It seems like you’ve been ill forever. For weeks, maybe months, it has felt like a major effort to do life. On a good day, you might muddle through. On not so good days, it’s hard to get out of bed, much less shower or get to work.
Major mental illness has knocked you down and out. Worse, it seems like you aren’t getting any better.
Hold onto the fact that long term studies have shown that most people diagnosed with even the most severe forms of mental illness at least get relief from symptoms. The NIMH Collaborative Depression Study of people diagnosed with major depression found that the recovery rate after two years was about 80%. That increased to 94% after 15 years. Other studies of patients with schizophrenia found that from 27 – 68% significantly improved. From 60 – 90% of those with significant anxiety have been found to respond to treatment. In most cases, people either go into extended remissions or recover completely. You can too.
However, it is important to be realistic. Recovery does take time and rarely happens in a straight line. It’s often helpful to see it as a journey through stages, from getting some relief from the most painful symptoms to living a satisfying life with a sense of personal control over relapse.
If you are in the midst of an acute episode, it’s essential to let the people who love you provide the emotional scaffolding and practical help you need to move from just getting through another day to having the motivation to make the efforts necessary to heal. Meanwhile, your prescriber and your therapist can manage your treatment so you get some relief. Don’t wait to accept help or go to appointments until you feel like you are worth the trouble. It goes the other way: Accepting help results in feeling more worthy.
Your commitment to your recovery can make the difference
Once out of the very acute stage, you are more likely to make progress in your recovery if you are actively involved. That means getting on board with using professional help, paying attention to self-care, engaging positively with others and sticking with treatment long enough to make a relapse prevention plan.
Professional help: For most diagnoses, the most effective treatment is a combination of medication and talk therapy. Preferably, your psychiatrist and therapist are either in the same practice or have easy regular access to each other. Each treatment should be informing the other.
Take your medications as prescribed. That means taking them at the right times and at the correct dose. Use a pill minder case to make sure you don’t miss a dose or accidentally take too much. Track side effects carefully with a written log. Your prescriber needs to see a daily record in order to assess whether to change your dosages or your medications. Do not, under any circumstances, increase, reduce or discontinue your medications without talking to your doctor.
Attend therapy regularly, even when you don’t think you have anything to say. A therapist can provide perspective and guidance that a family member or good friend can’t. Throughout treatment, being accountable weekly for your part in your progress can also help you stay on track.
Self-care: The journey toward mental health does require taking care of your body’s basic needs. It’s been well-established that there is a continuous loop between the body and the mind. Take care of the body and the mind feels better. Take care of the mind and you are more able to do the basics. It goes in an upward spiral.
It may be tempting to stay in bed all day or to stay up all night, but it is one of the worse things you can do. Allowing disrupted sleep contributes to treatment resistance. A study, published in The Lancet Psychiatry found that people with such sleep disorders are more likely to have symptoms consistent with bipolar disorder or major depression.
If your sleep has become an issue, you may have to institute a sleep hygiene schedule in order to get 8 – 9 hours of sleep a night — not more, not less. For more detailed information, do an internet search on sleep hygiene techniques.
The relatively new field of nutritional psychiatry is confirming what common sense tells us. Our diet is important for both physical and mental well-being. There is significant evidence, for example, that diet plays an important role in depression. Your body needs good food to heal and to grow. If you are unsure about what to eat and how much, see a nutritionist and follow their advice.
Regular exercise can have a positive effect on diagnoses like depression, anxiety, and ADHD. It will help you manage stress, improve your mood, and even improve your memory. If you don’t feel ready to commit to a gym or to do vigorous exercise, start small. Beginning a yoga practice or a stretching routine can be enough to increase your heart rate and clear your mind.
Don’t let self-care be a daily decision. By setting some routines, you can put taking care of yourself on automatic. Establish and stick to a reasonable daily diet, regular exercise and a bed time. Acting “as if” it’s important will eventually pay off in the formation of healthy habits that will help prevent relapse.
People need people. Isolating is a symptom of many mental health diagnoses. Although if may feel like just too much effort to talk to anyone, giving in to it only contributes to the illness. A 2009 study by researchers in Sweden found that social relationships are a key factor in recovering from severe mental illness. To feel fully human, we all do need to be with other humans on a regular basis.
If the idea of being social is overwhelming, start by just reaching out to one person or by joining an online forum. Participating in a drop in center, group therapy, a support group, or a clubhouse for the mentally ill can also help you transition back into the social world.
Relapse Prevention: Relapse of mental illness is common. Depending on the diagnosis, from 40 – 90% of those who suffered an episode of a major mental illness have at least one other episode. However, 40% of those relapses are due to people not sticking to their treatment plan or not returning to treatment soon enough. Knowing how to prevent or minimize the effects of relapse will give you a better sense of control over your own life. Work with your therapist to learn what may trigger a relapse, how to recognize the warning signs and how to manage symptoms to reduce their impact.
Getting well is a journey, not an event. Although miracles have been known to happen, you are far more likely to move forward if you participate in your treatment. By working consistently with your helpers and by doing everything you can to treat yourself well, you can reduce, work around, or eliminate symptoms. With patience and effort you can regain a life that is meaningful and productive.