It Gets Better… Or Does It? – Dealing with Chronic Mental Illness

It gets better... or does it? graphic of a smiling sun, rainbow, and butterflies

On a fairly regular basis, I see messaging along the lines of “it gets better,” or some variation thereof. While the intention behind it is good, I’m not convinced that it’s useful, because it’s not necessarily true.

There’s a U.S.-based non-profit organization called It Gets Better that provides support to LGBTQ+ youth who are being bullied. In that case, there probably is reason to think that things would get better in time, as graduation would change the environment.

What if the setting isn’t a factor, though? When it comes to mental illness, there’s no possibility that you’ll ever be able to remove yourself from… well, yourself. Is there any validity to saying it will get better, or is it just patronizing, another form of toxic positivity?

When “it gets better” makes sense

“It gets better” makes more sense when it comes to intense surges of symptoms above and beyond whatever that individual experiences at their baseline. A panic attack will get better in the sense that the particular attack will abate; however, that can’t be extrapolated in the same way to the disorder as a whole. Similarly, intense emotional states won’t be sustained indefinitely at the same intensity simply because it’s the nature of emotions to ebb and flow.

It also makes sense if it’s coming from someone like a health professional who has an understanding of the course the illness tends to take, so they’re in a good position to say with some degree of certainty that will get better. What I’m not comfortable with is people who whip out the “it gets better” without having any actual reason to suspect that things really will get better.

The reality of chronic mental illness

I try to be a realist, and the reality is that some people’s illnesses don’t get better. Some people’s illnesses get worse as time goes on. Telling someone who’s in that boat that it will get better can just come across as platitudes.

It’s certainly possible that someone with a treatment-resistant illness could figure out new ways to compensate for some of the symptoms. They may also find new ways to have a sense of purpose. However, that doesn’t necessarily make things better – different, maybe, but not necessarily better.

Probably all of this depends to some extent on the temperament of the person involved. For some people, optimism and hope that things will get better are really important to maintain. And for people who do achieve some degree of remission between episodes of symptoms, it may also be useful to hang onto the idea that it will get better.

But I think that it’s important that we do acknowledge that it doesn’t always get better, and recognize that it’s not necessarily helpful to tell someone that it does when that’s just not something that’s realistic for them.

We can’t predict the future

In cognitive behavioural therapy, one of the common cognitive distortions is fortune-telling, which involves being sure a certain thing will happen in the future even when there’s no evidence to support that. “It gets better” predicts that someone’s future will head in a positive direction, and usually there’s no way of knowing that will be the case.

We can’t control the future, but we can be in the present and work on getting through each moment as it comes.

Do you think “it gets better” is something that gets tossed around too freely?

The post Toxic Positivity: What It Is and Why It’s Not Helpful is the hub for all things toxic positivity-related on Mental Health @ Home.

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48 thoughts on “It Gets Better… Or Does It? – Dealing with Chronic Mental Illness”

  1. Perhaps that phrase is used a little too easily. I think though that it is used to encourage people who have mental illness and are new to the reality of that (if they accept it, which might be part of the issue). For chronic depressives like myself, we come to realize it won’t get better, but we will have good days, good enough days and some piss poor rotten stinking black hole days. It’s learning to ride the wave as it were. Newbies to the reality of all that may not realize that things won’t stay as black as they can get – not all the time. There will be a dawn of some sort. I think some judicious use of “it will get better’ might be in order though. That news isn’t always reassuring.

  2. I think things get different. I hope that I will be ‘better’ at some point at accepting the more difficult days and sometimes I already do. So that gets better as I get to know the illness better. My life in general got better so that helps too.
    When I was really sad, ‘it gets better’ held no meaning at all, it were empty words. The only words I do remember is that my psychiatrist telling me that things will be better, he still expects me to make progress. I see from day to day what happens. Sometimes – I feel – that having the hope is already tricky (imo).

    1. I guess it makes a difference where someone is in their illness trajectory. Sometimes there is reason to expect that things will get better, and having that come from an outside source may be helpful. But if the person saying it isn’t in a position to know that it will or it’s likely to get better, that’s where it gets problematic for me.

