You hear quite a bit about mental health recovery, but what does that actually entail?
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 a destination, 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.
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:
- the ability to feel joy/pleasure
- 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 now?
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.
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.
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.
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.
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.
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?