Mental illness recovery can be more of a journey rather than a destination, and if you’re aiming for a destination, that can end up being a moving target. Let’s begin this discussion by looking at what recovery actually entails.
An Australian National Standards for Mental Health Services document from 2010 defines recovery as:
“… gaining and retaining hope, understanding of ones abilities and disabilities, engagement in an active life, personal autonomy, social identity, meaning and purpose in life, and a positive sense of self.”
The Toronto branch of the Canadian Mental Health Association defines it this way:
“Recovery is the personal process that people with mental illness go through in gaining control, meaning and purpose in their lives. Recovery involves different things for different people. For some, recovery means the complete absence of the symptoms of mental illness. For others, recovery means living a full life in the community while learning to live with ongoing symptoms.”
Both of these definitions match up pretty well with how I look at recovery. I think of it as something that’s a direction rather than an endpoint, sort of along the lines of how acceptance and commitment therapy looks at values as directions, and goals are steps that you might take in a valued direction.
Recovery then…
Recently I was doing some decluttering and came across a blog post from June 2018 about what recovery would look like for me. At that point in time, I wasn’t doing well, but it had only been two years since my illness was last in full remission, so I still thought there was some reason to think that my symptoms could eventually ease up. Two years further on, it’s pretty clear remission isn’t going to happen unless some new treatment falls out of the sky.
My 2018 recovery picture included:
- confidence
- the ability to feel joy/pleasure
- resilience
- hope
- a sense of purpose and meaning
- feeling strong
- having a sense of control over my life
- being able to smile and laugh, and mean it
- looking forward to things
- being able to generate emotional responses to events in a way that is consistent with my values
- feeling open to new things
- being able to look to the past or the future without being overwhelmed by pain
… And now
So, where do I stand on each of those things several years later, as my illness has become increasingly treatment resistant?
Confidence
Looking back, I think confidence probably wasn’t the word I was looking for. What I probably meant was mastery. I think my confidence is fine, and I have a pretty realistic appraisal of what I can and can’t do. However, I have lost a sense of mastery because my illness has continued to limit my abilities, so instead, I work on building mastery in new areas.
Ability to experience joy/pleasure
This would be a hard no. The anhedonia caused by the depression does not seem to be going anywhere, and there’s really no reason to think it will unless some miraculous new treatment comes along out of nowhere. While there is a greater than zero possibility, I’m not holding my breath, and it seems rather futile to fuss over such an intractable symptom in relation to the notion of recovery.
Resilience
While resilience would be nice, it may not be particularly realistic. I’ve got to the point where fairly minor fork pokes (see here for fork theory) send my brain into shutdown mode, which affects my mind but more significantly has a major impact slowing down my body, which decreases my level of functioning. Even if, psychologically, the original fork stops bothering me pretty quickly, the cascade has started. And that’s worsening over time, not improving.
Hope
Again, it would be nice, but there’s no reason to have any. I consider myself a realist, and there’s simply nothing to suggest there’s going to be some massive change and things will keep better. So hope is kind of out of the equation for me at this point. Acceptance works better.
Feeling strong
Unlikely, and not really something that’s on my radar. See resilience above.
Sense of control
At that point in time, I was feeling like outside forces had more control than they should over my life. Now, I’m far less impacted by outside forces, so while my illness continues to exert its influence, I feel more control over what’s allowed in my life, and that’s important to me.
Smile/laugh/mean it
By mean it, when I originally wrote this I would have been hoping that some happiness would come back. That doesn’t appear to be the case, so let’s strike the “mean it” part.
Look forward to things
Yeah, not going to happen.
Values-congruent emotional responses
This was about being able to react to tragic events with something other than indifference. I still don’t experience sadness in relation to tragedy. I reacted to recent issues to do with systemic racism, but my reaction is on a social justice level rather than on an individual human life level.
Open to new things
When I’m not well, I need control. I need to select what I’m exposed to on a risk vs. benefit basis. I don’t see new things fitting into the picture anytime soon.
Look to the past/future without pain
This is something that’s gotten better. At the time I originally wrote this, I was still trying to come to grips with major changes that had happened to my life after due to traumatic events. I’ve been able to process a lot of that, but the career just isn’t going to happen.
Meaning & purpose
What I skipped so far from the original list is a sense of purpose and meaning. For me, that’s the defining part of moving in a recovery direction. Blogging and writing provide that for me. It’s something that engages my mind and keeps me as occupied as I choose to be. I firmly believe that talking about mental health is essential in combatting stigma and making things a little bit easier for others within our community. So it’s a reason to keep going, and right now, that’s what my recovery direction looks like.
What does your recovery direction look like? Has it changed as your illness has changed?
Managing the Depression Puzzle takes a holistic look at the different potential pieces that might fit into your unique depression puzzle.
