HOW TO AVOID A RELAPSE MENTAL ILLNESS Yia Mya TAKE MEDICATION REGULARLY Medication is indispensable in treating psychosis. It is important to know your medication regimen, its name and its dosage. The correct dose at the right times 1s essential to maintain the therapeutic level of medication within the body. Too low a level would not give the optimal benefit. Sometimes, side effects from medication may develop. It is vital not to discontinue medication without first consulting your doctor. Most side effects are temporary and can be treated easily and quickly Stopping medication, on the other hand, can cause a relapse. warning signs. The key to recognizing signs of relapse is to look for behavioural changes that indicate an overall worsening of behaviour. Identifying these early warning signs can help prevent a relapse or reduce its severity. If you experience early warning signs, talk about these symptoms to someone close, such as a family member. Your doctor should be notified of these symptoms too. With further assessment, he or she may prescribe an increase in medication for a period of time. This acts as a booster to prevent a relapse. When these symptoms subside, the medication can be reduced to a maintenance dosage. BE AWARE OF EARLY SIGNS OF RELAPSE The early signs of relapse vary from person. They can be subtle. A "personalized relapse signature," which is a list of symptoms unique to an individual, can be used to signal an impending relapse. To complete a personalized relapse signature, a list of 55 early warning signs is retiewed to help you identify the experiences you had just before you fell ill and sought medical attention. Your Personalized Relapse Signature Card is useful when you need to recall and improve awareness of your particular early Lecturer 1 Head Mental Herlth Nursing Department University of Nursing, Yangon Dip. G.N., Cert. Mid., BA (Law), C.O.T.N.(Singrporc) Cwt. C. I, Dip. Nsg Tufor, B.N.Se, M.N.Se. (AU, Adelaide), Dip. M.E. HOW TO MANAGE STRESS Stress in life i~~inwitable. Not all stress is bad. A lithe stress i s sometimes necessary to operate at an optimal level. It may bring out the best potential in a speaker during a presentation, or a student preparing for exams, It also provi* you with the energy and enthusiasm to be active. Without a little stress, you may not pefform at your best. Hence, m e stwss in life is a g w d thing. On the ather hand, if you're undcr too much stress. your performance can suffer. The key is to identify the "right" amount of stress for you SET REASONABLE EXPECTATlONS Know your limits. It is i m p o m t not to expect too much from yourself or others. This may also m a n learning to accept your strengths and weaknesses. During the initial period of recovety, make adjustments to your previously held goals and expectations, and learn to pace yourself. Not everyone recovers at the same rate or takes the same amount of time. It may be more crucial in the catly stages of recovery for you to take mall steps. To help determine re~listic goals, talk to a counselor, friend or family members a b u i your expectations. APPRECIATE TEE ESSENCE OF TIME Remember, take small steps and reward yourself For accomplishing them. This is just as important as achieving the goal. As the Chinese proverb goes, "A journey of a thousand miles begins with but a single step."For example: Set goals within a realistic time frame, and work towards them with defined steps to reduce stress Plan what can or is to be done each day, then make a list of the thjngs to be done in order of priority. Choose ct starting point after setting a goal to further clarify your priorities. Break down Big, overwhelming tasks into small, manageable ones. This also makes it easier for you to take note af progress or developments. If a problem is beyond your control, and it seems nothing can be. done, donY fight the situation. Learn to accept it for now, until such time changes can be made. GET HEALTHY, BECOME STRONG, BEAT STRESS Eat right and get enough sleep to h o s i your ability to deal with hassles and crises. Taking care of yourself includes hygiene and grooming Regular exercise can also help reduce stress and increase your sense of well-being. If you're angry, nervous. or uget, ease the pressure through some form of physical activity, such as walking, cycliw jogging, swimminb bawling or tennis. Physical exercise not only reksses that uptight feeling, it provides a healthy form of temporary distradion from the Stressor -50- - Dedicate time for exercise. Two to three times per week is ideal. Ask a friend to join in to help overcome the initial difficulty or inertia of getting started. The body and the ~nrnd are interconnected. When the body feels good, the mind is better equipped to take on challenges. UNWIND WITH FREQUENT LEISURE ACTIVITIES Make time for play. Get away from the daily routine to just relax and have fun. Go to a movie, cycle in the park, eat out, and go out wirh a friend. Take a moment to think about what you like doing, what you can do with or without others. Small breaks from routine can help to reduce stress. Take proactive steps and schedule simple enjoyable activities on a regular basis. This gives you something to look forward to and prevents stress from building up. STAY IN TOUCH Continue to keep in contact with femily and friends. initiate and plan the activities that you can do with them- a weekfy dinner perhaps, or participating m an activity together. Spend time to develop relationships with family and friends to create a supportive circle. Discuss with others what kind of activities you can undertake on your own, with another person. or as part of a group. Having had an illness does not mean that you have to be imprisoned by it. LET OFF STEAM Talk about your feelings when thry occur to prevent stress from accumulating. To let someone know how you're feeling often provldes tmntediate relief. Besides, other people may have ideas about how to deal w~tha stressor, or they may be able to see things in a different light. Share p;oblems wirh someone trusted, instead of attempting to solve problems aione. Being independent does not mean that you cannot depend on or talk to anybody about your concerns. If you're uncomfortable about speaking to others, or there is nu one available, keep a journal as an outlet for emotions and as a means of identifying the cause of stress. PRACTlCE RELAXATlON TECHNIQUES Learn and practice specific techniques for reducing stress. Some examples are deep breathing exercises, progressive muscle relaxatton, and guided visual imagery. These methods can be learned from books, classes, audiotapes, or sessions with a trained lherapist or counsellor. A simple and quick way to relax is to create a personal "escapade" In your mind. You can't always escape, but you can momentarily tune out the turmoil of a stressful situation. Imagine a quiet country scene, a beach or lake, a secret childhood place, or play some beautifbl music to create a sense of peace and tranquillity. When you are in a situation where you feel stress rising, take some deep h t h s and take your time to recover before moving on to the next step. USE POSITm TALK Most people are their own worst critics. They are harsher on themselves than they would be if the same thing happened to someone else. Positive self-talk can help you. It includes saying wpingoriented things, such as "This is a new challenge- it's OK to m&e mistakes. I can learn from them". Praise yourself on a daily basis. This can be used for small things or things you usually consider insignificant, or to stert the day off with a positive affirmation. LEARN PROBLEM-SOLVING SKIUS Learning problem-solving skills requires motivation and commitment. These steps help you to define the problem accurately and generate several possible solutions so that you can select the best possible option. The best option is usually the one that best meets your needs. This process is e f l t i v e and if you commit to following the steps and guidelines, you can succeed in applying it. BE FLEXIBLE Try and adopt a flexible outlook to life. A rigid view of life, people and situations will only add to your stress. A flexible orientation will help you handle most kinds of situations with an open mind, and you will solve problems and overcome stmore effectively. In the words of Helen KeHer, who was blind and deaf from infancy, "Although the world is full of suffering, it is also full of the overcoming of it" A LAST WORD OF ADVICE It's important to remember that having psychosis does not mean you are doomed to a life of hopelessoess. It just means you have to lesm to manage your illness better and be more atCunod to your stress kvels or possible triggers leading to a relapse. REFERENCES: Huei, C.C. & Verma, S. 2003, Delusions, Possession or Imagination? SNP Corpomtion Ltd, Singapore. pp.62-69.