ON MENTAL ILLNESS: Let's Reduce Expectations

By Jack Bragen
Friday May 04, 2012 - 11:15:00 AM

When someone has suffered a severe episode of mental illness, it has likely frightened and upset them and their family, and the expectations for success in life are sometimes off the table. Remaining stabilized and out of the hospital (and perhaps not wandering the streets in a psychotic state) is often a satisfactory goal. Sometimes it is not necessary and not appropriate to try to do more, such as going to school or getting a job, at least until one is ready. Simply remaining stabilized, for someone with a major mental illness, is often an adequate accomplishment. 

Most non-afflicted young adults believe they should either have a job or work toward one by going to school. This work ethic is ingrained in the minds of most people in the U.S. For persons with mental illness, in order to not create a relapse, sometimes the plan is to back off from the work ethic. 

The "work ethic" is often a means of self-punishment in the same way that many women are obsessed with being slim enough and men obsessed with being "manly" enough. When motivation becomes a "do or die" thing, it is toxic for someone with a psychiatric disability. We can not endure the same level of strain as someone who doesn't have this susceptibility. 

When someone who is subject to psychotic episodes merely takes good care of their mind and body, it serves the community because we are not out doing disruptive things, we are saving money for the care system, which can go elsewhere, and we do not need to receive the same level of assistance from others. Moreover, when we stay well, it is a load off of family members. We might also preserve friendships that could be lost during the thorny time of being psychotic. There are many parents who would count their blessings merely to have their son or daughter take the medication, stay out of trouble and be able to carry on a normal conversation. 

Taking care of ourselves includes not taking on more stress or more responsibility than we can handle. By preventing ourselves from becoming overwhelmed with too many commitments, it is more likely that we will stay well, and will be able to handle more things in the long run. 

It is okay to spend time playing scrabble, baking a cake, or producing oil paintings. Not all persons with mental illness need to be ambitious and "go somewhere in life." If a person creates an adaptation in which he or she is relatively happy much of the time, who are they hurting by not getting a job? 

A person with mental illness could consider the idea that they have an "early retirement." If one thinks about it in these terms, and even presents it to others this way, it could take on a more positive perception, one that doesn't cast a shadow on a person's existence. 

Excessive stress could be bad for the brain. Having repeated relapses of psychosis or mania is terrible for a person's mental health, in the long run. The brain apparently becomes biologically traumatized. (Brain trauma is a separate issue from emotional trauma, although many people get both.) Too many repeated episodes of bipolar or schizophrenia can leave a mental health consumer "burned out" and seemingly "dull-witted." These are diseases that must be dealt with in a timely manner. 

The above paragraph illustrates the importance of "merely" remaining stabilized on medications. If a person recovers enough from their disease, some type of achievement in life, which might or might not include regular work, is probable.