ON MENTAL ILLNESS: Limits to Resilience

By Jack Bragen
Thursday June 14, 2012 - 04:08:00 PM

People with mental illness are often more subject to aging than others. The average lifespan of persons with mental illness is sometimes ten to thirty years shorter than for others, and this is for a number of reasons. People with mental illness often receive a lower quality of medical care and at the same time take less care of physical health. Mortality comes sooner and often for preventable reasons. 

Additionally (speaking of just mental illnesses) when older, we can not make as rapid or as complete a recovery after an episode of psychiatric illness. 

A psychotic episode, even one that lasts just a few weeks until stopped by medication or other treatment, can entail years, rather than months, of recovery time. Each successive psychotic episode, even if they are years apart, does more damage and requires more time and effort for the ensuing recovery. Subsequent recoveries become less complete. After a string of psychotic episodes, apparently a person's brain loses much of its processing ability. 

Mental illnesses are serious diseases. The tendency not to take one's own illness seriously is an oversight that can have severe consequences. The intermittent tendency of some treatment professionals not to take us or our illnesses seriously is a disservice. 

Persons with mental illness can be fragile, and their successes when they occur can be more fragile. Much care must be taken if a person with a major mental illness is to do well in life. Effort of various types is a requirement in order to succeed at something, including treating the illness. An afflicted person must use much effort at the various tasks and accomplishments in life, but must also use much care. 

Effort in the name of achieving "success" should not be taken to extremes, as a person can easily do damage to oneself. I believe it is important to recognize and heed the warning signs that your body and mind are giving you, which means backing off from the effort when beginning to overexert. If a job situation does not appear to be working out, it is not necessary to crank up the physical and mental effort level, since this can sometimes be damaging. Keeping a job must remain a lower priority than staying well. 

I have seen people who were excessively motivated to a point where they have done themselves damage. I know of one person who tried much too hard at his job and then killed himself due to a relapse of his psychosis. 

It is important to realize that a job is only a job, and if one job doesn't work, there will be more in the future. Not all great people in history worked at a nine to five job. There are other things in life that matter, and this includes getting rest, taking care of oneself, and enjoying the little things in life. 

A person with mental illness can seem like a strong person. And we are often strong people in many respects. However, along with some types of strength comes much fragility. Brain cells require years to regenerate and are damaged easily. 

Having a consistent routine is helpful. It is helpful to have an activity that resembles some type of work, and this can be volunteer work, it can be a job, or it can be work that you do independently. It is important that capacities are exercised, but not to the point of overload. If a person with mental illness is excessively inactive, they risk atrophy of the mind and body. Effort needs to be used in life, but not in excess to where it becomes a form of self punishment.