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Is It Life Stress or Mental Health Relapse?

High stress levels increase the chance of a mental health relapse, but life stress reactions don't always mean you're in a mental health relapse.

Part of mental health self-care involves identifying potential triggers and avoiding them or, at the very least, preparing for the impact they may have on your life. Those of us who have a mental illness have a harder time adjusting to life changes: relationships, starting a new job or losing an existing one, changing locations, the loss of a loved one. It is ironic, but positive life changes can also have an adverse influence on mood. It’s hard to find balance among all of the different cards that life deals us, but it’s crucial to be able to distinguish circumstantial stress from signs and symptoms of relapse.

Reactions to Life Stress Can Resemble Relapse

I initially wrote this title as “Normal Reactions to Life Stress” but quickly realized that there is not a normal reaction, just a healthy one, rather, one that does not grind your life to a complete halt. Let’s use the example of the end of a long-term relationship. This is, in my experience, one of the most difficult changes we all face at some point in our lives.

Is It Life Stress or Mental Health Relapse?If you struggle with a mental illness, sudden changes can cause symptoms that resemble those of relapse. Anxiety can make you believe you are becoming sick. Depression, despite the circumstance, can instill fear of relapse. This fear causes more stress and the cycle is damaging. When you experience a life change, such as the end of a relationship, it is necessary to understand that the symptoms you are experience are not always related to relapse. They are human and they hurt.

Recognizing the Signs of Mental Health Relapse

Much of the difference between a relapse and a reaction to stress involves the amount of time you feel different from your normal. Usually, a good rule of thumb is feeling a certain way for 2 weeks or more, but if it’s been a week and you’re worried, see your doctor.

  • Constant anxiety: Anxiety is a feeling everyone experiences, but if it is consistent and disturbing your life, it’s time to check in with your doctor.
  • Sleep disturbance: Sleep disturbances that last more than a few nights.
  • Changes in appetite: Increased appetite or decreased appetite over several days can signal that something is out of whack.
  • Difficulty communicating with others: a desire to spend more time alone or the feeling that you just don’t want to talk.
  • Agitation: When anxiety comes out through my body, I know it’s time to check in with my mental health care team.

A proper list would be more extensive, but if you can understand what symptoms are signs of mood change and which are reactions to a negative or positive life change, the symptoms are not so scary. Educate yourself on your illness and pay attention to your mood even when you feel good.

Positive and Negative Life Stress Creates Anxiety

It is vital to distinguish healthy reactions to stress and those that indicate a possible mental health relapse.

Let’s look at a couple examples:

The stress of moving: I moved a few months ago. It was stress-free at first, packing boxes and thinking of my new home, exciting. But closer to the date, my anxiety kicked in. I started thinking about living in an unfamiliar area, living in an unfamiliar home. I found myself crying a few times. Ridiculous, perhaps, but the stress of a significant change always affects me.

I feared I was relapsing and constantly asked my partner if I was acting “weird” (this being my word for possible relapse) and he assured me that no, I was just experiencing stress. Four months later, I can recognize that it was just stress. But I did check in with my doctor, and you should too, if you experience anxiety surrounding changes.

Positive changes can generate as much stress as negative life changes. Most people are nervous when starting a new job because this involves learning new skills and meeting new people. Apprehension is a healthy reaction and usually abates once you have become comfortable in the new position and become confident that you can do the job effectively.

A negative reaction, something to watch out for, might include consistent anxiety, depression, and a feeling of worthlessness. This is when you make an appointment with your doctor. Ask those closest to you to give you feedback on your mood.

Life involves stress. No secret there. There is not a person on this earth who can tell you they have never felt some sort of stress. If they do, they are certainly lying. But it is important to educate yourself on a healthy response to stress and one that might indicate you need to check in with your doctor and support team.

20 thoughts on “Is It Life Stress or Mental Health Relapse?”

  1. I was diagnosed with cyclothymia six years ago but now am teetering on full-blown bipolar disorder. I lost a good job around the time of my diagnosis and was “blackballed” in the legal community (I’m a secretary, “the best I’ve ever seen,” according to the boss who fired me when I relapsed after an adverse reaction to Cymbalta.) After years of temp jobs, I finally landed a plum job at one of the more prestigious law firms in my city, thanks to an understanding HR manager. I’ve done great for a year and a half but recently have taken on more responsibility (I’m the only secretary in the firm who works for 2 attorneys and 2 paralegals) and am feeling a bit overwhelmed. Last week the “senior paralegal,” this old witch who’s been with the firm for 30 years asked me, “You don’t have anything to do,” to which I responded that I was working on three demand packages, etc. She then went to one of the paralegals I work for and asked her, “What is she supposed to be doing,” trying to catch me in a lie. I guess that’s all it took to push me over the edge. I was already feeling “down” but I’ve been unable to go back to work for fear of saying something I shouldn’t or “acting weird” or losing control or having a panic attack. I haven’t left the house in over a week and find I’m freaking out at the mere prospect of going back to work, though I know in my heart that I’m happiest when I’m working. My doctor changed my meds four days ago, from Zoloft to Pristiq, and I’m having trouble sleeping, etc. I don’t want to lose my job but how do I overcome the overwhelming anger at that nosy bitch’s comments? All I can think of is “you wanna f**k with me? the only secretary in this place who works for 2 attorneys and 2 paralegals; what more do you want from me…” etc. You know how it is. The harder you work (and I do work hard), and the more you do, the more they expect from you. I find myself angry and resentful that I am the only one who carries this kind of work load. Some advice, please! By the way, Natalie, your posts are spectacular. I wish I could get my husband to read them. (Just a little background: I’m 53, married 26 years to a wonderful, caring, understanding husband whose patience is hanging by a thread, I have 27 years’ legal experience and love the kind of work that I do.) I know I’m rambling but that’s what four sleepless nights will do for you.

