Is Mental Illness Recovery a Choice?

Mental illness is not a choice, but recovery is
HealthyPlace

“Mental illness is not a choice, but recovery is.” While this image floating around on Pinterest originated with Healthy Place, I couldn’t figure out the original source of this mental illness recovery quote (if, in fact, it is a quote from another source), but seems to have been around for a while. Anyway, I don’t really agree, so I thought I’d write about it.

The first part of it is good; mental illness isn’t a choice. Remaining ill/symptomatic also isn’t a choice, but people seem less likely to be able to grasp that bit. I’ve read in various places (including a book I recently reviewed) that staying depressed, or anything else, is a choice. Really, now?

Lack of effective treatment

The only way that staying ill could possibly be a choice would be if some magical form of treatment worked for 100% of people, 100% of the time. The current reality isn’t even in the same hemisphere, much less the same ballpark as that.

That means that if we chose to define recovery as full remission of symptoms, it’s not going to be in the cards for a whole bunch of people who are waiting for that treatment magic wand to come along and replace the at-least-it’s-better-than-nothing kind of deal that’s currently available.

Psychosocial recovery

What about psychosocial recovery, which is a popular concept these days? It means different things to different people, but MentalHealth.gov‘s definition is:

…A process of change through which individuals improve their health and wellness, live a self-directed life [and] strive to achieve their full potential.

The site also identified four major dimensions that support recovery: health, a home, purpose, and community.

Based on that definition, recovery is a process rather than an endpoint, which fits in with my own personal notion of recovery as being a direction rather than a destination. And sure, sometimes the choice is available to head in that direction, and if it is, that’s fantastic. But it’s not always.

When symptoms are awful and you’re trying hard to keep yourself from flying apart at the seams and/or offing yourself, choosing recovery is about as realistic as choosing happiness, which I could rant all day about. Sometimes that kind of choice is a privilege that’s just not accessible for some people.

Dialogue within the mental illness community

I’m not sure what Healthy Place was trying to accomplish with this graphic. Given the nature of the Healthy Place site, I’m guessing it was well-intended. I don’t think it’s actually doing harm in the sense of conveying inappropriate messaging to a non-mentally ill audience.

Within the mental health community, there’s a sometimes odd mix of different viewpoints. Take anti-medication attitudes, for example; I’d estimate that there’s at least as much of that coming from within the mental illness community as from outside. While diversity of opinions is a good thing, attitudes like recovery is a choice can be problematic if other people start to internalize it.

We’re probably more alert to stigmatizing messaging coming from people who don’t have a mental illness, and not so quick to critically evaluate messages from within. Being active in the mental illness community online, there’s a lot more exposure to this diversity of views than I’ve ever had in the “real” world. It’s certainly been an eye-opening part of my online experience since I started blogging 3 years ago.

I suppose that where I’m going with this is that there’s not a lot of black and white with mental illness. Mental illness life is complicated, and all kinds of things besides just the symptoms themselves get dragged into it. One person’s experiences and views may feel totally foreign to someone else. There’s room for all of it, but there needs to be some critical thinking and recognition that there is no one right way. The choices that are available aren’t the same for every person all of the time, and it’s okay if people can’t make the choices others expect them to.

What are your thoughts on recovery as a choice?

Mental health coping toolkit

The Coping Toolkit page has a broad collection of resources to support mental health and well-being.

100 thoughts on “Is Mental Illness Recovery a Choice?”

  1. My view: choosing to recover is *necessary* for recovery, but it isn’t *sufficient*. Lots of other things have to line up too.

    Let’s assume that some people’s depression is heavily affected by diet, but they may not be aware of that. This seems likely to be the case for me, up until a few weeks ago.

    Before then, I could be doing everything perfectly in my ideal recovery plan, but it still wouldn’t have been enough. So in what sense would I be choosing my illness? It was almost entirely out of my hands… until I discovered the link with food.

    Energy levels are a huge factor. When you’re depressed, your energy levels are running on empty a lot of the time. So who has the cast iron willpower to force themselves to recover when they can barely even get out of bed? Not many of us.

    I used to waste so much energy blaming myself for my illness. Now I see that it wasn’t my fault, I wasn’t lacking in some way or just lazy. I was ill, just like someone with cancer is ill.

    And with depression, when you blame yourself, you can make things even worse.

    Really, it’s kindness, love and acceptance we need when we’re depressed, not memes which seem to imply we ought to be trying harder.

  2. There’s another element to this too… I think there’s good scientific basis for believing that we don’t truly have free will, even if we feel like we do. That means that NOTHING in life is actually a free choice. Every event, no matter how big or small, is preceded by an unbroken chain of causation which stretches back to the beginning of the Universe. Lots of people feel troubled by this possibility, but I’ve spent a lot of time thinking about it (thanks to Sam Harris) and I now find it very freeing. There’s no point ruminating about the past because it literally would be impossible for it to have happened any other way. And there’s no point worrying about the future because it’s already written.

  3. This statement resonates deeply with me: “Recovery is a process rather than an endpoint …” How does one make such a choice for recovery? Free will? Almost certainly, not alone, or without proper mental health support/diagnosis. I like to claim “my choice” was based on my willpower, but that would exclude my doctor, therapist, friends, family and God.

  4. It’s unfair people still think mental health is a keyboard with multiple buttons, you push them and change the whole situation. the words choice shouldn’t be attached to mental health at any stage. if it was this easy nobody would be suffering.

    can i reblog this post?

