Recovery from a mental health condition isn't always a straight line. There may be times when you feel well, confident and back into your usual routine, and other times when things begin to feel a little harder again. Sometimes the changes are obvious. Other times, they are subtle - a few nights of poor sleep, withdrawing from people, losing motivation or noticing that you're struggling with thoughts you've worked hard to manage. Recognising these changes early can be an important part of looking after your mental health. A change in how you're feeling doesn't mean you've failed. It may simply be a sign that you need some extra support.
Relapse generally refers to the return or worsening of symptoms after a period of improvement or stability. It can happen with many different mental health conditions, including depression, anxiety, bipolar disorder, psychotic illnesses and substance use disorders. Relapse doesn't necessarily happen suddenly. For many people, there can be early warning signs that things are beginning to change. Learning to recognise your own warning signs can help you respond sooner.
Everyone is different, and your early warning signs may not be the same as someone else's. Some common changes can include:
You might find yourself sleeping much more or much less than usual, struggling to fall asleep, waking frequently or feeling that your sleep is no longer restorative. For some people, changes in sleep can be one of the earliest signs that their mental health is starting to shift.
You may start cancelling plans, avoiding phone calls or spending more time alone. Perhaps you're telling yourself you just don't feel like seeing anyone, or that you'll reconnect when you're feeling better. Sometimes, however, withdrawing can make things harder.
Activities that normally give you pleasure may suddenly feel like too much effort. You might stop exercising, seeing friends, pursuing hobbies or doing things that usually help you feel like yourself.
You may notice increased irritability, sadness, anxiety, frustration or emotional sensitivity. You might find yourself reacting more strongly to things that wouldn't normally bother you.
Pay attention if you notice yourself becoming increasingly negative, hopeless, self-critical or overwhelmed. You may begin thinking things like:
“What's the point?”
“I can't cope with this.”
“Nothing is going to get better.”
These thoughts can be important signals that you need support.
You may stop eating regularly, neglect personal care, struggle to get out of bed or find everyday responsibilities increasingly difficult. Sometimes the first sign is simply that you're not doing the things you normally do.
Some people turn to alcohol or other substances when they're struggling. You may notice that you're using more often, using to cope with difficult emotions or finding it harder to cut back. This can be an important sign to reach out for support.
One of the most useful things you can do during recovery is learn to recognise your own pattern. Think back to previous periods when your mental health deteriorated.
What changed first?
Was it your sleep?
Did you stop answering messages?
Did you become more anxious?
Did you start missing appointments?
Did you stop taking medication?
Did you lose interest in things you normally enjoy?
Did you begin isolating yourself?
Knowing your personal warning signs can make it easier to notice when something is changing.
It's easy to think:
“I'll see how I feel tomorrow.”
And sometimes tomorrow is better. But if changes continue or you're noticing several warning signs at once, it may be worth reaching out. You could contact your GP, psychiatrist, psychologist or treating team and simply say:
“I've noticed some changes in myself and I'm worried my mental health might be slipping.”
You don't have to wait until you're back where you were before seeking help. Early support may give you an opportunity to review your treatment, reconnect with strategies that have helped before and put additional support around you.
If you've experienced a period of significant mental health difficulties before, consider creating a simple plan for what you will do if you notice warning signs. It could include:
My early warning signs:
What changes do I notice when I'm beginning to struggle?
People I can contact:
Who can I talk to when I'm not doing well?
Things that help me:
What strategies, routines or activities have helped me in the past?
Professional support:
Who is my GP, psychiatrist, psychologist or treating professional?
My next step:
What will I do if my symptoms start getting worse?
Having this written down can make it easier to act when you're struggling, particularly when motivation and concentration are low.
One of the most important things to remember is that experiencing a relapse or a return of symptoms doesn't mean that all your previous progress has disappeared. Recovery isn't about never struggling again. It's about learning to recognise what you need, knowing when to ask for help and having strategies and people around you who can support you through difficult periods. You haven't gone back to the beginning. You are responding to what's happening now with everything you've learned along the way.
If your symptoms are becoming severe, you're experiencing thoughts of suicide or self-harm, you're feeling unable to keep yourself safe, or you are experiencing a mental health crisis, seek urgent professional help. You don't have to manage a crisis on your own.
Sometimes the hardest part is admitting that you're not doing as well as you thought. But recognising the signs and reaching out early is an act of self-care - not failure. You don't have to wait until things fall apart. A conversation today may be the first step towards getting the support you need.
If something feels different, it's okay to talk about it.
