When you carry a mental health diagnosis, you are in almost constant fear of relapsing. Whether you have a chronic long standing condition, or are suffering from a new diagnosis, the fear of symptoms re-activating, or worsening, is real problem for those of us that suffer from mental illness. Most of ask ourselves everyday: 1) will I always be like this?, 2) what if this happens again?, or even, 3) how do I know I am truly recovered? These are all totally normal questions to ask ourselves, wonder about, and feel scared if our worst fears become a reality.

The truth is though, we are in just about complete control over our mental health. Despite what some people believe, our mental health is in our own hands. What I am saying is the sure, there are some environmental, biological, genetic, and parental contributing factors to how we feel, and what we think, but are these markers the only indicator which speak to how we measure our own health? The answer is, probably not. In fact, these contributing factors, are just that. So, in the event your life circumstances are particularly limited and you feel restricted your capacity to maintain good mental health, think again.

For the most part, and for most people, the capacity for people to maintain their mental health, recognize new symptoms when they activate, and work on eliminating the impact of extraneous factors which can contribute to limited or poor mental health is truly in our hands. Self-determination, our drive and the very mobility needed to work on ourselves, and harbor enough self-awareness to realize our own strengths, as well as limitations, comes from within. Sure, some of us are put in impossible situations, born into poverty, victimized, abused, and maltreated, but even in these circumstances, there are those that rediscover resilience, and make it, despite the seemingly desperate nature of their problems.

So, why do we fear relapsing so much if it is in our means to stay or get healthy? The answer is, because people, regardless of the successes they experience, and the positive aspects of displaying certain behaviors which serve us well, often, loose sight of the bigger picture. For people in recovery, the road ahead can seem long, especially with more seemingly chronic diagnoses, and often, believe, they cannot persist over the long-haul or in some cases, life-span. The rest of our lives for a lot of us, especially young, and even middle-aged people, can seem like a lot of work, or too much of an effort to sustain for the long-term across the life span.

The fact of the matter is maintaining good health, especially our mental health, will only make living easier in the long term, create and allow for more solutions during difficult situations, and make everything more manageable. Aside from remembering this totally reasonable explanation for why people lose sight of their recovery plan, people continue to rationalize stopping or discontinuing behaviors which promote healthier decision-making, and stop putting into action self-management techniques consistently during their everyday routines, and self-care measures during the tenure of their illness. This can be due to several reasons. Sometimes we deem ourselves cured. Other times, we encounter a seemingly insurmountable situation created by our negative behaviors as a result of playing out symptoms of a disorder.

Whatever the reason, because there are many, almost infinite self-rationalizations we can manifest to discontinue our self-care practices. These are merely negative self-messages we create, which become cognitive distortions, seemingly real and true, but at the root of it, are untruths and outright lies our minds manifest. They are maladaptive, unhelpful, at times frightening, and if we follow these negative thoughts to their horrific conclusion, are disturbing to most of us experiencing them. Self CBT, disputing and challenging these rationalizations everyday, and when they first occur, will go a long way in terms of sustaining our positive behaviors, and persisting towards our goals for ourselves, and good mental health.

There is no question that these negative, maladaptive, and self-defeating behaviors can and need to be stopped when they first trigger us to stop doing what we all need to do for ourselves. Like most thoughts surrounding fear, paranoia, and anxious thinking, they all snowball, combine and multiply our worst thoughts. Following our self-care plan across the lifespan will mean living a life free of this fear or at least, regulated as best as possible to reduce the likelihood and chances of paranoia, and the fear we will one day relapse or become sick without warning. Thus, this concern of relapse is truly our own doing, and ultimately, when left to our own devices, we set its limits, and create the solution for disarming its paralyzing force which can make life seem like we are on a ride or a just passenger in our lives. The truth is, we are driving our own health foward at a rate and speed and course of our own choosing.

I recommend allying with your therapist, treatment team, and close peers with a vested interest in your mental health. Establishing a deep trust with those which have close personal contact with you everyday. In doing so, if these collaterals begin to detect an extreme and toxic abnormality in your health, you can feel safe in taking their advice and concern very seriously. Sure, no clinician or friend can get a perfect read on our health. But for those of us without a great deal of self-awareness or drive to look after ourselves, there are still options and strategies to stay healthy without relying completely on your own devices. Indeed, not everyone cares enough about their health to self-monitor all the time. In other cases, the priority of the day will capture our attention e.g. paying the rent, housing, employment, and even just showing to work on time. All of which, if not also addressed in our lives, would disrupt our mental health and even put our lives in jeopardy regardless of our diagnosis.

So, staying connected with collaterals in which you can delegate your health needs to is a great plan “B” when your own self-care takes a back seat to the priorities of life which only seem like they come before focusing on maintaining or working towards good mental health. Regardless, while taking your health and quality of your mental status into your own hands is the the best way to maintain good mental health, and reduce the likelihood of relapse. A second more short term plan can always be handing out this responsibility, or at least part of it, to family, friends, and those we trust to follow their advice even when we disagree with it (unless it puts us directly or in directly at risk of harm). The reasoning here is regardless of how we feel or think about the validity of our friends opinions on our mental status, for some of us, our disorder disrupts our capacity to stay connected to reality and may take the form of complex delusions about our life which complicate our own interpretive eye to know what is truly happening with our health.

In the end, anyway you want to manage your mental health, do at least that much. Have a plan, and have another plan when the original road map to better health becomes unworkable. Ultimately, whether you have a chronic condition, or an acute diagnosis, relapse is only something to be feared when you aren’t doing what you need to do to work towards better health and healing. Relapse is real. Relapse is awful. But it isn’t the end of the world. Relapsing and experiencing the renewal of old symptoms can still be a reminder to get back on track with your recovery. Keep going, and don’t stop. When you stop taking care of yourself, be prepared for your worst fears to not just haunt you, but become the grim reality you feared so vehemently instead of investing the same mental energy in health and healing.