  5. LoseWeightWithAng

    I feel like you can choose to take steps toward recovery, but whether those steps help you recover can vary greatly. I have trouble with binge eating and depression and both of these diseases can affect people for different reasons and in different ways. Recovery really is a learning curve, not just a simple task you go and do.

  6. Wow, if only recovery was a choice! I know when I first became unwell many years ago, I chose to recover and tried many routes such as massage, hypnotherapy, mindfulness……………. and medication.

    While I’ve had some success with a huge combination (mindfulness, medication,breathing techniques and other coping skills), mental illness remains. Yes, I can cope with it, in the main, but it’s hard work constantly keeping on coping.

    Of course, I choose recovery because it’s crippling living with mental illness but I know I’ll never recover fully, whatever that means.

  7. For me I use the words being healthy in my mental health rather then recovery. Part of my being healthy iss seeing my psychiatrist and taking my meds.

  8. when given recovery tools that act like a crutch … you heal regardless. it’s comparable to being as broken as a bone. you will have new growth regardless but possibly crooked if not healing with proper support. then learn to walk again.. you must put in hard soul grinding effort but its you, only you that ultimately does make the choice to recover.

  9. Oh Ashley, this is a seriously good quality post – provocative and profound too – well written and observed. A deep thinker. Is recovery a choice? Yes and no ….. if it was easy – we would have no serious problems in life – l have known people be so negative even when on the road to recovery that they refuse to allow recovery entrance to their mind – therefore they are refusing choice to recover.

    Might sound wrong – l’ll explain using another example ..

    I remember a good few years ago and by this l am referring to 2014, so six years ago now. I was unemployed and l had to go and sign on to receive unemployment benefit… the agent l saw asked me various questions .. and when l told her l was on the spectrum, and had Asperger’s she responded with this …… ‘Last year l broke my leg in a skiing accident, but l recovered and you will do too, it’s your choice to and not use not wishing to recover as an excuse!!”

    I was taken aback by this and l answered with, “I was born with Asperger’s, but it doesn’t stop me from working, all l said was l didn’t do well in large crowds of people, not that l was refusing to work!!

    But it was her insistence that l was refusing to allow myself time to recover like it was a deliberation to be an Aspergian, like l had a choice!!

    I have never used any disorder, my Aspergers, my breakdown, my bipolar, any previous depression to stop me from pressing forwards. If l could bounce back from a depression like it wasn’t there l would leap at that opportunity as would many others but some don’t and they are more happy to be unhappy than recover.

    My choice of recovery is to remain positive as often as l can … you see l think that when we hit a great deep and dark depression, it never truly goes – but we work with it, we have good and bad days, great days but the choice to continue to keep recovering is ours and we should take it – that’s where the choice is.

    1. I agree, sometimes people choose not to pursue recovery. But I would argue that sometimes the effects of illness are such that recovery isn’t a choice that’s available.

      1. I don’t disagree on that Ashley, nit at all .. l was thinking of three people who l knew once, no longer because their deliberate negativity proved too much – but they were recovering, but if they recovered, they would not get the attention they wanted. So they deliberately refused to allow recovery and made themselves iller on purpose.

        It annoyed me, because they were getting help for something they were pretending with and there were and always will be people that genuinely need the support.

  10. This post has generated so much discussion! Thanks for getting us all jump-started!

    I was just going to add that I like using the term remission for my mental illness. My propensity toward the illness is still there, there are some things I can do like exercise and eat right to help mitigate these risks. But if the depression/anxiety/mania comes back for a time, it can be expected – no surprise there. What is not expected or what is not a given is how I choose to react if remission does not stay in place for good. There are often little bubbles of anxiety that pop up here and there which means the remission is not a steady state but something to strive for even if there is a break-through of symptoms from time to time. Most important is the compassion to have for yourself if things don’t go your way. Having love for yourself even when crazy stuff is happening is the goal.

  11. I agree with you in this aspect. I mean why do people even say that recovery is a choice. When someone is having it all at the same time like mishaps, a lot of problems, depression, stress, traumas etc. You can’t just expect him/her/them to see the light in their situation, can you? Not all people are same. Their way to deal life is different. Their reaction to stimuli are different. So if someone chooses recovery, well good! But people can’t judge other person who doesn’t seem to find any energy to go towards their journey of recovery. This statement sounds kind of judgemental towards us, the mentally ill people.

  12. For me recovery was a choice… to a point. I was depressed for years and medication and counseling didn’t actually help me. It was like getting into a rubber dinghy in a stormy sea. Certainly safer but didn’t get me any closer to dry land. When I chose to start actively creating a less toxic lifestyle instead of treating depression as an illness, my life was transformed. So for me it isn’t necessarily a choice to get better, but it can be a choice to start paddling in the direction of the shore. (But sure you can’t just choose to be on dry land and appear there) hope what I’m trying to convey comes across. 🙂

    1. I’ve never fracked up a comment before lol. Recovery is a myth. just like saying my gay sun is in a phase.. healing can sssdega

  13. i feel like my life has got very bad and no one cares what happens to me and i dont have any friends and makes me sad

      1. yes i know i dont have one female friend i only have my partner only and also in jan next year it will make two years that i have lost my dad and i miss him everysingle day so i find life very hard

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