Repeated Blowouts

I’ve had hundreds of conversations with clients over the years about the fluctuating nature of their mental health problems. When a mental health problem that you think you left behind blows up again, you can easily feel overwhelmed or defeated -  especially if you thought it was gone for good. The sense of disappointment, fear, and sometimes despair can be intense. But understanding that these ups and downs are part of the journey can help us handle these recurrences.

Flare-Ups and Remissions

Chronic conditions—whether physical or mental—tend to follow a pattern of flares and remissions. Physical ailments like psoriasis or eczema might worsen with certain triggers, such as stress or seasonal changes. Similarly, mental health conditions such as depression, anxiety, OCD, and trauma-related symptoms can wax and wane, often unpredictably. Just as arthritis may flare up in colder weather or hay fever during spring, psychological symptoms can intensify under specific stresses or at certain times – whilst at other times, there seems to be no reason for the flare. Each episode can feel as though it’s the hardest one, and every return can feel like a setback.

The “Blowout Principle”

This is where the helpful concept, of the “blowout principle,” comes in. Imagine, the first time you experienced a blowout while cycling or driving. It’s alarming and disorienting; you may not know what to do or how to handle it. Panic can take over, and you can feel helpless. But after that first blowout, you learn. You gain experience and know that, while unsettling, you can pull over, breathe, assess, and make a plan to sort the situation.

Mental health conditions work in a similar way. The first time you face a major depressive episode, for instance, it’s often bewildering, and it can feel as if you’ll never find your way out. But by the second, third, or even fourth time, you have more knowledge. You’ve navigated that terrain before, and even if it’s challenging, there’s a part of you that remembers what worked last time. This knowledge becomes your resource—a guide that shows you it’s possible to pull out of the whirlpool again.

In my work, I often remind people that, although they may feel like they’re back to square one, each episode builds on the last, creating a body of experience that can help. You’ve done it once, and with that experience, you can do it again. I  encourage clients to rely on what they’ve learned in their past struggles to fight their current own.

Creating an “In the Event of an Emergency” List

An “in the event of an emergency” list can be a brilliant tool (there’s a separate article on this). Think of the safety drill every time we board a plane—it’s the same, but it’s always repeated to ensure that, in the unlikely event, everyone knows exactly what to do. When you’re in a period of relative stability, take the time to reflect and create a list of things that have helped you before. This list might include:

People you can talk to: A friend, therapist, or family member who has been supportive in the past.

Activities: Things that have helped you relax or feel grounded, such as breathing exercises, meditation, or a specific book or movie that brings comfort.

Mantras: Phrases that remind you of your resilience, such as, “I’ve been here before, and I made it through.”

Techniques learny from therapy you’ve had before: challenging thoughts, relaxation.

Professional contacts: Names and numbers of mental health professionals or crisis support lines.

With this “emergency kit,” you have something to fall back on when the ground feels unsteady - a reminder that you’ve done this before and can do it again. This process of preparation builds resilience and, over time, can lessen the intensity of that initial despair when symptoms return.

Experience Is Your Strength 

As Einstein said, “the only source of knowledge is experience.” When you’ve faced an episode of depression, anxiety, or any other chronic condition, you gain experience. That experience is power. It doesn’t make the next episode easy, but it does make it navigable. If you’re feeling lost, remember that you’ve been here before, and each time you emerge, you carry more knowledge, more resilience, and a deeper understanding of the issue.

So if you’re currently facing a setback, know that this experience is part of the journey. Lean on what you’ve learned, remember your “emergency kit,” and trust in yourself. You’re stronger than you think, and you’re not starting from scratch—you’re building on the strength of every time you’ve come through before.