Hidden in Plain Sight: The Subtle Signs of Mental Health Relapse

I live with bipolar disorder, and managing its constant ups and downs is a full-time responsibility. With over 20 years of experience and a platform as a mental health advocate — including co-hosting the Inside Bipolar podcast on Healthline.com alongside a board certified psychiatrist — I’d assumed I had all the tools to prevent a relapse. Yet, despite my expertise and dedication to helping others, I recently experienced a deep depression that lasted over a year and is still lingering today.

While I am gradually recovering, the experience was a stark reminder that even the most knowledgeable among us can be caught off guard.

My recent relapse has led me to reevaluate how we view mental health. Society often describes mental struggles as unforeseen events, but that mindset can breed complacency. We convince ourselves that once we’ve navigated a mental health challenge, we are immune to future episodes.

In reality, mental health is dynamic. The small, everyday practices — tracking sleep, monitoring mood changes, and maintaining routines — are crucial not only for prevention but also for the detection of warning signs.

Subtle signals can reveal more than we realize. For instance, when I lost the excitement I once felt for attending music concerts, it could have served as an early sign of an impending relapse.

The medical guideline is simple: If an emotion or feeling disrupts your daily life for more than two weeks, it’s a clear red flag. Unfortunately, I failed to recognize the abrupt loss of enthusiasm for events I had eagerly anticipated — events I even rearranged my schedule for and spent hundreds of dollars on.

The irony is that, unlike physical health, mental health challenges require us to be vigilant about our own well-being. Imagine if someone experiencing heat exhaustion had to actively request help before receiving assistance. Realistically, if I passed out, people would come to my aid without me needing to be aware at all. I have always advocated that we treat mental health more like physical health and empower those around us to assist us when we need it.

I struggled with a depression relapse for several weeks, and while my family and friends said they noticed, they just assumed “I had it under control.” They had some concerns, but they said they weren’t worried because I’d always managed my mental health on my own.

Ultimately, what got me the care I needed was the manager at a local restaurant I frequent daily, who followed me to my car one day and asked me, privately, if I was OK. That was the moment I knew something was wrong.

I am profoundly grateful for the support of my loved ones. While our culture has shifted to platitudes as a resolution for complex problems, my inner circle knows that sending me thoughts and prayers won’t help me get well. Their proactive involvement — listening, reassuring, and helping me reengage with life — made all the difference. Platitudes and well-meaning thoughts, while appreciated, cannot replace tangible understanding and active support.

Mental health challenges are complex and deeply personal, and there is no one-size-fits-all solution. Yet, one lesson stands clear: While we must remain aware of the big warning signs, we cannot overlook the small ones.

Paying attention to the seemingly insignificant details can be the key to preventing a crisis and ensuring that we, and those around us, receive the care and support we deserve.

Gabe Howard is the host of Healthline podcasts “Inside Mental Health” and “Inside Bipolar.”