Is Mental Illness Recovery a Choice?

Mental illness is not a choice, but recovery is

“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‘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. I don’t know about this. I agree with those who say getting help can be a choice, but what if the help someone gets isn’t the right kind for that particular person or situation. I say this as someone who’s spent a lot of time in nursing homes — which is where a lot of people with severe mental illness (schizophrenia, etc.) end up when there’s nowhere else to go. Other than being heavily medicated, which they invariably were, the only other help they got were group activities, and a brief weekly (or less) visit from a visiting therapist like me. I was pretty much the only person who spent any time talking with them as human beings rather than walking disorders.

    Of course the patients made choices along the way, often bad choices, to end up in ‘long term care’, but at some point they got to a point where they no longer had any control over their lives — yet they wanted the same things we all want — independence, companionship, and some sense that their lives had meaning.

    1. I agree, even if people choose to seek help, that doesn’t mean that whatever help is available is going to be effective. Until there are treatments available that work for everyone all of the time, that particular aspect isn’t a choice. Instead, the choice is in how others choose to interact with the person experiencing illness.

  2. During an acute breakdown I once had a Psychiatrist tell me that it was ‘easy to do breathing exercises’. When I tried to explain that my mind was careering away from me like a runaway train and I couldn’t bring it under control for long enough to focus on anything, he said it was ‘nonsense’. There are so many poor judgements made by people who have never experienced mental illness (unfortunately usually those people who are supposedly there to help us), about those of us who suffer with mental illness. Ironically the recovery path laid out for us often doesn’t take into account that our mind is a little broken, that it isn’t functioning in a ‘sensible way’. Recovery would be a choice, if only we had nothing to recover from in the first place.

  3. The statement that Recovery is a choice actually says that there’s a refusal in some people to get better. Perhaps it has a point. Once a psychiatrist told me that he also has to treat psychosis junkies. I guess, that be about that. However, I don’t agree with the statement. Isn’t someone refusing to get better not also caught in a trap that leaves him no choice? Recovery is a process and it most likely starts with a spark. I would say most other people around aren’t abe to see at first. There’s a lot to talk about… I recently realized: Recovery = Many ways.

  4. I also recently saw this meme on their site and had a similar reaction. I do not like to use the work “recovery” for the chronic mental illnesses in which I suffer. I prefer saying that I am “healing” and that it is a process whereby I am continually refining my “coping skills”, etc.

    The main issue I have with using “recovery” for mental illness (I also dislike saying that my mental illness is “my superpower”), is that it, in my opinion, it takes away from the actual severity some of us experience. I feel it can add to stigma, particularly in the workplace, because some might look to others and wonder why if one individual is “recovering”, others cannot. It could cause employers to be less empathetic. I have struggled at work getting the accommodations needed and have had employers even not take my illness seriously. Using the word “recover” places the blame on the individual struggling and does not truly see the illness as something we do not choose.

    I would choose to “recover” every day, but living with a psychiatric disorder means that on some days, when it is exacerbated, I lose the capability to engage in self-care or even employ my coping techniques. There are even times I am taken down the road of mania without even realizing it until it is over and that can be disorienting. I am left picking up the pieces and apologizing to others for any behavior that came across as offensive or hurtful.

    I have lived long enough now with my illness to separate my symptoms from my personality, and ultimately, I wish others were able to do the same. Many times if in mania or depression, I have a difficult time truly exhibiting the behavior that is authentically “me”. I might come across as “short” or “distant”, and my mood colors my perceptions until it ‘passes”.

    My illness is something I have tried to “recover” from my entire life…. 32 years and counting. It has taken so much from me. I am even on disability now. So, some who suffer might have a complete remission or truly “recover”… but, where does that leave many of us who struggle with a severe and persistent illness? Often, it can lead to some feeling our struggle is not credible… that is just yet another layer of the illness that causes pain and depression.

    In any case, great post. I actually applied to write for Healthy Place and was not given the position, maybe I was not “positive” enough, lol.

    Thanks for this insightful post!

    1. Thanks! Yeah, Healthy Place seems rather gung ho on the whole positivity shtick.

      I got quite an amusing comment yesterday on a different post from someone who seemed to find it offensive that I’ve accepted that I have treatment-resistant depression. It was like if I wasn’t “recovered” then I should put a lid on it. I’m at a point with my own illness where that kind of nonsense is just funny rather than hurtful. Chronic mental illness is a chronic illness. That shouldn’t be so hard to grasp.

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