Yes, I used to want full recovery, no symptoms and especially anhedonia, as well as a bunch of other things: friendship, community, career… Little if any of this seems particularly likely any more. I am more functional and my mood is somewhat better than in the years ca2003-2014, but the idea of having a ‘normal’ life seems to be beyond me. I might get a job at some point, but I doubt it will be full-time or anything that builds towards a career. I’d like to make some money writing, and that does give me some purpose at the moment, but I’ve sold so little work that I am not getting my hopes up. And so on for all the other things. I feel my religion should give me some idea of meaning and purpose, but often it does not.
It’s hard when illness takes away so much.
My recovery is bloody hard I’m not even sure what the end goal looks like at the minute. More ups and downs than a rollercoaster and I can’t help but to chastise myself when I have a down. I think all in all in the past two years I’ve had around 6/7 weeks not in remission as such because I suffer nightmares and flashbacks every single night but I’ve felt more like me if you get what I’m saying. But even in those weeks I’d catch myself before I allowed myself to laugh and sometimes I’d punish myself for laughing. I just feel so guilty all of the time. I wish there was a magic cure! Xx
It’s bad enough to have the underlying problems without guilt making it worse. It’s okay to be up, and it’s okay to be down, and I don’t think anyone with mental illness can escape that rollercoaster ride.
Your sense of purpose and your commitment to your writing and to others’ writing are very clear. Your online voice at WordPress is very, very strong. I commend you for always having something relevant to bring up and/or address.
Thank you! 💕
I remember when I was on the Board of MHE based in Brussels. We had a video on recovery back then and I presented it to members in Croatia with subs. Over the years I can see some people contend the concept of recovery. I happen to think anyone should be able to chose their model. Recovery works for me.
I agree, people should be able to choose their model based on what’s the best fit for them.
We used to think recovery meant getting back into a career. Now we understand that our view of reality is changing, and we cannot see ourselves yet being comfortable with human people. We are open to that changing as we change.
If we could wave the magic wand for us, it would be self-love. If we could love ourself and not blame, judge, punish, act out our trauma over and over, we could feel worthy enough to exist.
We have not given up on this goal set in late 2016. It’s just not a goal we can work on in the way we would take the yard. We have multi-pronged approach of therapy, meditation, practicing nonviolence, practicing accepting, trying not to judge self and others, medication.
The goal exists, and we don’t visit it very often
You, Ashley, are easy for us to love! 💕
And you’re all easy for me to love, so I think that you’ll eventually be able to get to a place of self-love. ❤️
It’s weird but I feel this lockdown has helped my eating disorder. At first, especially with my roommate gone, I worried I’d go nuts a bit, but that hasn’t happened. I’ve quit caring about food and body image so much. It’s not something I ever expected! I guess with all the other things to worry about, plus feeling so sad over not seeing family, the other thoughts finally faded. Somewhat, not completely. But I’ll take it!
At least something positive has come out of this!
For me recovery has been about re-engaging with life. Feeling the joy and excitement again. Not always, but some of the time. It has been about looking after myself and my health. The top priority for me was always to rebuild my relationship with my two boys. I am hopefully getting there. Good days and bad, but the good days are there now at least. I think the support your blog and your comments bring is invaluable and you should be proud of your achievement here.
Thank you! ❤️❤️❤️
I like how you are honest with yourself and your abilities/capabilities. I try to be the same, and where some people have hope, I do not have a lot. I am an optimist, but hope is not something I have a lot of as it pertains to recovery. I do need to take a new inventory like you have here. 🙂
I figure optimism is fine if it’s at least somewhat based in reality, but certain things just aren’t going to happen, and I’d rather be grounded in reality.
I agree. I feel as though my optimism is attached to the potential to improve my mood or feelings (usually on a day to day basis), more than some kind of magical thinking.
That makes sense.
I find it difficult to see the bigger picture of recovery for me. I struggle to understand what recovery could mean for me and how to go about it.
I find that blogging helps me to get that overview over what has changed over time as the steps are small and the road is windy!
“The steps are small and the road is windy” – how true!
Of course I’d love to have hope and something to look forward to. However, they and other things you’ve mentioned feel out of reach at the moment. I know it will change again as my current low mood mood is situational, both physically and mentally right now.
Once I’ve processed that I will start to look forward to the things I want to do as soon as this bloody virus malarky is over. Your having meaning and a sense of purpose by blogging really resonates with me Ashley, and for the same reasons.
Thank you for this post; it’s made me look at recovery again and I think I need to address a few issues.
Just before I read this I was checking when my massage therapist will be back from maternity leave, and thinking that’s a very recovery-oriented element that’s been missing for me over the last over the last several months.
Wow, that’s something I miss too, along with acupuncture which I find soothing and it lasts for days…..
I’ve never tried that, but I’ve heard good things.