One of the challenges faced by people who have a mental illness — such as depression, bipolar disorder, schizophrenia, or ADHD or the like — is that not too many people will talk to you about “curing” the condition. (Except snake-oil salesmen, who will claim they can cure your bipolar disorder with their amazing technique or CD.) In fact, you’d be hard-pressed to find a professional who talks openly about “cures” for mental illness.
For instance, Pete Quily (twitter: petequily) drives the point home with a recent set of twitters:
If someone on twitter saying he/she can “Cure #ADHD” with their snake oil/brain machine, donkey ride, miracle ebook etc. Realize 2 things: 1. They’re spammers. 2.They’re ignorant, liars or both. You don’t cure #ADHD, you learn to manage it more effectively.
Really? It got me to thinking why we don’t talk about “curing” mental disorders.
What we have instead of cures are a bunch of treatments. Most of which work pretty well, to varying degrees. But to most people seeking mental health assistance, treatments can take a frustratingly long period of time before finding one that works. For instance, finding the right medication can take months. And finding the right, experienced therapist you feel comfortable working with can also take months (even longer if the “good” therapists have waiting lists).
Once in treatment, your physician or psychologist rarely mentions the word “cure.” Cure is what doctors do for a broken wrist or scurvy. Set the wrist or give the patient a vitamin C shot, and voila! Done. Treating mental illness rarely results in a “cure,” per se. What it does result in is a person feeling better, getting better, and eventually no longer needing treatment (in most cases). But even then, rarely will a professional say, “Yes, you’re cured of your depression.”
Why is that? Why is there such a reluctance to invoke this magical word? I mean, cure literally means, “recovery or relief from a disease,” so if someone has recovered or has found relief from depression, why not say the person has been cured?
I think our reluctance comes from the belief that mental illness is far more recurring than most diseases in many people’s lives. If you have a bout of depression or a depressive episode, that doesn’t stop the depression from coming back at some later time (even if successfully treated). Whereas once you’ve treated a broken wrist, it’s not going to return (unless you break it again); once you’ve treated scurvy, it too won’t return if you prod the patient into drinking more orange juice or eating an orange once in awhile.
Depression, on the other hand, like most mental illness, knows no boundaries. It will come and go as it pleases in our lives, even if we’ve successfully treated one episode of it. There seems to be little rhyme nor reason to when a mental disorder strikes, who it will strike (outside of genetic predispositions for some of them), and how deep or long the episode will last.
To Pete Quily’s claim that one does not “cure” ADHD (attention deficit disorder), there are certainly many good treatment options for ADHD that minimize its impact in a person’s life. I’m not sure I’d call that a “cure” either, but I wonder at how demotivating it must be for someone to hear that a mental disorder — like ADHD, depression, or bipolar disorder — is not typically “cured,” but rather just treated in varying degrees of intensity for the rest of one’s life. But what accounts for the discrepancy in prevalence rates between childhood ADHD (5.29%) and adult ADHD (4.40%) — a 0.9% difference? If not being “cured,” then children seem to be doing something that makes them less likely to receive an adult ADHD diagnosis.
Professionals have a term for this “non-curing” of mental illness, too… Instead of removing the diagnosis from the chart at the end of treatment, they often place the phrase, “In remission” onto the end of the diagnosis instead. It’s good to hedge your bets, because you see, even when you are “cured” of your mental illness, nobody will come out and actually say it.
Naturally professionals can’t lie to people and tell them depression or ADHD or any other disorder can be readily cured. They cannot. In virtually every instance, treatment for a mental disorder takes time, effort, and money. And even treatment takes 3 to 4 months, in most cases and for most disorders, before one starts feeling any sort of relief.
Which brings me back to the question — how do you cure mental illness? The answer — you don’t. You help people understand what it is, learn and engage new ways of coping with its symptoms, and help them do the best they can with the resources they have available. Right now, there’s no “cure” for mental illness. I hope within my lifetime, I can answer this question in a very different way.