, routine, or self-care that are noticeable to you or others. Being aware of the changes that are Warning Signs for you will help you recognize the signs early. This will give you a chance to intervene and change the course of the depression or bipolar episode.
Symptoms that might be Warning Signs are those characteristic to depression or mania that last for two weeks or longer (see chapter 2 ). They may include changes in appetite, sleep, thinking, or concentration; loss of interest; sad, worthless, hopeless, or guilty feelings; negative or elevated thoughts or feelings; or behavior that is slowed down, irritable, restless, or overactive.
Develop an Action Plan
An intervention Action Plan for Relapse Prevention is a written self-care plan to help you deal with a worsening or a recurrence of depression. It outlines the steps you will take to manage, cope with, and distract from the intensity of a depression or manic episode. In your plan, you also list the people you will ask to help you: health care providers, family, and friends. Work with your therapist to develop an intervention Action Plan to use when things get worse, when you or others notice your Warning Signs or a change in your emotional state. Create your Action Plan now and have it ready to use before you have any intense symptoms. See page 78 for a sample Action Plan.
Use Relapse Prevention Strategies
Relapse Prevention is a day-to-day approach to help you stay well. It is a way for you to identify, monitor, and respond early to changes in your symptoms. The approach also involves daily preventivesteps to strengthen your emotional resources. For more information on Relapse Prevention, see chapter 5 . A Relapse Prevention Strategy includes five main steps that you and your treatment team will act on:
1. Identify in advance what your Warning Signs are.
2. Pay attention to your Warning Signs. Notice when changes from baseline begin to show.
3. Have an Action Plan prepared in advance and ready to use when your symptoms change.
4. Follow daily prevention steps to help you remain stable.
5. If you notice a change in your emotional health, follow your Action Plan. The plan will enable you to intervene early and modify or improve the course of the episode.
Use Coping Skills
Coping skills are the actions we take to lessen the effect of stressors and to get us through difficult times. These skills include problem solving, self-soothing, distraction, relaxation, humor, and managing the little things before they get too big. Learning and using effective coping skills are essential to managing your mood disorder. Coping skills are discussed in more detail
Having a clear image of your baseline healthy self to draw on during your recovery will help you know what you are working toward. You may need to ask people who know you well to help you. Ask your friends or family to remind you honestly of your strengths and unique personal qualities, then write them down. Review that list periodically. See chapter 3 for an exercise on how to do this.
Identify and Monitor Your Triggers
Triggers are events or circumstances that may cause you distress and lead to an increase in your symptoms. Being aware of what can worsen your symptoms is crucial to avoiding relapse (see page 74 ). You may not be able to change the Trigger itself, but you can learn to modify how you respond to it so that you do not feel as much distress. Work with your therapist to identify, monitor, and modify your response to your Triggers.
Identify and Monitor Your Early Warning Signs and Symptoms
Warning Signs are distinct changes from your baseline that precede an episode of depression or mania (see page 75 ). Each person has a characteristic pattern of Warning Signs. These are changes in your thoughts, feelings, behaviors, routine, or self-care that are noticeable to you or others. Being aware of the changes that are Warning Signs for you will help you recognize the signs early. This will give you a chance to intervene and change the course of the depression or bipolar episode.
Symptoms that might be Warning Signs are those characteristic to depression or mania that last for two weeks or longer (see chapter 2 ). They may include changes in appetite, sleep, thinking, or concentration; loss of interest; sad, worthless, hopeless, or guilty feelings; negative or elevated thoughts or feelings; or behavior that is slowed down, irritable, restless, or overactive.
Develop an Action Plan
An intervention Action Plan for Relapse Prevention is a written self-care plan to help you deal with a worsening or a recurrence of depression. It outlines the steps you will take to manage, cope with, and distract from the intensity of a depression or manic episode. In your plan, you also list the people you will ask to help you: health care providers, family, and friends. Work with your therapist to develop an intervention Action Plan to use when things get worse, when you or others notice your Warning Signs or a change in your emotional state. Create your Action Plan now and have it ready to use before you have any intense symptoms. See page 78 for a sample Action Plan.
Use Relapse Prevention Strategies
Relapse Prevention is a day-to-day approach to help you stay well. It is a way for you to identify, monitor, and respond early to changes in your symptoms. The approach also involves daily preventivesteps to strengthen your emotional resources. For more information on Relapse Prevention, see chapter 5 . A Relapse Prevention Strategy includes five main steps that you and your treatment team will act on:
1. Identify in advance what your Warning Signs are.
2. Pay attention to your Warning Signs. Notice when changes from baseline begin to show.
3. Have an Action Plan prepared in advance and ready to use when your symptoms change.
4. Follow daily prevention steps to help you remain stable.
5. If you notice a change in your emotional health, follow your Action Plan. The plan will enable you to intervene early and modify or improve the course of the episode.
Use Coping Skills
Coping skills are the actions we take to lessen the effect of stressors and to get us through difficult times. These skills include problem solving, self-soothing, distraction, relaxation, humor, and managing the little things before they get too big. Learning and using effective coping skills are essential to managing your mood disorder. Coping skills are discussed in more detail
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