Mental health

Finding Agency in Mental Illness

Mental Health @ Home: Finding Agency in Mental Illness - photo of person holding a sparkler

Agency is a sociological construct that refers to the capacity to freely make decisions and then independently enact those decisions.  Agency can be limited by our own individual beliefs, and it can also be limited by social structures that impose rules and constraints.

Structural constraints imposed on people living with mental illness can come from power structures within the psychiatric system, the illness itself, and the associated diagnostic labels.

According to a paper by Lysaker & Leonhardt, agency in mental illness recovery can involve creating meanings, asserting personal rights, and having a sense of ownership over one’s own thoughts, feelings, and actions.  It can also mean being able to create and tell one’s own story.  The authors wrote: “To be an agent is the result of the recognition and basic experience one has at an elemental bodily level which can be shared with and understood by other people.”

When I started blogging almost two years ago, I was at a real low point in terms of agency.  Between my illness and the impact of external circumstances, I felt like I had very little control and a very limited capacity to effect change.  [Word of the day note: “effect” used as a verb means “to bring about”, and this is perhaps the first time I’ve ever used it in a sentence]  I felt like I had been actively and repeatedly silenced.

Blogging allowed me to share my story (visit this post for ideas on where to share your mental health story).ย  In the process of telling, it gave me a greater sense of control and ownership.ย  My illness is still present, and it still knocks me on my ass sometimes, but blogging has allowed for a sense of agency that brings the concept of recovery closer to within reach.

It also helps that my key treatment provider, my GP, allows me to be very much in the driver’s seat.  A large part of my experience historically with psychiatric care has involved the imposition of structure that boxed me into a corner and stripped me of power.  I don’t want to go back to that.

When the system takes away agency, it deprives those of us caught within it of the ability to create change that promotes our own recovery.

When people try to silence us, that also reduces our agency and correspondingly reduces our ability to heal.

So let’s keep talking.


Visit the Mental Health Websites & Apps page for listings of lots of great mental health resources.

16 thoughts on “Finding Agency in Mental Illness”

  1. I think the mental health system often does strip the patient of agency, especially with long-term illness. I feel like psychiatrists and therapists start supportive, but when everything they suggest fails, they begin to act (perhaps not consciously) as if I’m deliberately sabotaging things and that it is all my fault somehow. I go from being a patient to being a problem to be got rid of somehow. Maybe that’s just my paranoia.

    I don’t know how private vs. state healthcare fits here. I’ve mostly been seen on the NHS for psychiatry; with psychotherapy I’ve had a mixture of NHS and private. I feel that the private sector comes across as more caring, perhaps inevitably, but obviously that’s not open to most people.

  2. Golly geez, what a beautiful blog post. I’m so glad that blogging has helped you so much–your blogging has helped us as well!! And I totally know what you mean about having great healthcare providers who aren’t walking egos–I know you’d love Dr. Phlegm if you were to meet him.

    Your last three paragraphs are just gorgeous. So true!!

  3. Ashley,
    Congrats on your website. it is the most helpful I have encountered. I am a new blogger. My book is due out in June, 2020. It is about living like a king, while being mentally ill. You will be notified of its release. I am schizophrenic and bipolar. Neither illness bothers me these days. I live life to the fullest. While I am not hang gliding, I have a rich social life and many hobbies. I feel good. The book is about how I got here. I wrote it when i was in the abyss. It is about the factors that helped me climb out. Professionals and their drugs were important to my recovery. But my friends, family, and the things I did made life worth living. In a sense, the book is a recipe for recovery. It prescribes action, not the head trips of psychiatry. It is about downhill skiing, duck hunting, and handball. It is about renovating a car, making friends, and being a caretaker to my mother who had Alzheimer’s disease. It is about doing things, not thinking about them. It advocates replacing bad times with good times. For all intents and purposes, I am well. Getting there was half the fun.

  4. I’d be honored. Take a look at my today’s post. It is about the jobs I’ve had. My first psychiatrist said work was my salvation. I have had 46 jobs since high school. Most were minimum wage jobs. I tried to be good to each one.

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