Dr M said the other day – “People who have gone through recovery are very powerful”. And I would have to totally agree. It got me thinking though, where is it that that power comes from?
I think/hope it’s reasonably well known by now that there is no quick fix or stand alone cure for mental illness. Instead what we aim for - for ourselves and for our loved ones - is ‘recovery’.
This in itself can be a bit confusing. When we are physically unwell we do all we need to do in order to recover. We go to the doctor, we take the medicine, we get the physiotherapy or the surgery or the rest or the whatever it is we need. We can see and feel the results when we are recovering and they are obvious to others as well. From my understanding, in the medical world, recovery generally means cure or no current symptoms.
To add to general life complexities, in the psychiatric world the concept of recovery is not about being restored to your previous health. Indeed, it could be argued that nobody returns unchanged to a prior state after an event. We are changed, if not in the objective sense, certainly in the experiential sense and how we see the world. As such, mental health recovery does not always refer to the process of complete recovery from a psychiatric condition in the way that one might recover from a physical health problem.
For many people, the concept of recovery is about staying in control of their life despite experiencing a mental health problem. Recovery can be described as a process of change through which people improve their health and wellness, live a self-directed life, and strive to reach their full potential (SAMSHA, 2011).
Recovery is "a deeply personal, unique process of changing one's attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness" – William Anthony, 1993.
So, just because the illness isn’t there anymore doesn’t mean the battle is over. I remember very clearly when Dr M and I were discussing my current state and experience well over a year ago and he cheerily said “Well, you’re not clinically depressed anymore.” I nearly cried. I was bordering on devastation. There was no celebratory dance for no longer meeting DSM-V criteria for a current psychiatric condition. No, I was upset because whilst I was not technically “unwell”, I knew I still had a really, really long way to go. I was in recovery again. And I knew what I was in for.
This wonderful picture explains recovery from a mental illness perfectly to me:
(Source: Anna Borges, Buzzfeed)
Recovery is messy. Really, really messy. And hard. Really, really hard. And time-consuming. And a bit shit. For me, the process has felt like trying to walk up a really steep hill on really unsteady legs during a cyclone.
And why wouldn’t it? I was in the process of building a meaningful and satisfying life, with the threat of recurring symptoms or mental health problems. The evidence suggests, the key themes of recovery are:
- Agency: Gaining a sense of control over one’s life and one’s illness. Finding personal meaning, an identity which incorporates illness, but retains a positive sense of self.
- Opportunity: Building a life beyond illness. Using non-mental health agencies, informal supports and natural social networks to achieve integration and social inclusion.
- Hope: Believing that one can still pursue one’s own hopes and dreams even with the continuing presence of illness.
So what does recovery look like in action? I think this is what we’ve got so far. Diagnosis is helpful, but just because a person no longer is identified as a ‘patient’, doesn’t mean there’s not still work to be done. The development of resilience might still be required to meet the challenges of life. Also, based on the definition there is more than one road to recovery and treatment is just one route amongst many. Sure there are a lot of well researched pharmacological, psychological and social interventions widely available, but there are a lot of ways forward here. And possibly most importantly, the best judge of recovery is the person directly affected. How could anyone else possibly comment or judge on whether another individual is living the life they want to lead? It’s impossible.
Personally, the thing that I have been most surprised about is that recovery is not all bad. I knew back when I was beginning recovery that I would probably not get my previous life back – because, really no one can go backwards – but I didn’t expect to have such a mixed reaction to it all. I would never, ever in my wildest dreams wish the experience of a mental illness recovery on my worst enemy, yet I also wouldn’t ever want to wish my own experience of mental illness recovery away. My recovery has helped to create a more meaningful life than I have ever had. It feels pretty powerful. And I’d never, ever wish that away.