Relapse Prevention

Plan
Instructions
Record situations that upset or aggravate you in a way that it makes you unsettled.
Then write your reactions to these situations. In the relapse prevention section,
you will evaluate these triggers as to how you can avoid them or lessen their
impact.

Trigger List

Sample Triggers
Staying up too late on my phone
Drinking too much
Not taking a break on the weekends
Waiting too late to finish assignments
Letting my partner aggravate me
Going to too many parties in a week

Trigger Reac)on

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Trigger Reac)on

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Relapse Prevention
Plan
Intervention Plan
Look at each situation from your trigger list. Think about what role these triggers
played in the lead up to a depressive or manic/hypomanic episode. Brainstorm and
record how to avoid the situation or lessen the impact of the situation.

Situa)on Interven)on

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 Activity Plan
Instructions
Maintaining a routine is very important with bipolar disorder. Even minor
disruptions to your routine can make you more vulnerable to becoming unstable
and triggering an episode.

Establish your anchor points. These are the times you wake up,
Step One go to bed and eat your meals. You can use a short range for your
meal times.
Wake up_________________________ Breakfast_____________________________

Go to bed________________________ Lunch_________________________________

Dinner________________________________

Have a back up plan for activities to implement when you are

Step Two depressed and oversleeping or laying around with little energy
or motivation. This is a plan to force structure into your day.
This can also address withdrawing from people.

Activity Options
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 Activity Plan Sample
Instructions
Maintaining a routine is very important with bipolar disorder. Even minor
disruptions to your routine can make you more vulnerable to becoming unstable
and triggering an episode.

Establish your anchor points. These are the times you wake up,
Step One go to bed and eat your meals. You can use a short range for your
meal times.
7am
Wake up_________________________ 7:30-8a
Breakfast_____________________________

11pm
Go to bed________________________ 12pm-1:30pm
Lunch_________________________________

6pm - 7:30pm
Dinner________________________________

Have a back up plan for activities to implement when you are

Step Two depressed and oversleeping or laying around with little energy
or motivation. This is a plan to force structure into your day.
This can also address withdrawing from people.

Activity Options
1 Walk around the block
2 Drive to Walmart and look at the electronics
3 Go to Starbucks with my laptop on Saturday for 1 hour in the morning
4 Meet up with my sister for lunch
5 Go to the library and sit in the media section for 30 minutes
6 Fill one box with stuff from the basement and take to Goodwill
7 Take 3 pictures outside and post to my Instagram feed
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 Mood
Diary
Instructions Sample moods
Record your moods as you feel them Happy, Sad, Tired, Excited, Anxious,
intensify. You can also track unusual Fearful, Worried, Angry, Depressed,
moods that may be a sign that something Hopeless, Tense, Ambitious,
is changing. Invincible, Rageful

Date:

Time Mood Circumstance

8am-10am:

10am-12pm:

12pm-2pm:

2pm-4pm:

4pm-6pm:

6pm-8pm:

8pm-10pm: 

10pm-12am:

12am-2am:

2am-4am:

4am-6am

6am-8am