Recovery and relapse prevention

From: Anxiety disorders: An information guide (© 2005, 2008 CAMH)
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When someone begins treatment for an anxiety disorder, the first goal is to reduce and manage symptoms. The process of achieving this goal, known as “recovery,” often includes a combination of medication, CBT and supportive psychotherapy, and may also include other support such as occupational, recreation and nutrition therapy. Recovery also includes the way you apply the skills learned in treatment to real-life situations. Your idea of what you hope to achieve through recovery is unique to you. Long-term goals may include improved relationships with others, a full and satisfying work life, increased self-esteem and improved overall quality of life.
Once recovery is underway, and you are ready to focus on getting your life back to normal, the next step is “relapse prevention.” Anxiety is not an illness with a “cure.” Medication and therapy can help to bring symptoms under control, but some of the symptoms of anxiety, such as worry and fear, can arise for anyone during everyday life. To prevent relapse, you need to be ready with a plan to manage symptoms as they appear. Moving through the process of recovery and relapse prevention depends on a combination of planning and attitude. Achieving and maintaining your goals is easier when you develop:
  • awareness of warning signs and strategies to respond to setbacks
  • a healthy lifestyle
  • hope and optimism about the future
  • self-confidence.

1. Become an expert on your condition. Learn about your symptoms and how to recognize when symptoms begin. Many resources are available, including books, videos, support groups and information on the Internet. Be aware that not all Internet sites provide reliable information; see the resources section, for recommended sites and other suggestions for further information.
2. Develop and stick to a plan for managing symptoms of anxiety. Maintaining improvements in symptoms of anxiety requires commitment and dedication. Resist the urge to limit your life in the same way that you did when you were in the grips of your anxiety disorder. Develop a plan that includes a commitment to:
  • Take medications as prescribed. Any changes in your medication routine should be discussed beforehand with your doctor.
  • Learn warning signs that the anxiety disorder could be returning (e.g., if you begin again to avoid situations you associated with anxiety).
  • Respond to warning signs by using the skills learned during therapy. To remain well, continue to expose yourself to situations you associated with anxiety.
3. Develop a social support network. Family, friends and a support group can help you to recognize when stressful situations may trigger anxiety symptoms, and can remind you of your strengths when you feel discouraged.
4. Learn to cope with stress. Stress, fatigue and feeling out of control can trigger symptoms of anxiety. Pay attention to which situations are stressful for you. Learn ways to manage stress. Here are some suggestions that can help you to return to a calm state:
  • Diaphragmatic breathing: One way to do this is to lie on your back with one hand over your navel. Breathe so that your hand rises and falls with each breath, allowing your lungs to completely empty and fill. Ask your clinician about other approaches to this technique.
  • Pleasurable activities: Do something you enjoy that is relaxing, such as reading an inspiring book, walking in nature or talking to a supportive person.
  • Take action: When you take your mind off the things that cause you stress, it can make them seem less important. Take a class or try a new interest; learn something new.
  • Become more aware of the present moment: Yoga and mindfulness meditation are two ways to help you focus your mind on the here and now.
5. Live a healthy life. Eat a healthy diet, sleep well and exercise. Regular exercise, including sports, can help to manage stress. Use your faith, religion or spiritual practices to support your recovery. Remain connected with the aspects of life that nurture you, and explore new ways to nurture yourself.
6. Focus on developing a well-balanced life, with time for work, family, friends and leisure activities.

An anxiety disorder can affect your relationship with your partner. When your symptoms are severe, it may be hard for you to be supportive and intimate. When you are most affected by your anxiety disorder, your partner may take on more responsibilities than he or she feels is fair. Over time, this can lead to distance and even hostility in the relationship. It takes time, patience and effort to rebuild what may have been lost.
Include your partner in your recovery. Let him or her know about your progress, and begin to offer to take on more responsibility again as you make improvements in managing your symptoms. It may be helpful for your partner to meet with your clinician, to better understand your treatment. Your partner may benefit from a family support group as well.
Couple therapy with a marital or couple therapist who understands anxiety disorders can help you to improve communication and to work together as a couple once again. A good therapist can help to remind couples of what brought them together in the first place.
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**Anxiety disorders: An information guide**
  1. Anxiety and anxiety disorders
  2. What causes anxiety disorders?
  3. Treatment for anxiety disorders
  4. Recovery and relapse prevention
  5. Help for partners and families
Suggested readings
Internet resources
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Anxiety disorders: An information guide
Anxiety disorders: An information guide

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Mar 24, 2010 5:10 PM
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