How to Prevent a Relapse

This section is for people who have already done the work needed to reduce their anxiety symptoms.

Congratulations!

Many people are afraid of losing the progress that they have made, and having what is called a “relapse”. That is, once your symptoms are reduced and you are feeling better, you want to make sure that you hold on to these positive changes in the long-term. This desire is understandable, because some people do slip back into old habits, and they can lose the improvements they have made. Luckily, there are ways to prevent relapse and get control over lapses.

What is the Difference Between a Lapse and a Relapse?

A lapse is a brief return to old and unhelpful habits. It is a common and normal phenomenon. Sometimes lapses are triggered by stress and low mood or simply fatigue.

A relapse is a complete return to all of your old ways of thinking and behaving when you are anxious. People who have a relapse are usually doing the same things that they did before they learned some new strategies for managing anxiety.

KEEP IN MIND: Lapses don’t have to lead to relapses. You can stop a small lapse from becoming a relapse!

Here is an example:

Let’s say that you had a phobia of dogs. If you used the cognitive behavioral techniques (CBT) recommended on this website, you probably know that when you see a dog it is best not to avoid it or run away. Instead, you might try to practise some calm breathing, tell yourself some coping thoughts, and gradually approach the dog.

If you were walking down the street and saw someone walking their dog and you avoided the dog, and possibly all other dogs for the rest of the day, this would be considered a lapse.

If you then begin your old, unhelpful routines when you see someone walking with a dog (e.g. not walking near dog parks, avoiding malls with pet shops, refusing to leave the house),  then you are probably having a relapse.

When does a lapse turn into a relapse?

Often, it is what you say to yourself after you have a lapse that can either help you get back on track or lead you into a relapse. If you see your lapse as a sign of failure, you are likely to just “give up” and have a relapse. If you see your lapse as a slip-up but one that you can recover from, then you probably won’t have a relapse.

Going back to our dog phobia example: If you avoided dogs all day but at the end of the day you said to yourself: “Well, it looks like I fell into my old habits again; I’d better start doing some exposure or something tomorrow so that I can get back on track.”

Result:

Your lapse would probably stop and you would continue to face your fears and anxieties in a helpful way.

If you avoided dogs all day, and at the end of the day you said to yourself: “Great! All that hard work trying to manage my anxiety was a waste. I’m right back where I started… I’m such an idiot. Well, I guess there is no cure for my anxiety; why even bother trying?”

Result:

Your lapse will probably turn into a relapse; you will probably stop using your CBT strategies and return to your old, unhelpful habits.

Tips for Preventing Lapses and Relapses

TIP #1: Practise, practise, practise!

The best way to prevent a lapse is to keep practising your CBT skills! If you are regularly practising, you will be in good shape to handle whatever situations you are faced with.

How do you fit in practice?
Make a schedule for yourself of what skills you are going to work on every week. This might include exposure, or practising some calm breathing and relaxation. Get friends and family to help!

TIP #2: Knowing your red flags

You are less likely to have a lapse if you know when you are more vulnerable to having one. For example, most lapses occur during times of stress or change.

  • Make a list of warning signs that tell you your anxiety might be increasing. This list might include:
      • More feelings of anxiety
      • Increased responsibilities at home or at work
      • More anxious thoughts
      • Arguments with loved ones
      • Major life changes (e.g. wedding, childbirth, death in the family)
      • Avoiding more activities
  • Make a plan of action. When you know what your “red flags” or “danger signs” are, you can make a plan for how to cope with them. This might involve:
      • Practising your CBT skills more often
      • Taking some time for yourself
      • Relaxing (reading a book, going shopping, talking to a friend)

TIP #3: Coming up with new challenges

Like everyone else on this earth, you are a work in progress. That is, there are always things you can do to improve yourself and make your life more enjoyable and fulfilling. A good way to prevent future lapses is to continue working on new challenges and new feared situations. You can make a list of situations that are still scary or cause you anxiety and work on them in time. You are less likely to slide back into old habits if you are continually working on new and different ways of overcoming your anxiety.

TIP #4: Learn from your lapses

Remember that it is normal to occasionally have lapses. In our daily lives, everyone has times of greater stress, and if you are coping with anxiety, this can make you even more vulnerable to a lapse. The good news is that you can learn a lot from these lapses. Try to figure out what the situation was that led to you having a lapse by asking yourself:

  • Were you having upsetting or anxious thoughts?
  • Was your anxiety very high?
  • Did you do something different?
  • Did you know that the situation was going to be difficult or did it take you by surprise?

Knowing why a situation was more difficult for you can help you to prepare for the next time. You can make a plan to help yourself cope more successfully with difficult situations in the future.

TIP #5: Knowing the facts!

We know that what you say to yourself after you have a lapse has a huge impact on your behaviour later. If you think that you are a failure, and have undone all your good work, you are more likely to just give up, stop trying, and end up relapsing.But here are a few facts:

  • It is impossible to go back to square one: you cannot unlearn all the skills and techniques that CBT teaches you. Being back at square one means having anxiety and not knowing how to handle it. But once you have started using CBT, you DO KNOW how to handle your anxiety.

     

  • If you relapse, you CAN get back on track. It might have taken you months of practice to reduce your anxiety symptoms, but it won’t take you that long to get back to where you were before the relapse. When you get back to practising your CBT skills, you will be mastering your anxiety again in no time.

Like riding a bike…
Think of your CBT skills like learning to ride a bike, they can take time to learn, but once you know how, you don’t forget how. If you stop biking for a while you might be a bit rusty, but it won’t be long until you are as good as before.

TIP #6: Being kind to yourself

It is very important to remember that lapses are normal. Don’t beat yourself up or call yourself names like “idiot” or “loser”, because this doesn’t help. It is far more helpful to realize that we all make mistakes sometimes. We don’t speak to other people in such a mean way, so it is certainly not a good idea to speak to ourselves in this way. In fact, it can actually be helpful to have a lapse, because it gives you a chance to learn that lapses are normal and that lapses can be overcome if you get back to practising your skills.
Remember to be patient with yourself, learn from your lapses and move forward.

TIP #7: Rewarding yourself

Make sure to always take the time to reward yourself for all the hard work you are doing. It is very motivating to give yourself a treat once in a while. A reward might be going out for a nice meal, buying yourself something new, going out with friends, or just taking some time to relax, enjoy or pamper yourself. Remember that managing anxiety is hard work and any progress you make is due to your own efforts. Doesn’t that deserve a reward?