      1. Exactly. The source need to be a credible one and the person receiving the message must be able to hear it. I still think sometimes about those words. My psychiatrist also told me (back then) that I would take my medication for maximum a year. We’re over a year now and he doesn’t tell me to decrease the dose yet. (he first stated that after 6 months we would be able to decrease the dose). It’s all a mystery sometimes! But still those words give me some form of relative hope.

  3. Secretum Hortus

    In my experience, dealing with Borderline Personality Disorder, PTSD, and other anxiety disorders, I think you just get better and more familiar with your illness, and therefore get better at handling it….hopefully!

    Many people see it as a destination. Going from a) – which is sick to b) better. But that is not realistic.

    I find that only things like having a cold or something are like that.
    Where you are sick and then you get better.

    But with mental illness, it’s a different journey and not to put people off, but it’s probably going to be with you a while and so you have to learn about it, and get used to it, and then learn how to handle it.

    It is lots of little adjustments along the way. Progress is individual and sometimes slow…and recovery is often one step forward and two back. But progress is still progress. Its lots of falling down and getting back up again. Sometimes every freakin day almost and it’s not easy! It hurts…and its gonna hurt.

    A person can be often healing, and changing their way of thinking about things as well as changing their maladaptive behaviours. Making new pathways within their brain.
    This all takes time and processing, and we are all a work in progress.

    Hope is needed at times perhaps with the right person, and can add some temporary relief.

    But that hope has to be sure. I find often it’s the older generation that sometimes rely on hope more.

    As you rightly say, hope is all very well but mainly what you need is to cope with the present.

    Often with me, it’s just time that I need.

    Sometimes it doesn’t get better, it gets more s*** actually!
    But you get more familiar with that.

    1. That’s a good point about the hope needing to be sure. If it comes from someone who’s really not a position to be sure, then it seems like a rather false hope. And with mental illness, sometimes the illness gets easier to manage over time, but in other cases, the illness itself progressively gets worse over time.

      1. Secretum Hortus

        True, and that’s exactly why I couldn’t do a blog about spiritual things and mental health. One tends to associate one with the other for different reasons. And one can negatively impact the other.
        You see my dilemma. I either have to write about mental health and forget the spiritual stuff or write about the spiritual stuff and forget the mental health.
        It is easier to pretend like you either don’t have beliefs or you are not mental lol!

          1. Secretum Hortus

            But then the positives are I feel I would rather talk about something that is good and can “potentially” help some if they wished, and has… (outward), than talking about me and my mental health (inward). Different things help different ones.

            It just feels better to use my energy on that, on something I do believe in rather than on anything to do with me.

            I would rather concentrate on the future too, than dwell on my past, or even the present where often it just feels horrible and awful, because of my mental health.
            Nobody has to listen to what I say.
            I find it is also a useful deterrent for any of the toxic type people.
            They are more likely not to follow.

            1. That makes sense. And I think in general it’s better to let the person who the conversation is focused on take the lead. If you want to focus on the future and someone tries to drag you back to the past, that’s a bad sign.

  4. Yes, I think it’s a false promise. I have always felt like my bipolar disorder has a bit of a degenerative side to it and in the last couple years, there has been talk about moving into the family of neurological disorders that dementia and Alzeheimer’s is a part of, and let’s be honest, those don’t get better. But, sometimes it’s better to tell people things will get better because hope is all they have and they don’t research and analyze things to the level you and I do. It’s like the line in The Great Gatsby: “I hope she’ll be a fool—that’s the best thing a girl can be in this world, a beautiful little fool.” I think that the best thing a lot of people can be is a fool. I just didn’t get that lucky.

  5. Sometimes, from personal experience, emotional pain does get a bit easier – is that ‘better’?

    I know what you mean Ashley, it is bandied around a lot, even by professionals. I’d say it gets different and somehow you have to learn to live with your different.

