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How Can a Wellness Recovery Action Plan Help?
One of the things about bipolar disorder and other mental illness is the unpredictability of it. You can be going along with a great life, everything going according to plan, when all of a sudden – WHAM! Mental illness pops out of nowhere. Suddenly you’re acutely depressed, manic, or even psychotic.
But there are ways to take control over this cycle. You might not be able to change it, per se, but you may be able to alter and plan for it. You can create your safety net when you’re best able to—before you need it.
The Wellness Recovery Action Plan – WRAP
Mary Ellen Copeland PhD is the designer of the Wellness Recovery Action Plan, which aims to provide people with a serious mental illness some control over their wellness and recovery. Many centers now teach this plan to people with schizophrenia and other mental illnesses.
The WRAP requires planning ahead both for what wellness looks like and for what illness looks like. This can be done on your own but can also be done with the support of friends and family. There are five sections to a WRAP plan: Daily Maintenance, Triggers, Early Warning Signs, Getting Worse and Crisis Planning.
WRAP – Daily Maintenance
This is something that many people forget to do—they forget to document what life is like when things are going well. For example, is it normal for you to spend two days depressed every month? What is “normal” for you?
And even more important is how do you maintain that wellness? These are your wellness tools. Examples might be:
- eat three nutritious meals a day
- see your therapist
- sleep and take naps
- exercise, play with the dog
- write in a journal
- make my bed
- listen to music
And so on. Each person’s list is different.
WRAP – Triggers
We all have triggers—things that might create a mood or psychological shift. For example, triggers might be:
- conflict at work
- a fight with a friend
- reminders of a past trauma
And so on. Again, this list is different for everyone. Also list what to do about each of these triggers. Maybe when a trigger occurs, your action might be to see your therapist.
WRAP – Early Warning Signs
Early warning signs are the individual signs each of us has that signal a possible change in our illness. According to Psych Central:
“Early warning signs are internal and may be unrelated to reactions to stressful situations. In spite of our best efforts at reducing symptoms, we may begin to experience early warning signs, subtle signs of change that indicate we may need to take some further action.”
Your WRAP should indicate your early warning signs and list plans for how to handle them. Ensuring you use your wellness tools, or more of your tools, might be one way of handling these signs.
WRAP – Things Are Getting Worse
Once you have progressed past the early warning signs, there are likely signs that things are breaking down. At this point symptoms may be serious or even dangerous.
Again, the secret is to identify what this breakdown looks like and what to do if this occurs. At this stage it might be important to start reaching out to others like doctors, friends, and family.
WRAP – Crisis Planning
In spite of your best efforts, sometimes crisis happens anyway. This is why it’s critical to create your WRAP before you become sick as once you are in a crisis, you likely aren’t in a position to fully express what you need or make good decisions.
Writing a crisis planning plan involves telling others what a crisis looks like for you and directing others in the way in which they should take care of you. List what is helpful for you and what isn’t.
- Maybe you wish you parents to come to your home and look after you.
- Maybe you need them to temporarily take care of bills.
- Maybe you need them to call you psychiatrist or take you to the hospital.
Whatever you need is OK, the idea is to express it and make these decisions early.
Also include in your plan:
- the medications you take
- the medications that might help in a crisis and those that should be avoided
- treatments you prefer or want to be avoided
- acceptable and unacceptable treatment facilities
- instructions as to when the plan should be ceased
When You Create a WRAP
When you create a WRAP it’s essential that other people know about it. It’s critical that you discuss it with others, especially those who are included in the plan. They may even be able to help you include things you hadn’t thoughts of. Give others that you trust copies of your plan. Give copies to your doctor and therapist as well.
Need Help Creating a WRAP?
Many organizations now formally teach the WRAP process. Check if a local mental illness groups near you does this. Also check out Mary Ellen Copeland’s site for more details on wrap and online learning resources.