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Limiting Severity

There are many things you can do to limit the length and severity of relapses. Some are actions to take; others are mental adjustments to make the situation more understandable or bring consolation.

Get Losts of Rest

The most common strategy for overcoming setbacks is to take extra rest, continuing until the flare subsides (and even beyond --see next point). Dr. Lapp recommends alternating small amounts of activity and rest in a quiet, non-distracting place such as a sofa or lounger. (He discourages patients from staying in bed.) He also advises stretching and relaxation techniques.  
Return to Normal Slowlly

Long periods of rest can create frustration, which may lead to resuming a normal activity level before the body is ready, leading, in turn, to another relapse. To avoid a double-dip relapse, return gradually to a normal activity level. 

For many people, this means taking more rest than usual for two or three days after a relapse seems to be over.
Postpone, Delegate or Eliminate Tasks

Reducing activity by postponing tasks, asking for help or deciding not to do something can help speed the end of a setback.
Use Positive Self-Talk

It's easy to get discouraged during a relapse and to say things that increase discouragement, such as "I'll never get over this" or "What if I'm stuck permanently at this level?" 

Being able to speak positively and truthfully to yourself is a way to reduce stress and make it more likely you'll do things that will help. To do so, you can say soothing words to yourself that make it more likely you'll stick with things that help. You might say things such as “I've bounced back from all my other relapses, so chances are good I'll bounce back this time, too."
Stay Connected

It's easy to feel isolated during a relapse. You can counteract that by staying in touch with people.via phone calls, emails, and sometimes in-person meetings. Jusl feeling connected with another person can be reassuring. By talking to others, you can distract yourself from your problems. Also, you may hear some ideas about how to deal with the relapse.

Postpone, Delegate or Eliminate
Reducing activity by postponing tasks, asking for help or even letting go of something as unnecessary can help speed the end of a setback.

Write a Letter to Yourself to Read in a Flare

Knowing that relapses can lead to depression, several people in the self-help program have planned ahead and written a reassuring letter to themselves, which they can read to buoy their spirits while in a relapse.

Having things handy and in place can help reduce the anxiety of a crash and make it easier to weather. You might keep a large supply of food in the house, including food that your family can cook (or defrost and heat).
Learn to Identify and Respond to Warning Signs

You may be able to reduce the length of a setback, or even prevent it, by training yourself to spot relapse warning signs and to take quick action. 

Warning signs that a relapse is imminent may include:
  • Feeling especially weak, dizzy, tired or confused
  • Having more intense symptoms than usual
  • Feeling more confused than usual
  • Feeling cranky
Responses may include lying down, reducing your activity level, limiting sensory input and/or limiting your time with other people.

Address Perpetuating Factors

If a setback goes on longer than usual, Dr. Lapp suggests you look for perpetuating factors and address any you find. 
  • Sleep often deteriorates during a relapse, so attempts should be made to insure a good sleep. Eight to nine hours of sleep nightly are generally recommended, but it may be necessary to sleep longer during relapses. 
  • Anxiety and depression often flare up during a relapse. If untreated they may perpetuate the relapse by interfering with sleep, motivation, pain tolerance, and energy. If positive self-talk is not effective, it may be helpful to increase an antidepressant dose temporarily. 
  • Relapses can be caused or lengthened by other medical problems. Infections such as recurrent bronchitis, cystitis, infected teeth or absesses can both trigger and perpetuate relapses. Hidden infections such as a dental absess canperpetuate symptoms. In endemic areas persisting infections such as Lyme Disease can be the cause. 
  • A good medical examination and some laboratory studies can identify infections as well as medical problems such as thyroid abnormalities and hypoadrenalism. 
  • Allergies, either seasonal (hay fever) or situational (new pet in the house), may be an aggravating factor, and hormonal changes such as menopause have far reaching effects on sleep, joint discomfort, and neuroendocrine imbalances. 
  • Finally, medications can contribute to relapses. Failure to take prescribed medications can worsen symptoms. Also, drug interactions may create problems. If you suspect medications could be a cause of symptoms, review them with your doctor and eliminate everything that is non-essential.

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