1. “Get real.” If you won’t settle for anything less than a “cure” for a persistent and chronic mental illness, you may be setting yourself up for disappointment. A good friend would help you accept a realistic idea of what “recovery” means. She might remind you that physical illnesses like hypertension, arthritis, and diabetes can’t be totally cured but people can live happily and productively once symptoms are brought under control. Similarly, even serious mental illnesses like schizophrenia can become part of the fabric of one’s daily life without overwhelming it. Just as there is currently no “cure” for hypertension, there is no “cure” for psychosis. But staying in treatment and being engaged in a healthy lifestyle can push both into the background.
2. “Take your medicine” – on time and in the correct dose. A true friend wouldn’t let you convince yourself that it’s okay to abruptly stop a medication because you are feeling better. You may be feeling better because you are taking the medication. A friend would remind you to tell your doctor if you are experiencing side effects, if you miss a dose, or if you think your medication isn’t working. Your doctor can only help you if you follow directions and provide good information about results. Most medications require a gradual step-down if you are to discontinue them safely, so talk to your doctor if you want to stop.
3. “See a therapist.” A friend would not support an idea that a pill alone will make the pain go away. Studies have found that a combination of medication and talk therapy is the most effective method for getting and staying better. A therapist can help you learn and practice new coping skills. Sessions can be devoted to helping you identify issues, people, and places that are challenging for you so that you can develop strategies for dealing with them. Perhaps most important, your therapist can encourage and support the efforts of your internal friend until you’ve developed a natural support system to take over.
4. “Get enough sleep.” A true friend would call it a night at 9:00 so you can be in bed by 10:00 or 11:00. Regardless of how much fun the two of you are having, your friend would understand that you need a minimum of 6 to 8 hours a night every night. She’d know bodies require rest to heal. If you have trouble falling asleep or staying asleep, she’d remind you to make sure you are doing the sensible things you need to do to wind down from the day. She’d tell you to shut down anything that is overstimulating at least an hour before bedtime. She’d get offline and tell you to do the same. She’d remind you to turn off the TV and not to answer your phone or make any calls unless there is a bona fide emergency. If you need further coaching, she’d tell you to take a warm bath if that is soothing, to get into pajamas and head for bed; to play some soft music and lower the lights. You want to establish a routine that says to your system, “The day is over. We’re going to sleep now.”
5. “Treat your body well.” Treats are only treats if they’re rare. A true friend wouldn’t bring you chocolate – except when it is extremely special and then in only small amounts. Instead, she’d insist that you get into the habit of eating three healthy meals a day plus 2 – 3 healthy snacks. Your body needs fuel to heal. Exercise? Of course. Your buddy would get you moving. Taking a walk together or hitting the gym for at least 30 minutes a day would help you both feel great. She’d encourage you to limit caffeine, alcohol, sugar and nicotine and to stay away from illegal drugs. Your body and mind have enough to do without struggling against effects of stimulants and depressants that you do have control over. Gently and consistently, your friend would stress that these are the habits of healthy living. To be healthy, you need to act that way – especially when you don’t feel like it. Doing the basics shouldn’t be a decision every day.
6. “Learn relaxation techniques.” A good friend would drag you to a workshop to learn meditation, the relaxation response, yoga or mindfulness. She might join you in prayer for health and guidance. Your friend would know that when you find your mind spinning, you need to have a natural and effective way to slow yourself down.
7. “Make more friends – or at least acquaintances.” People who are isolated have a much harder time managing their illness. Your friend would encourage you to join a church or club or support group – anything that meets weekly so that you have regular contact with people who share some of your interests or concerns. You need more than one friend, even if that friend is the best possible good buddy you can imagine. You need to find a group of people who look out for one another.
8. “Tell me about it.” A supportive friend would want to know what she might see if you start to lose control. Often it happens so gradually, it’s hard to recognize that the illness is taking over until it has already become serious. Remind your internal friend that you both do know your signals. Agree that when you first start to feel uneasy, you will call your therapist – even if you don’t think it’s that serious.
The imagination is a wonderful thing. Your partner in healing is only as far away as your mind. When you are discouraged or lonely or tempted just to pull the covers over your head and avoid dealing, your avatar self can be a very helpful and, yes, loving support. Your inner best friend forever is that part of you that is healthy and whole. The more you get in touch with her and listen to her, the stronger both of you will become.