  6. I think if people said “I hope your day gets better” or “I hope tomorrow is better for you” that would be so much easier to hear. Instead of a patronizing cliche, or dismissive fortune-telling, it would sound like an honest, caring wish. Often, when I have a migraine, people DO say this, and it is very nice to hear. But when I’m depressed… the cliches come out. It’s weird. The worst thing is when I take time to explain how awful dating was for me after my divorce and how it led me to such a dark bleak emotional place of pain… and then someone goes awww don’t be scared to try again! Your soul mate is waiting! Wtfff? Did you not read a word i said? The process left me suicidal!

  7. THIS!!! I wanted to write about this for sometime but I just don’t have the cognitive capacity to do so. You spoke my mind. You can say to me, “I hope it gets better” but don’t tell me “it gets better”.

  8. I think it is good to be optimistic overall, but when you are suffering, platitudes can hit you in a different way that is almost enraging. I think people have to be sensitive to the state of mind of the person you are talking to.

  9. It’s certainly an overused statement. I’ve decided it’s something people say out of nervousness, ignorance, feeling helpless, or they are just into canned phrases. Jase and I have been talking this over the past few days about no matter how proactive I’ve been and will continue to be in getting help I might not get better or I could get worse before I get better. He has bi polar and before it hit was naturally a happy and positive person. He got the right cocktail of meds that he’s been on for the past 20 years and has been in his natural state of happiness ever since. I on the other hand am hardwired to be a bit more negative and moody, so even if I find the right therapy I may always be a bit more ass-hole-ish than he will ever be. Plus we are seeing his bipolar was and isolated easily treated thing for him, where I have many layers going on.

    1. When there are those layers of complexity, trying to simplify it down and say it will definitely go in direction X seems like an exercise in futility.

  10. I find the people who say it to me are either eternal optimists or they know it might not get better but they don’t know what else to say.

  11. Now that you mention it, yes, it is something that is freely tossed around. I think in a general sense, a lot of people just want to not have to deal with people who are suffering, so they make statements such as these.

  12. I do think a lot of people toss that out as a general placebo. But when someone that has gone through some s*** or your therapist says it. I feel like it does come from a source of knowledge and experience that is trying to shine some light into your darkness. However, I really think you need to be in a place that you can accept that things can get better and also take some accountability in how your behavior affected where you are at. The great thing is you can always change your behavior. Doesn’t mean that you done have low times where your head goes back there but you can learn things to help you cope.

    1. I agree, it can be a very good thing when it comes from someone who’s actually in a position to have some certainty that things will get better.

      I would say, though, that dealing with mental illness isn’t always as simple as accepting that things can get better, changing behaviours, and learning new coping skills. Sometimes the illness trajectory gets worse over time.

  13. This is interesting. I think now I have been through periods of anxiety and depression and come through the other side it does help to tell myself it will pass. I don’t ever consider that it will ‘get better’ because that implies it’ll never happen again. Which is not true. Things are currently ‘better’ for me than they were 2 weeks ago but then may be worse again in 3 weeks time.

    I think sometimes, though well meant, ‘it’ll get better’ feels a little like the ‘snap out of it’ school of support.

    1. I think that’s very reasonable with things that ebb and flow over time to say the low part isn’t going to last forever.

      My issue is more with the “it will get better” that someone pulls out of their butt without actually having any knowledge of what they’re talking about. “I hope it will get better” isn’t a problem, but when someone says it will get better without having a bloody clue, that’s my issue. Sorry, bit of a rant there. Not directed at you.

      1. I totally agree. That’s when it feels like a comment that is of the ‘pull yourself together’ and ‘everyone feels like this sometimes’ variety. No they bloody don’t!!!! It’s a very difficult thing to understand if you haven’t experienced it. Plus ‘it’ doesn’t get better, you treat it and manage it. Without that work and effort from the person involved .. it would stay the same or get worse.
        Hope you’re ok x

  14. I don’t think it’s a particularly helpful thing to say, but how unhelpful it is probably varies from person to person.

    Ironically, CBT therapists seemed to get frustrated when I said that they couldn’t know that I will get better (or for that matter make friends, find a job etc.) even if I couldn’t know that things wouldn’t stay the same or get worse.

    1. And you’re right, they have no crystal ball to predict that. I would think in that situation it would be more workable to say there’s no definitive proof that you can’t do those things rather than insisting that they will happen.

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