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ON MENTAL ILLNESS: Preventing Relapses

Jack Bragen
Friday July 24, 2015 - 10:10:00 AM

For persons with a severe mental illness, it is helpful to recognize symptoms early, and to steer clear of a relapse before it happens, rather than allowing the illness to sneak up on us. If we are undertreated or overstressed, symptoms can occur and judgment can become compromised. This can then lead to becoming "noncompliant" because insight has been obliterated by symptoms.  

A symptom that might indicate worsening of the illness could be something like "talking to god" and having god talk back to us. It is fine to be religious. However, obsessions with certain aspects of religion could be a symptom of worsening psychosis.  

And there are other examples as well. "Unusual thoughts" can be a signal of creativity, or are sometimes a symptom. Believing that there is a conspiracy to do something to us is usually an example of a paranoid delusional system. Believing that we have special powers is usually another example of a delusion.  

If mentally ill and having a few symptoms, it doesn't always mean we should panic that we are getting worse. Some amount of problems will remain even when medicated and stabilized.  

(I am having some dilemma with pronoun use, and I am not using the royal "we.") 

Many people considered normal have a low level of delusions, depression, or other symptoms. The difference is that it isn't severe enough to necessitate intervention with meds. I know of several people who have had some amount of depression or delusions, yet they have no diagnosis, have regular jobs, and never need medication.  

While I am in treatment and on medication, it helps me a lot to do a mental "virus scan" in which I attempt to recognize and remedy delusional thoughts soon after they occur. If I am uncertain of a thought, as to whether or not it is paranoid and delusional, I might ask someone like my wife or a counselor (hopefully neither of whom are subject to delusions) if a thought sounds reasonable or paranoid.  

Getting the thoughts aired out rather than keeping them to ourselves is very helpful. This is fine so long as the listener isn't taking what we are saying literally. It is important to be aware of to whom we are talking, and to not share bizarre things with people we don't know very well.  

If we have an excess of problematic thoughts (which for psychotic people would be delusions and for a depressed person might be thoughts of doom or hopelessness) it might be necessary to raise medication or switch medications. If thoughts are okay but when there are an excess of medication side effects, it might be time to reduce dosages or switch to something less strong.  

If it seems like a psychiatrist is wrong or out in "left field" we can get a second opinion from another psychiatrist.  

Medication allows a psychotic person to have the potential for tracking reality. It doesn't guarantee being free of delusions. There is no potion of any kind that can guarantee that any human being, mentally ill or not, will have clarity and accuracy of thought. Someone with an untrained mind will have more errors compared to someone who has learned more about how their mind sometimes can fool them.  

However, medication to treat psychosis has a tendency to make accurate thinking become at least possible. When the mind has spun into psychosis partially through a biological cause, everything is scrambled and we can't even begin to look at thoughts and weed out the bad ones.  

Medication in the absence of other help will not make a psychotic person well.  

Learning to recognize the early warning signs of a possible relapse can save a mental health consumer from some very bad experiences. If there are problems with getting enough sleep, and/or if there is a loss of appetite to a point of becoming underweight, this could be a sign that we are headed for a relapse.  

Rather than expecting that someone other than oneself knows how to prevent a relapse, or expecting that they somehow know we are having problems, we should realize that we could be the first one to know. Being proactive, and telling a treatment professional, "I'm having problems…look at these symptoms…" or something to that effect, is a way to catch it sooner. 

Mental illnesses are considered by most doctors to be medically produced problems. And, just like with other physically caused diseases, such as cancer, diabetes, heart disease, and so on, mental illness is best caught early and treated rather than allowing it to worsen.  

Unlike with other diseases, which generate sympathy, get well cards, and kind words--of the sufferer being "brave" and "a fighter"--those who suffer from mental illness are considered depraved, weak, crazy, and possibly stupid. This is one reason why it can be so hard to convince someone with mental illness of the need for treatment. 

Society's stereotypes of mentally ill people are part of the predicament that keeps sufferers stuck. Only unconditional self-approval can allow us to love ourselves regardless of perceived "defects" and can allow us to stop believing we are "broken" people. This may be the key to a lasting commitment to being proactive in treatment, and thus preventing relapses.