How to Navigate a Relapse

By Karen R Mizrach 

A frustrating aspect of vestibular disorders is their tendency to move in an up and down pattern rather than a straight upward path toward recovery. We work hard to take care of ourselves, follow medical advice, do our physical therapy exercises and avoid known triggers. Yet even when we seem to be improving, setbacks often occur. This discouraging pattern can cause us to feel like we are back at the beginning of the journey, not having made any progress. But that is not the case. 

Beth Wagner, (DPT, CCVR of Movement & Function in Hawaii) likes to call these setbacks “speed bumps.” She says, “They can be of any size and any length (like an elongated speed table), but they are temporary.” They are a normal part of the symptom cycle. 

A recurrence of vestibular symptoms may feel like being thrown back to square one, but in reality you will never go back to square one. You’ve learned so much about your condition, found resources and learned how to manage symptoms. You are automatically way ahead from the beginning. With each setback it’s likely you will return to your “normal” much faster and with more confidence. Let’s look at some ways to manage these setbacks without sinking into despair. 

What Has Worked Before?

Think back. What, over your journey with vestibular challenges, has helped? If you haven’t kept track of meds, supplements, exercises, modifications, or aids you’ve used, now is a good time to note all those things. Try to determine which activities and interventions actually made a difference. When you have a setback, do those things again. Many times when we start to feel better we slack off treatments or begin to add back more triggering activities. With a setback, it is often beneficial to slow down and reintroduce items, people, and/or activities that were helpful, track your symptoms, and reframe the setback as a reset rather than a relapse. You can get back again. 

Mindset

Believing you can bounce back is crucial when you’re dealing with difficult symptoms you thought you’d said goodbye to. Keep telling yourself that this is typical for these disorders and you will improve again. Try to avoid catastrophizing (picturing worse case scenarios) or self-shaming. You know that you are not at fault for the nature of your vestibular condition, and you know that you have learned how to cope when symptoms flair. Give yourself credit for adjusting and staying the course. 

Wagner suggests trying to “shift to a more objective way of seeing the condition.” She explains that it may help to “do a brief inventory of your condition, especially if you feel you are back to square one. Are the symptoms as severe and frequent as they were in the beginning? If you can, give a percentage or qualitative ranking like mild, moderate or severe . “ It can help put the setback in perspective. In other words, observe the situation like an outsider, rather than with the emotion of the patient. Be your own healthcare provider. 

Who Can help?

When you first became sick with a vestibular condition, who did you turn to? And which one of those people was the most helpful? Identify your best resources and contact them. Remind them how they helped you and explain you need a boost again. 

Doctors may not have any new meds or tests for you, but they can listen to the details of the setback and support your efforts to stabilize. Physical therapists can reevaluate and offer techniques and support that worked in the past. 

And don’t forget friends/family. They say that when you have life challenges you find out who your true friends are. So, by now you know that. Don’t suffer in silence when symptoms reappear. Reach out to those people who care about you. Even if it’s just for a quick phone call. If you’ve been part of a support group in the past, reconnect when you need it. Many times those groups are fine with people coming and going as they need to. 

And don’t forget your best resource. You! Write down a pep talk for the difficult times. Cheer yourself on. Be kind to yourself. Nurture yourself through the setback, until you come out on the other side.