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Planning ahead for flare-ups

Accounting for flare-ups

We’re constantly surrounded by messages to “maximize!” It’s easy to think that you need to aim to put in 120% effort all the time. However, planning for flare-ups requires setting your schedule up to require less than 100% of your baseline capacity so that you can handle periods when your symptoms are worse. That may mean cutting back on extracurriculars or making sure that you balance very difficult classes with ones that are easy. Sometimes it means exploring the option to take a reduced course load.

Look for patterns

Flare-ups may follow predictable patterns. Identify when flare-ups are likely to occur and then plan ahead.

  • Triggers: Are there certain things that activate your symptoms? These could be events such as the end of a visit with someone important to you, or actions such as driving, or emotional states such as feeling lonely or shame.
  • Seasonal: Do your symptoms fluctuate predictably throughout the year? For example, trauma symptoms are often worse during the days surrounding the anniversary of a traumatic event. Depressive symptoms may be worse in the winter and manic symptoms may be worse in the spring.
  • Academic: Are there courses that exacerbate your symptoms?  Are there classes in which your symptoms interfere more than others? For example, someone with social anxiety may notice that classes which emphasize class participation or presentations trigger them. Someone with major depressive disorder may notice that they have a particularly challenging time with professors who provide higher than average levels of corrective feedback.  Quarters with flare-up conditions are more likely to reduce overall productivity.


Adjust for feeling disconnected from periods of symptoms

When you don’t have symptoms, you may find it very difficult to remember what it was like when your symptoms were acute. People often say things like, “it felt like I was a different person;” or “I know I was really upset, but it’s hard for me to get it now.” If you have difficulty remembering how overwhelmed you felt, then you may have trouble accounting for it in your planning. If this sounds familiar, make sure that you spend some time reflecting on patterns you’ve noticed about your symptoms in the past, particularly during periods of stress. It also helps to regularly build in buffer time and to avoid schedules that seem like they may push you to the edge of what you can handle.

Anticipate that high stress will decrease performance

A certain amount of stress is helpful. It increases our concentration and motivation. When our stress levels are low, we’re generally relaxed and unmotivated. These times are needed to give us opportunities to rest and recharge. As our work demands increase, so does our stress level and this helps us to be more productive. However, there’s a tipping point where too much stress starts to have the opposite effect: it starts to deplete us. If stress levels continue to rise, we’ll be less productive. Eventually, we’ll start to see some really negative impacts on our mental health like anxiety, anger, depression, and disorganization.

Stress and mental health issues interact. Mental health issues tend to make you more vulnerable to stress meaning that you’re likely to hit that tipping point sooner than you would if you were not coping with symptoms. Stress also impacts the amount of bandwidth you have to manage your mental health symptoms. Once you hit the tipping point, you may find that your symptoms get worse and it’s harder to manage them.

Practically speaking, this means you’ll want to take into account that everything will take longer during periods of stress (such as during midterms or finals). You’ll also want to make sure that you have a solid plan in place for coping with stress. It’s normal to drop self-care when you have a lot going on, but that’s exactly the moment when you need it the most. It helps to have some efficient self-care activities (5-10 minutes max) identified before you head into a busy period and then make sure you schedule them directly into your academic plan.