On Mental Illness: There Are No Shortcuts to Recovery (Part 1 of 2)

By Jack Bragen
Tuesday April 12, 2011 - 09:23:00 PM

Recovery for someone with a mental illness has a different definition compared to some other types of recovery. For one thing, a “recovered” mentally ill person is likely to still be taking medication. A “recovered” mentally ill person may still participate in psychotherapy. The things that define that person as recovered, versus not there yet, are partly intangible signs of progress. For example, how easy is it to get along with a recovered mentally ill person, vs. someone less than recovered? How developed are his or her social skills? Does the person have insight into their condition? 

If you say that someone is recovered from cancer, for example, the definition tends to include the physical absence of a tumor. The cancer survivor likely will no longer be taking chemotherapy or radiation. The cells that were responsible for the illness aren’t in the body any longer. Yet, for a recovered mentally ill person, the cell structures responsible for the illness continue to live in that person’s brain. 

Merely being alive and well and not incarcerated after ten years is some evidence that some recovery has taken place. When I look at the population of mentally ill people in this county, many of whom I have met and have become acquainted with, the ones who didn’t “get it” about maintaining their treatment aren’t around any more after ten or twenty years go by. They have either passed away through health problems associated with our lifestyle, or through a misjudged action due to delusions that led to death. Or, they have been put into some type of permanent facility. The few who did get the idea of staying with treatment are still here, and may even have had an occasional relapse, (albeit far fewer relapses than the ones who were unconscious). Often they have become contributing members of society, and they no longer need as much help from the mental health treatment system. 

Part of the definition of recovery for a person with mental illness includes that you have “moved on” from a life dominated by institutionalization. A second, but not final, part of this definition is that you have become a contributing member of society. 

{Being a “contributing member” could include something as simple as working part-time as a cashier at a hot dog place. A cashier provides the public with goods and services that it needs. Or, the individual could be a volunteer at a pet rescue cleaning cages or feeding the animals. Even having a newspaper delivery route makes a person a contributing member of society, as I see it. Making money or not making money at such an activity is irrelevant. The scale of “importance” of what the person does is irrelevant. It is not necessary to pick up and go live on a Greenpeace ship. One does not have to plant vegetable gardens in bad neighborhoods.} 

According to medical science in its current level of development, we do not have a cure for major mental illnesses. The best doctors can do, at this point, is to manage the illnesses so that the patient has some acceptable quality of life. Equally important to many doctors and mental health professionals is that we don’t become a threat to society, or even a nuisance. Based on the above, the definition for what I am calling “recovery” includes, but is not limited to, successfully managing one’s condition, rather than making it go away. 

Mental illnesses have certain things in common with an addiction to a substance. Addicts or alcoholic persons may refer to themselves as “an alcoholic in recovery,” or “an addict in recovery.” It is not usually asserted that “I used to be an addict but I’m over it now.” Just as with mental illnesses, substance addiction never completely goes away; eternal vigilance must be maintained in order to prevent a relapse. And when a mentally ill person or an alcoholic claims that their problem has been cured, it usually ends up being “famous last words.” It tends to be a telltale sign that the person is going into relapse. 

Like with alcoholism or other substance related diseases, a person can go for years in remission, but then a relapse can sneak up on us at any time; and we feel that we are back to square one. In fact, the progress that was made before the relapse doesn’t disappear. However, when a relapse happens, it can take more years to feel as if the problem is well behind us, once again. 

I have gone about fifteen years since my most recent hospitalization due to schizophrenia. Yet I know a relapse is still possible, and I could be back in the hospital next week. 

Finally, I think it is safe to say that the mentally ill person in recovery should be in the process of learning how to socialize and mix among the “mainstream” population in society. The recovered person may still be awkward and may still not know all of the rules of etiquette, but has the social bravery to mix with people in spite of that.