    1. Hey Julie!

      First, get some sleep!:)

      I have also lost jobs due to this illness; I believe many people have, unfortunately. The good news is we can find other jobs once we recover and they will be meaningful because we have worked so hard to obtain a state of mind in which we can work!

      Sounds like office politics on your end—always messy but comes with the territory (bipolar or not). I’ve had my fair share of office work and so I understand this. Med changes are hard so hang in there. It’ll get better. Try to leave the house—if you get anxious about it ask your husband to go with you. I often find company makes me feel “safe” in situations like this.

      When you’re recovering, on new meds, it’s best to limit stress but I understand you cannot halt your entire life. Just take care of yourself first and thank you very much for the kind words on my writing.

      Take Care,

  2. Stress can be positive or negative, but affects the nervous system all the same but in different ways. if you find yourself lapsing into depression and dreading certain situations it may be a warning sign that such people or places are bad for your health. If you can consider your options and make healthy changes or good choices this may help you to feel better. Mental illness tends to leave your nervous system and body more vulnerable to stress, but some events do traumatise people or tax people more than others. Steering clear of abusive or highly stressful environments may help you to regain equilibrium. Domestic violence contributes to ill health and toxic workplaces with overly demanding bosses and clients can also take a toll. A problem is that under stress we tend to lose the ability to think straight… If you can detach and calm down you may be able to make wiser choices instead of feeling obliged to remain trapped in a no-win situation. Finding methods to calm down and relax can help to buffer emotional storms or stress.

  3. After reading this wonderful article, I apprehend that stress, as hurtful life experience, present an adjustment daily disorder, that extend a short time after any circumstance change event. While, mental disorder indicates a constant emotional, cognitive and conduct disturbances, that should treated from adequate psychiatric intervention. Otherwise, they would have a worse course, with frequent relapses and many unbecoming complications. In terms of separating life stress experiences from relapses of mental illness, I may say that this issue is often confounded in real life, even Your four observations serves as useful recommendation. Furthermore, when it is well-known fact that many relapses befalls suddenly after life changes, either positive or negative ones. On the other side, mentally ill persons are sensitive subject that react in vigorous manner to unexpected life events. These and others features of stress and relapses of mental diseases constitutes an unsolved clew, that seek a careful attitude, as from psychiatric patient view such from psychiatrist country side.

  4. I need to see and understand the difference. Also ways to cope with stress. A relapse? I am terrified of it. What to do?

  5. I have Bipolar-d Disorder and If I feel overly anxious, it’s usually fear that has come ino me. I keep busy and definitely exercise, that definitely helps!

    1. Cher,
      In regards to stress–coping mechanisms are different for us all. But I try to think positively, hard I know, and do the things that should come easily aka sleep, diet, exercise. Also trying to connect with people–hard sometimes! Also, trying something new, artistic—I try to pick up a hobby.
      Please share your experience

  6. I have 2 kids a husband and 2 dogs! That says it all but there is more; I have a health phobia and in stressful times it is worse. I have gotten much better with everything but taking medical tests. This is a stressful time because my daughter is in marching band( big commitment) and 13 year old son in basketball. I have tons of responsibility,

  7. I find that it is hard to tell the difference between what is my illness and what is normal situations in life that one responds too. Personally I hate my life. My sweetheart has gone through a total breakdown. I was homeless and without an ability to get on my feet.

    I didn’t have any highs just debilitating depression. Everything hits me hard. I feel like normal life events take me to a place that I find difficult to understand. I can understand if it hard for you. I know I need a lot of support from my partner and if something should take that away I would slip slowly without a lot of help.

    1. Hi, M-spirit:

      Thank you for your comment. Being able to separate life stress from relapse is always difficult and it can be helpful to write down our symptoms–the ones that appear when you have a healthy reaction to stress and those that appear when you might be experience symptoms of a relapse. We are so lucky to have a supporting partner.


  8. I know stress and this couldn’t have come at a better time. My husband who is 39 years old was just diagnosed with colon cancer. I don’t know if I’m relapsing or if it is the stress, but I am very down and sleeping a lot (when I can). I have told my psychiatrist and therapist so they think it is the situation, but I am still unsure. I guess time will tell.


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